Careers in Anesthesia are Changing, with Opportunities Outside Hospitals
Careers in anesthesia treating non-hospital patients is at the cutting edge of technique and skill while offering greater work-life balance.
It is hard to overstate the devastation wrought by the COVID pandemic. But, like all painful and tragic situations, there is something learned from such a crucible, what institutions and ideas held and what gave under pressure or revealed themselves to be illusory all along. So what will healthcare post-COVID look like? We spoke with Dr. Meghan Valach, Chief Medical Officer of Mobile Anesthesiologists, to find out what COVID has exposed and what it has accelerated in healthcare going forward.
There is much to learn from COVID’s impact, now and in the future, on our collective health, our cultures, and the systems that manage our lives and modes of operation. Healthcare, quite clearly, is under the microscope, not just as it pertains to deadly outbreaks, but also how it serves the public day-to-day.
(This interview was edited for clarity and length.)
The Scope: COVID left a lot of people leery of visiting hospitals and even their doctor’s office. Can you speak to how this uneasiness and fear has affected the quality of care received and how the healthcare sector has responded?
Dr. Meghan Valach: During COVID, when people didn’t want to go into hospitals for fear of encountering sick people, we had to look for other ways to treat those patients. One of the ways that really took off was telemedicine.
The technology has been there a long time to be able to do this kind of medical care, and physicians will tell you that for a long time, they have used it. They’ve been on the phone with their patients after their appointments to discuss lab results, to discuss the next steps in their care. But the reason it hasn’t become more available to patients to have these virtual visits with their doctors is because nobody was willing to pay for it.
So, payers suddenly said during COVID, “Hey, we should pay doctors to talk on the phone to patients if that’s when they’re doing their medical care.” And it really freed up people to not only not have to go in, but for doctors to be able to take care of a lot more patients in a day in a way that was more convenient for them and their patients. They could do these video visits, they could have these quick phone calls, and get reimbursed for it.
The Scope: What about those situations where a phone call or a video conference won’t cut it? How did the pandemic affect and possibly improve how people receive more hands-on care?
Dr. Meghan Valach: Over the last 10 to 20 years, as procedures have moved from the hospital to the ASC setting and then trickled into the office setting, there have been some stalls along the way with people just not thinking that those places could handle the same level of care that hospitals do.
Again, during COVID, there was a lot of fear by patients of going to a hospital. People put off care that they needed or looked for other places to get that care, and physicians did a great job of pivoting and realizing that they could use the places that were already out there, like ASCs or office settings, to do procedures, to get things done that patients still needed done. There was kind of a cessation of elective surgery, but that also made people realize that a lot of what we considered to be elective really isn’t elective, it’s just not emergent.
The Scope: Such as?
Dr. Meghan Valach: Like getting your colonoscopy done. Everybody’s always looking for a reason to stall their colonoscopy anyway, and then COVID, and they’re like, “Nope, won’t sign up for that.” But a leading cause of cancer death in the United States is colon cancer. If you’re not getting the colonoscopies to prevent it, you’re causing a detriment to your health. People who were having symptoms or had a history of problems with this or a family history and knew they needed their colonoscopy and looked for a place to do it that wasn’t the hospital. They found that they could get that same care in an office-based setting or in an ASC and not have to go to the hospital where the sick people are.
The Scope: What are the broader implications of how COVID forced us to change our idea of what healthcare service looks like and where it can be performed?
Dr. Meghan Valach: It started opening, not just patients’ eyes, but physicians’ eyes to the idea that not all healthcare has to happen at a hospital. There are other places where you can get high-quality health care that is more efficient, that saves money and time, and still provides the care that you need.
The Scope: What does this all mean for the future, as we emerge from the COVID pandemic? Will these changes stick in post-COVID healthcare, or is it back to business as usual?
Dr. Meghan Valach: Change is always hard and it’s particularly difficult in healthcare, especially in the U.S. where there are so many different moving parts that sort of determine what the next step is in healthcare and where it’s going to go. But I do think that now that people have embraced this use of technology, doing telemedicine, doing telephone visits, and moving the care out of the hospital, it’s going to continue because patients have seen the value that it adds to their life by being able to have less disruption to their overall schedule. Physicians have seen the benefit of being able to care for more people in compact time and regardless of physical space, of not needing patients to drive all the way into an office, not needing to make sure someone’s physically in the waiting room when you’re ready for them, whether it’s early or late. And, I think payers have seen the value too, because you can pay a little bit less when it’s more convenient for everyone, because everyone can do more.
Same thing with moving care overall outside of the hospital; when you need less physical space, when you don’t need a giant central registration desk, when you don’t need those huge operating rooms that take up a big land mass and a lot of real estate space, you can do the same care that just takes the physician and the patient to be present to get that care done at a lot lower expense to everyone involved. There’s also a lot more buy-in from the patient and willingness to get that care because not only is it cheaper, but it’s easier, and that just benefits everyone because the healthcare is getting done and it’s not costing those large amounts.
COVID really opened people’s eyes to a lot of ways that technology can help healthcare do the things that we need to do on the day-to-day basis to have the long-term prevention and health benefits for patients and physicians alike.
Careers in anesthesia treating non-hospital patients is at the cutting edge of technique and skill while offering greater work-life balance.
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