Since the last issue of The Differential, we have seen the distant specter of a novel coronavirus strain transform into the COVID-19 pandemic, a viral force dominating our everyday lives. Social distancing, quarantines, and stay-at-home orders have created a global state of extreme physical separation, leading to optimistic reflections on the ways in which we are still connected. Sentimental statements lauding grocery store employees, delivery drivers, teachers, and farmworkers abound, whose labor allows a significant portion of the population to remain at home, in relative comfort and safety. Recognizing their worth is long overdue, and I sincerely hope the increased collective regard translates from abstract sentiment into concrete improvement!
But the scope of this column is a specific sort of interconnectedness, interprofessionalism, the importance of which has arguably never before been demonstrated so profoundly. I’ve been consistently impressed by how leaders in both academic and clinical medicine are fostering interprofessional collaboration, described as a framework in which all members of the healthcare team understand everyone’s role, scope, and expectations, for the good of the patient. In our respective programs, we spend years accumulating vast amounts of medical knowledge, eager to put it into practice. We feel confident that with the correct diagnosis and management, we can help our patients; however, the horrific stories from places especially hard-hit by this virus revealed just how shaky that premise is. Surely, the providers on the frontlines in China, Italy, New York, Detroit, and elsewhere were adequately equipped with clinical prowess, yet hundreds needlessly died. Shortages of tests, ventilators, masks, and gowns not only hampered perfectly qualified providers from doing what they were trained to do but also carelessly exposed lesser-recognized frontline workers like sanitation and transport crews to infection. To hearken back to basic chemistry, in this reaction, supply and demand were the rate-limiting steps, rather than knowledge, skill, and adherence.
I do believe we’re in an era of unprecedented synergy between the various clinical entities (MD/DO, PA, NP, PT, OT, etc); however, we’re only as strong as our weakest link, or in the non-linear, more web-like healthcare industry, I suppose it’s our weakest filament(s). Our colleagues in public health do amazing work, but somehow their message wasn’t sufficiently received and implemented in the US. Additionally, the voracity of this virus has been exacerbated by glaring inequities in the social determinants of health. These factors account for a portion of the demand problem. Meanwhile, healthcare administrators work behind the scenes to ensure all the pieces are in place for us to do our jobs, yet despite best efforts, there has been a grave disconnect in requisite supply.
As I assume describes most of my colleagues, I’m a fixer. Once presented with a problem, my mind automatically begins the analytical process that will hopefully lead to a solution. It appears that the next frontier in interprofessional collaboration includes the more seamless assimilation of healthcare administration and public health into the fabric of clinical medicine. Presumably, this is precisely why the AAMC has taken steps to turn out more holistic physicians, by incorporating elements of quality improvement and social sciences into the most recent iterations of the MCAT, medical school curricula, and STEP exams. But what else can we do right now? Does the deficit lie more in infrastructure, policymaking, or funding, and how do we address these as clinicians? Unfortunately, dear reader, rather than offer definitive solutions, I can only invite you to join me in pondering this quandary. To this end, as we simmer in gratitude for the many parts of this complex tapestry of healthcare, from CEOs to providers to janitors, and let us also continue working to integrate and acknowledge the vital components and professions that lie outside the clinical setting, realizing that to adequately care for individual patients, we must also care for the health of society at large.
Jessica Pirkle is a member of the Class of 2022 at the University of Arizona College of Medicine-Phoenix. She completed a BA in Spanish at ASU and worked for several years as a school teacher before switching gears and obtaining an MS in Health Care, also at ASU. When not studying the marvels of medicine, she enjoys making and eating delicious healthy food with her four children, and daydreaming about being a music festival groupie.