Medicine's biggest challenges in a post-COVID world
Key Takeaways
Some experts predict the pandemic’s ending in 2022. That won’t be the end of public health crises that Americans face, however.
An increasingly aging American population makes dementia-related death a major issue. In addition, the number of Americans with multiple chronic conditions is on the rise, necessitating that these individuals be adequately tracked and monitored.
Looming physician shortages, intensified by the COVID-19 pandemic, could be tackled using physician extenders, as well as by leveraging technologies such as telehealth, to reach underserved populations.
In terms of public health, the big question on everyone’s mind has been, "When will the pandemic end?"
According to the results of a modeling study published in the Journal of Medical Virology, based on the global mortality and case fatality rate of COVID-19, the pandemic could end in 2022.[]
Starting in 2023, the virus could continue to be one or two times deadlier than seasonal influenza. Of course, differences in herd immunity and vaccination rates in various countries could affect these predictions.
With a bang or a whimper, COVID-19 will likely come to a denouement in the foreseeable future, according to the research. There are, however, other concerning medical issues at hand.
Rising level of deaths due to dementia
With aging populations growing in size worldwide as more people are living longer, dementia-related deaths will likely rise accordingly, according to research published in Alzheimer’s & Dementia.[]
Researchers from the Institute of Health Metrics and Evaluation found that all-age mortality rates increased by 38% from 1990 to 2018, with women outnumbering men nearly 2 to 1. Worldwide, 1.55 million people died due to dementia in 2019. The authors hypothesized that this trend will continue.
In an accompanying press release, Maria C. Carrillo, PhD, chief science officer of the Alzheimer’s Association, stated, “Without effective treatments to stop, slowm or prevent Alzheimer’s and all dementia, this number will grow beyond 2050 and continue to impact individuals, caregivers, health systems, and governments globally. In addition to therapeutics, it’s critical to uncover culturally tailored interventions that reduce dementia risk through lifestyle factors like education, diet, and exercise.”
More Americans with multiple chronic conditions
Research out of the CDC points to an alarming increase in the number of Americans with multiple chronic conditions.[]
Based on data from the 2018 National Health Interview Survey (NHIS), the authors found that 51.8% of American adults were diagnosed with at least one of 10 chronic conditions (ie, arthritis, cancer, COPD, coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak/failing kidneys), whereas 27.2% of US adults harbored multiple chronic illnesses.
Previous research has already noted increases in the burden of multiple chronic illnesses. Groups most affected were women, Whites, the elderly, and those living in rural environments.
Regarding the implications of their work, the authors wrote, “These results may inform efforts to track and monitor multiple chronic conditions among the US population.”
Skyrocketing drug prices
Prescription drug prices remain a serious problem for many Americans who struggle paying for life’s necessary expenses. This issue is nothing new and has been a focus of both the Trump and Biden administrations.
Proposed efforts to negotiate Medicare drug prices, limit out-of-pocket drug spending by Medicare beneficiaries, and make insulin more affordable have stalled in Congress, with the Senate failing to approve the Build Back Better Act.
According to research by the Kaiser Family Foundation, of the 1,947 Medicare-covered drugs that topped inflation rates in 2020, approximately one-third of them went up by 7.5% or greater over the prior year.[]
Between July 2019 and July 2020, half of the 3,343 drugs covered by Part D and about half of the 568 Part B–covered drugs increased in price by more than the 1% inflation rate that existed during that time.
Physicians intent on helping patients receive their prescriptions can tactfully bridge the topic of financial assistance, as detailed in this MDLInx article. Keep in mind that there are numerous prescription assistance programs for which a patient may be eligible.
Physician shortages
Projected physician shortages in the US are detailed In a white paper published by the American Association of Medical Colleges (AAMC).[] The AAMC projects that by 2034, there will be shortages of 17,800 to 48,000 primary care physicians and 21,000 to 77,100 specialists.
Not surprisingly, COVID-19 exposed the dire nature of physician shortages. As the AAMC wrote, “COVID-19 has raised awareness of the disparities in health and access to care by minority populations, people living in rural communities, and people without medical insurance. If underserved populations had health care use patterns like populations with fewer access barriers, demand would rise such that the nation would be short by about 102,400 (13%) to 180,400 (22%) physicians relative to the current supply.”
Unfortunately, there is no quick fix to the physician-shortage problem. According to an article published in the American Journal of Managed Care (AJMC), possible interventions include increasing the use of physician extenders, increasing funding for residency programs, and utilizing new technologies such as telehealth to further medicine’s reach in rural and underserved communities.[]
What this means for you
The good news: the pandemic will likely wind down. The bad news: there are various other pressing issues in healthcare that will tax physicians and patients alike. As a physician, it’s imperative to remain vigilant in the face of the increasing chronic-disease burden, and to use technologies and support staff to serve your patients efficiently and effectively. You can advocate for your patients by helping them secure financial assistance for costly treatment.