Page 22 - RU RWJ Medicine Magazine • Winter 2021

Initially, it seemed to prey on the elderly and those with pre-existing conditions, but as more people become infected, this seems to be less
“Our hospital, physician, nursing,
and care providers have seen a paradigm shift. . . . There became a much greater
sense of collaboration across specialites that historically have been independent of each other. ”
limiting the use of inpatient beds, and using outpatient services for more of the care given to an older, more complex patient base.
3. We as a country need to take stock of our hospital needs, assess the number of beds (inpatient and ICU) needed per capita, accounting for our growing elderly population.
4. The federal government needs to restore and increase the funding available for life-saving research and clinical trials while empowering those agencies (CDC, NIH) with more autonomy.
5. Finally, Medicare, Medicaid, and third- party insurance carriers need to rethink their reimbursement strategies to maintain the sanctity and quality of health care.
Although it may be politically unpopular to say, the national focus of health care cannot just be on the recipient (insuring the uninsured), although that is important. Without adequate resources and financial support, institutions and providers will be ill-equipped to aptly care for those in need, as shown during this pandemic. It is likely that the practice of modern medicine will never revert to what it was just one year ago.
Hopefully, these lessons will not go ignored but will guide what we, as a country, should do to provide the best health care possible. M
of a guiding principle.
Typically, the critically ill patient is
work-intensive for the bedside nurse and other providers, with frequent in and out from patients’ rooms and donning and doffing PPE. The current circumstance, however, has encouraged new and innovative treatment strategies: IV poles outside of rooms controlling the life-saving medications being delivered to the patient; ventilator controls outside of rooms to manage the respiratory needs of the critically ill, all while keeping our frontline care providers out of harm’s way by limiting traffic in the room, and preserving the precious resource that PPE has become.
We as a community of health care providers were grossly unprepared for this pandemic intellectually and emotionally. In 1970, the life expectancy in the United States was approximately 70 years old, but by 2018 that had increased to 80. Undeni- ably, our population is living longer with more chronic disease, resulting in sicker patients requiring more complex care.
Yet, cuts in funding by the federal government over the past several presiden- tial administrations, in addition to the great limits placed on the practice of medicine by Medicare, Medicaid, and third-party health insurance carriers, have resulted in a push toward short hospital stays, minimizing diagnostic tests, limiting consultations,
As a result, the burden has been placed squarely on providers and hospitals. Who would have ever thought that we, the wealthiest nation in the world, would not have everything available to us to care for our sick while keeping providers safe by providing adequate supplies for such things as ventilators and PPE. The national stockpiles were woefully understocked at the start of the pandemic, federal health agencies, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), are ill-equipped and ill funded to deal with a national medical emergency. Federal research dollars have dwindled to a minimum, resulting in the reduction
of life-saving research and vaccine development that could have mitigated the early spread of this deadly virus.
The lessons learned from this pandemic:
1. We can use technology such as web- based videoconference and chat formats (compliant with patient privacy regulations) to streamline and improve patient care.
2. We can and should be more collab- orative in a multidisciplinary way, leveraging this technology in real time at the patient’s bedside.
20 Robert WoodJohnson | MEDICINE