Doctor standing with and smiling at patient in open hospital area
HealthSeptember 24, 2020

How COVID is changing the way the GP functions in India

In late March 2020, India had scored a perfect 100 on the Oxford Covid-19 Government Response Tracker1 which tracks and compares the stringency of government responses to the Covid-19 pandemic. The initial emphasis on flattening the curve of Covid-19 cases and the resultant nation-wide lockdowns gave the public health sector much needed breathing space to gear up to face the challenge.

Private healthcare practitioners, however, have been hit by the triple whammy of rising costs, falling revenues and cash crunches. More than 70% doctors have reported a drop in the face-to-face consultations, with pediatricians being the worst hit2. A large number, though, had expected things to get better in three months.

What’s causing strain?

  1. Patients unable or unwilling to avail healthcare
  2. Deferred elective procedures
  3. Reduced service capacity due to distancing norms and isolation requirements
  4. Increased spend on equipment, PPE and preventive measures
  5. Reduced staff due to infections

Private practitioners will also have to work hard to woo patients back into clinics, perhaps a first for many. Patients are wary of the risks and this has been compounded by difficulty in mobility due to lockdowns and a financial stress brought on by the economic slowdown. This has led to postponed routine medicine, management of chronic diseases and even immunization. A sense of confidence in their physician to mitigate the risks and a feeling of safety in the healthcare facility make up the new needs of the patient.

The pandemic has changed how medical care is sought. One of the more permanent changes here to stay is telemedicine—by preference, not just requirement.

The Ministry of Health and Family Welfare, in collaboration with the Niti Aayog, has published detailed guidelines for providing healthcare through telemedicine. As social distancing becomes the norm, it will become a conduit to access to services which are otherwise unavailable. This will also be a boon for the increased burden in the management of routine medicine and management of chronic diseases that is expected as restrictions are lifted. With private healthcare providers playing a significant role in addressing the gaps, especially in low and middle income countries (LMIC), digital health can also play a very important part in providing quality healthcare.

This advent of technology in healthcare has also set off ripples in other areas of medicine as healthcare solutions enable doctors to provide better quality of care. Continuous and e-learning are on the rise with libraries and repositories making their resources available to doctors globally. The sector has also seen growth in technology solutions for physicians like telehealth solutions and clinical decision support tools like 5MinuteConsult.

Solo practices, clinics, small hospitals and labs has been especially stressed in LMIC, according to a document commissioned by the WHO3. Conducted in 12 countries including India, this document postulates policy changes and a plan of action for coordination between governments and private health delivery apparatus. Support from the government in the form of loans and grants will help the sector survive this crisis. A robust public-private partnership model will go a long way in supporting practitioners and change the face of general practice and private healthcare in unprecedented ways. The challenges raised by the pandemic also present a crucial opportunity for strengthening the relationship between public authorities and the private healthcare sector. Medical associations and representative bodies must step up for their members in their hour of need.

Family doctors or general physicians are usually the first point of contact for patients and are initially at the forefront of any outbreaks. They also manage the aftereffects of these emergencies. Private healthcare forms the bulk of secondary and tertiary medical care in India. It needs to restart and reinvent itself to regain its relevance from the pre-Covid world.

5-point recap

  1. Patients unable or unwilling to avail healthcare
  2. Deferred elective procedures
  3. Reduced service capacity due to distancing norms and isolation requirements
  4. Increased spend on equipment, PPE and preventive measures
  5. Reduced staff due to infections
Solutions
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