RT Journal Article
SR Electronic
T1 Redesigning Primary Care to Address the COVID-19 Pandemic in the Midst of the Pandemic
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 349
OP 354
DO 10.1370/afm.2557
VO 18
IS 4
A1 Alex H. Krist
A1 Jennifer E. DeVoe
A1 Anthony Cheng
A1 Thomas Ehrlich
A1 Samuel M. Jones
YR 2020
UL http://www.annfammed.org/content/18/4/349.abstract
AB During a pandemic, primary care is the first line of defense. It is able to reinforce public health messages, help patients manage at home, and identify those in need of hospital care. In response to the COVID-19 pandemic, primary care scrambled to rapidly transform itself and protect clinicians, staff, and patients while remaining connected to patients. Using the established public health framework for addressing a pandemic, we describe the actions primary care needs to take in a pandemic. Recommended actions are based on observed experiences of the authors’ primary care practices and networks. Early in the COVID-19 pandemic, tasks focused on promoting physical distancing and encouraging patients with suspected illness or exposure to self-quarantine. Testing was not available and contract tracing was not possible. As the pandemic spread, in-person care was converted to virtual care using telehealth. Practices remained connected to patients using registries to reach out to those at risk for infection, with uncontrolled chronic conditions, or were socially vulnerable. Practices managed most patients with suspected COVID-19 at home. As the pandemic decelerates, practices are now preparing to address the direct and indirect consequences—complications from COVID-19 infections, missed treatment for acute problems, inadequate prevention, uncontrolled chronic disease, mental illness, and greater social needs. Throughout, practices bore tremendous financial burden, laying off staff or even closing at a time when most needed. Primary care must learn from this experience and be ready for the next pandemic. Policymakers and payers cannot fail primary care during their next time of need.