As the pandemic rages on, family doctors play an important role in keeping our healthcare system from collapsing. While the bulk of hospital capacity and workforce has shifted to respond to COVID-19, family physicians are lending critical support to the global fight. They are working just as tirelessly by responding to general medical concerns of communities or referring COVID-19 cases for specialized care.
According to the American College of Physicians (ACP), due to the broader education they receive compared to internal medicine specialists, family doctors can handle a wide range of medical issues. The typical patient mix of a family doctor is around 10-15% of children and 85-90% adults. As generalists, their extensive range makes them extremely valuable in communities that may not have nearby specialists.
An essential component in the healthcare system, the family medicine specialty, was borne out of the general practitioner movement in the late 1960s that sought to address the growing specialization of the medical field. The practice primarily responds to the medical needs of the family unit as opposed to a specific segment of the population based on markers or health needs like age, sex, organ system, or the nature of the required intervention.
Supporting The Frontlines
This critical role is in sharp relief amid the ongoing pandemic. Even as COVID patients account for a growing number of in-patient cases, general medical conditions and injuries—flu, cold, and high blood pressure, to name a few—do not just magically go away. This is the domain of family doctors who are helping pick up the slack, allowing limited resources and workforce to go where they are most needed and augment efforts against the COVID-19.
An article published in the European Journal of General Practice in April 2020 tried to map out how family doctors are coping with the unique challenges of the pandemic. The authors attempted to unpack the various anxieties faced by family physicians as they try to carry out their job without the tools of physical examination and observation.
When face-to-face consultations are limited, how can family doctors make accurate decisions? When COVID-19 shares symptoms with the common flu or cold, how can they make sure that it’s just flu and not something worse? These are some of the concerns raised by the authors in the journal article.
In The Line Of Fire
In addition to intense pressure, family doctors also face the ultimate risk. A July 2020 study by the Perelman School of Medicine at the University of Pennsylvania revealed alarming findings suggesting that those working in primary care may have faced the highest risk of dying compared to in-patient hospital workers at the frontlines. Family physicians seemed to have felt the impact of the virus more than hospital-based physicians.
Of the reported global deaths among healthcare workers as of May 13, the study observed that more than half were physicians. Among the physician fatalities, the most significant subset at 26.9% were general practitioners, family medicine, or primary care doctors that succumbed to the disease compared to 7.4% of deaths from those in closer proximity to the COVID-19 health response like emergency medical workers, critical care specialists, and anesthesiologists.
The study argues that part of the reason why fatalities were higher for the former than the latter was that the former was likely to be ill-equipped at that time compared to workers at the frontlines who may have had better access to personal protective equipment (PPE). Recall that during the first few months of the pandemic, healthcare workers grappled with widespread shortages of face masks, shields, and gloves as supply chains buckled under intense demand.
Due to their embedded role in the community, the study added that family physicians, general practitioners, and primary care doctors, might have been more likely to see patients with early-stage, mild, or asymptomatic COVID without PPEs at a time when the virus was not fully understood. Some have already paid the price and died in the line of duty.
The New Normal
Despite the emotional toll of the pandemic on healthcare workers, researchers say that family physicians are adapting quickly in the new normal and still keeping their practice open. There are instances when physicians separate patient streams of potential COVID patients from non-COVID cases, while strictly enforcing physical distancing in waiting rooms, and embracing telehealth services.
It is also observable how hospitals promptly place triage centers so that the general population still gets the care they need in the middle of the pandemic. Additionally, new guidelines were developed at record time to guide family medicine practitioners in areas of protective measures, video call systems, referrals to ICU, care guidance, and other decisions they have to carry out in the line of work.
As we can see, our family doctors are an essential part of keeping the virus at bay, but the responsibility is not solely their own. Let us all do our part by washing our hands frequently, avoiding non-essential travel, and wearing a mask when going out so we can give our health workers the recognition they deserve once this is all over.