Title:Telemedicine and COVID-19

What has changed in your medical practice?

Overnight we went to seeing primary care patients nearly 100% virtually, via telehealth. We were able to mobilize our resources, and think creatively and quickly to meet the needs of our community.

We looked at our patient list to figure if we really needed to see them in the office. This challenged some of our ways of practicing medicine, needing to be face-to-face in the same room, touching the patient, doing the physical—and there is something sacred about that—but it’s nice to see how we could quickly meet the patients where they needed to be met: in their homes.

How are D.C.’s vulnerable populations impacted?

Although our clinic is in an affluent area, we serve vulnerable elderly patients. Loneliness can be hard on the elderly who may not be able to do grocery shopping on their own, go to the bank, etc. Social distancing can bring about anxiety and depression.

A lot of our providers do precept at the family medicine residency in Prince George’s County, and there it’s a different challenge. Patients may not have access to a cell phone, computer, or internet for televisits. The providers are still seeing patients in person, but they’re changing how and where they screen.

What drew you to family medicine and health policy?

I was born and raised in San Diego. My parents came from Iran. I went to UCLA, then taught fourth grade on the south side of Chicago. The experience shaped me to care for vulnerable populations.

I saw the importance of public health in education. My students had a hard time staying in school because of health issues like asthma, or their parents had poor health. We had a school-based medical program because kids couldn’t get to the doctor’s office easily. I decided to study medicine at Georgetown, and really meshed with the idea of taking care of the whole person, and with family medicine’s emphasis on vulnerable populations.

Today I’m the medical director at the Robert Graham Center, a health policy research center under the American Academy of Family Physicians. Our research informs evidence-based policies, insurance impacts, primary care outcomes and spending, and how we pay for and access primary care.

We are doing a qualitative study on women in the primary care workforce. Data shows female physicians, especially younger ones, are burning out at higher
rates than males. At the same time, more women are going into family medicine and primary care in general. With a large proportion going in but then burning out, what does that mean for the future of primary care and the physician shortage?

What gives you hope and joy in this difficult time?

A big positive is the ability for MedStar Health and the medical community in general to come together, be flexible, open up the telehealth rules and get everyone quickly switched over to them. I’m hoping we can see innovations like video visits continue. It’s going to expand what we can do.

Personally, our kids are home from school and all their activities are cancelled, so we suddenly have a ton of time as a family. We’re eating dinner together every night. I’m helping them with homework. They’re hanging out together. With the busy schedule taken away, they have a chance to just be children.

I’m finding little rays of sunshine every day, watching the kids work on a puzzle, my colleagues being so caring, and a system as big as MedStar finding ways to move things quickly to meet the needs of our patients.