We have all felt the effects of Covid-19. For some, the challenges have been minor annoyances—while for too many others, the impacts have been fundamentally life-altering.
Regardless of how the virus has affected your personal health, chances are that it has made a difference in the health care you receive and are able to access. “To say that Covid pushed the U.S. health system to its limits is not hyperbole,” says Dan Carlin, M.D., CEO and founder of concierge telemedical practice WorldClinic.
We asked Dr. Carlin for some of the biggest health care-related lessons that he thinks will come out of the pandemic and the implications for all of us going forward.
Covid’s lasting effect on health care delivery and access
When Covid first hit, and then later when it resurged, many medical offices and primary care facilities across the country were essentially closed to anyone who wasn’t infected with the virus. Routine checkup visits, preventive care treatments, and elective procedures were pushed off or canceled entirely as hospitals and health care workers focused on addressing Covid. Other factors also put up roadblocks to access—for example, inadequate supplies of personal protective equipment meant that many health care facilities couldn’t create a Covid-safe environment for patients or providers. Indeed, it’s highly likely that you had to delay some sort of test or procedure during the past year and a half—or you felt it was in your best interest to avoid walking into a doctor’s office, clinic or emergency room during the worst periods of Covid.
If you think such delays are a thing of the past, think again, says Carlin. Even when Covid is far in the rearview mirror, traditional or easy access to health care services could remain constrained for years or decades to come. According to Carlin, we may never fully return to “normal” health care delivery again. “We don’t need a pandemic for the system to become unavailable to you,” he says.
- Fewer physicians. Many health care professionals—including highly experienced physicians—decided to leave the industry entirely in the wake of Covid, due in part to the workload and stress they experienced trying to care for so many patients as the virus surged and surged again. On top of that, many physicians actually saw their pay cut during the pandemic because—you guessed it—those moneymaking elective procedures were put on hold.
- More relatively inexperienced professionals. As physicians exit, different types of health care workers and professionals—such as nurse practitioners and physician assistants—are increasingly entering the field. These midlevel professionals, while extremely talented and hardworking, simply don’t have the same experience or credentials as do physicians. Over time, this may lead to a reduction in the services or expertise that health care providers can capably deliver.
- The wave of aging baby boomers. If the supply side of the health care system seems shaky, the demand side is ramping up like never before. Baby boomers will need more and more health care as they age into their 70s, 80s and 90s—and likely live longer than past generations. Additionally, medical advances in cancer treatments, knee replacement and other areas will create greater demand for elective procedures—just as there will be fewer doctors to perform them. Perhaps most troubling: The sheer size of the boomer demographic (72 million) will likely create significant problems in terms of access to care. With so many older Americans needing so much health care, Medicare will be strained—likely resulting in waiting lists, denials for service, and health care that doesn’t measure up to previous levels of quality.
As Carlin puts it: “Covid is a shock to the system—a hurricane. But hurricanes end. The boomers will be a systematic strain on the system for decades—like a drought that seems to never end.”
Taking charge of your own care
All of these trends and developments suggest to Carlin and others that it’s time for individuals to take charge of not just their health but also their health care, rather than assume that the health care system will continue to be the easy-to-tap resource of the past.
Of course, that can be much easier said than done in a health care model that relies on private insurance to reimburse providers for services. Likewise, the rise of for-profit health care encourages providers to ignore preventive care in favor of expensive procedures that generate larger levels of reimbursement from insurers. This creates a business model that keeps patients in a state of sickness for as long as possible in order to boost the bottom line. In the “normal” health care of the future, healthy people will most likely be unprofitable—and therefore undesirable.
The good news is that there are workarounds that can help you become a more powerful advocate for yourself as a recipient of health care services and improve your health steadily over time. Consider the following action steps going forward.
1. Embrace telehealth.
Telemedicine is designed to diagnose and treat patients remotely—without the physical presence of a health care provider. Instead, patients and providers exchange information through online video chats, emails and phone calls. In its most advanced form, telemedicine allows doctors to monitor their patients’ health and vitals remotely using technology.
Telemedicine and remote care were vitally important for many patients throughout the pandemic when physical locations were closed or unsafe.
This approach is designed to help make access to health care easier and faster. For example, providers may use devices that communicate with smartphones to capture data points like blood pressure, cardiac rhythms and blood sugar levels. The phone then transmits the information to the providers, who can monitor the data in real time. If there’s a problem, the provider will call the patient right away with an update and, if needed, an immediate treatment plan. If all is well, the readings are stored so the patient’s long-term health trends can be identified.
2. Consider concierge practices.
Concierge medicine is a blanket term covering a wide variety of health care delivery models. Essentially, however, concierge medicine is a membership model: For a fee—concierge practices don’t accept insurance in most cases—you get access to medical practices with relatively small ratios of patients to physicians. The results can include shorter wait times, longer visits and significantly more personalized care, given (in many cases) by physicians with greater expertise than the typical provider. The fee-based, noninsurance approach also means that care is far less likely to be denied or watered down in the name of profits—a real benefit if, for example, you’re given a diagnosis that you’d like to address with extensive or highly specialized care.
3. Manage your own risk.
Helping you be as healthy as possible may not be “top of mind” in an overburdened, understaffed health care industry and a for-profit health system. Carlin recommends becoming your own primary care provider as much as you possibly can, by both making better health decisions and working with providers to track key metrics that can help you get a more personalized picture of any health risks that may need to be mitigated.
The obvious key metrics and procedures are the ones you can track and manage largely by yourself—including your weight, the number of steps you take each day, your blood pressure, home breast exams and so on.
Among this group, Carlin notes how overlooked sleep is among most people. Not having enough of it can lead to degenerative illnesses, cardiovascular disease and premature death. To get a truly good night’s sleep consistently, take steps such as these:
- Get seven to eight hours every night.
- Go to bed and wake up at the same time every day.
- Limit exposure to blue light at least one hour before bedtime (by using the “night shift” feature on your iPhone/iPad, for example).
- Avoid eating within two hours before you go to bed.
- Avoid taking hot showers or vigorously exercising within three to four hours of going to sleep.
- Get evaluated for sleep apnea if you are a heavy snorer (sleep apnea is a major risk factor for cardiovascular disease).
Another smart move is to work with a provider to track how these and similar metrics change over time. These include foundational tests and screenings that should be done regularly (blood pressure, HDL cholesterol, mammograms, and key labs such as PSA and fasting blood sugar).
Finally, home in on data that is especially important to you. Thanks to the ability to map the human genome as well as a better ability to identify ancestors’ ailments, it’s easier than ever to determine your most pertinent health risks. Armed with that information, you can set out to track the metrics that matter most in your life. Say, for example, your family history reveals that the men tend to die from heart disease in their 70s. You might work with your provider to do regular targeted cardiac screenings such as a high-sensitivity CRP test (a blood test that reveals how much plaque you have throughout your vascular system) and a cardiac myeloperoxidase (MPO) test, which reflects your risk for the rupture of unstable plaque.
Here again, actually getting these tests approved and done may be easier when you work with a concierge practice that isn’t tied to insurance reimbursements. Be prepared to advocate strongly for yourself if you’re using a traditional private insurance approach.
Ultimately, the look and feel of health care may be significantly different in the years to come. By preparing yourself today, you can better navigate that transition—and put yourself in the best possible position to get the care you want and need.