5.1 Understand the institutions and individuals that participate in healthcare delivery and the role of the physician in the healthcare system
5.3 Understand the interdependence of the component parts of the healthcare system and the potential for unintended consequences within the system.
One of the most difficult and eye-opening experiences of medical school has been the COVID-19 pandemic. We had been pulled off our rotations unexpectedly. We didn’t know when we would be able to return to the hospital. How much would we have to make up during our fourth year? How will our residency applications be impacted? Would the medical center be able to handle a huge influx of infected patients? Would there be enough medical resources (staff, ventilators, PPE)?
After watching what unfolded in New York City during their surge of cases, hospitalizations, and death, I started to wonder how Columbus had been preparing for an event like this. What sort of preparedness training had individuals completed? What was our hospital system’s plan for a surge of COVID cases? What did our PPE stockpiles look like? Due to a cancellation of my scheduled step 2 test date, I was required to reschedule for later in the summer. Because of this, I was able to take a disaster preparedness elective. During this elective, I was able to learn about all of the plans that the medical center had in place to deal with a pandemic like we were going through now. There are also plans for natural disasters, and structural failures, which hadn’t even crossed my mind.
As part of the course, I had to complete a lot of online training modules related to disaster preparedness. We had zoom lectures on past pandemics, zoonotic diseases, mass casualty situations, and toxicology, among others. We also completed a group exercise where we developed a contingency level care plan for staff and the health of the workforce at the medical center. Through this exercise, I was able to appreciate how important each job at the medical center is. Without proper staffing, things can go south pretty quickly. Our plan had a conventional level, a contingency level, and a crisis level. At the crisis level, staffing was prioritized based on immunity. We implemented training for staff that needed to cover in a position that wasn’t their typical duties. There were mental health resources for employees. If the medical center was still short-staffed, asymptomatic individuals with known exposure would be able to work, and wouldn’t have to quarantine. Below is a part of our crisis level plan.
From this course, and being a part of the medical system during the COVID-19 pandemic, I was able to better appreciate all the different parts of the healthcare system and how important each one is for its proper functioning, and how easily the system can break down, even if everyone does the best that they can to prepare for these unknown scenarios. Even the patients who were not infected with COVID had negative health impacts secondary to the pandemic. Many patients I saw in clinic had to have their cancer screenings delayed and then had trouble rescheduling due to the backup of patients who needed testing. Delaying cancer diagnoses can result in a monetary impact on the system as well as on the patient. In addition, canceling all elective procedures had a massive effect on the income of hospital systems, which impacted all of the employees who work there. I was also excited to learn that physicians play a huge role in how healthcare systems prepare for disasters. It made sense, but I always enjoy being exposed to the roles that physicians can have in the healthcare system that isn’t research or direct patient care.
The impact of the COVID-19 pandemic has been indescribable. Every area of our lives has been affected. After seeing how many roles are out there for providers that aren’t direct patient care, I’ve started to think about getting a master’s degree after my residency training in business, healthcare economics, or healthcare policy and management. I’ve done a bit of research on the topic and some of these master’s degrees can be done completely online over the course of six months to one year. While I won’t have time to pursue this venture during my residency training, I’d like to obtain one of these degrees within two years of finishing my training. In the meantime, before graduation, I will reach out to some of the OSU professors in the business school and the school of public health who are experts in these areas to ask for a list of resources they might recommend in order to start educating myself more on the topic.