It is time to take stock of where we have been and where we are going.
As 2022 moves along, I think it is time to take stock of where we have been and where we are going. As I reflect on the difficulties of the past two years, I find reason for optimism. First, our health care system has been stretched to the breaking point but was held together by the dedication of an amazing workforce. The struggles of this pandemic have clearly illustrated our weaknesses. As the grip of COVID-19 lessens, I am hopeful we can honestly discuss how to be better prepared next time and fix our health care system flaws.
Such conversations are already beginning at the local level. Maybe these collaborative discussions will trickle up to policymakers. It is often in times of struggle that we find the will to make changes for the better.
I am hopeful that preparation for the next public health emergency involves not just our public health institutions and hospitals but also the rest of the health care workforce, those closest to the patients and their communities. Primary care practices, local pharmacies, nursing homes and emergency medical services, for example, all need to be part of any comprehensive response system. The power and innovation of the grassroots response by physicians and nurses gives me hope.
I am hopeful that the loss of bedside nurses will lead to better pay and staffing for these essential professionals. The flight away from clinical nursing in favor of administrative, nurse practitioner or other roles began long ago. The pandemic only spotlighted the weakness in our system and the lack of support for these vital staff members. I hope we improve staffing ratios, pay and appreciation for our clinical nursing professionals.
I am hopeful that all our trusted physicians and other health care clinicians will rediscover their connection with their patients. We have been sidelined too long and need to be the voice of truth and reason on subjects of health.
I am hopeful that the power of telemedicine will be retained and permanently reimbursed by payers at the same level as in-person visits, so that primary care physicians and other providers can use it to expand access, convenience and continuity for their patients. I am hopeful that we will begin to address our country’s mental health needs and recognize that mental health services are key primary care services and belong integrated in our primary care system.
I am hopeful that we will evaluate any improvements in outcomes promised by value- based contracting and will strive to simplify and standardize the rules and metrics of value-based care. While we’re at it, let’s look at the impact of consolidation and venture capital on our health care system.
I am hopeful that the growing call for increased investment in primary care will be heeded. We need payment improvements to support rural physicians and independent practices because these practices are a vital access point for many underserved populations and communities.
I am hopeful that the call for more investment in primary care will bring a significant increase in primary care residency positions and incentives for medical students to choose primary care as a career. I am hopeful that the need for more primary care will lead to discussion of the ideal mix of primary care physician, physician assistant and nurse practitioner resources needed in this country and that we ensure adequate training and standard certification of all clinicians. There is also a need for transparency surrounding the credentials of each type of primary care clinician seeing patients. The public has the right to know the training and credentials of any professional providing them service.
I am hopeful we will address the needs of our elderly and begin to make improvements that support patients growing old gracefully. Finally, am I hopeful or just wishful? I am hopeful because I see in our new residents and young graduates a passion for service, energy and professionalism that will rise above the politics and business of medicine that often get in the way of true change. Here’s to 2022 being the year that we begin to make significant strides in improving the U.S. health care system.
L. Allen Dobson Jr., M.D., FAAFP, is a family physician and editor-in-chief of Medical Economics®.