Healthcare in the Time of COVID-19

Last night, for the first time ever, the tenants in my apartment complex all sat out in the quad together (6 feet of distance between them) to just chat because everyone is so lonely due to the COVID-19 social distancing rules. I was overjoyed to see this community building occurring. It is my hope that people continue to recognize the importance of human connection and communication, and just talk to each other.

The last few weeks have been strange and exhausting. There have been moments when my worst fears about the human race seem to be proven true, and moments when my heart just bursts with love and joy at seeing people helping each other get through this COVID-19 health and healthcare crisis. The videos coming from Italy of the communities singing together actually make my eyes well up with tears, they are so beautiful.

I work as a psychotherapist for a major HMO, and am considered essential personnel, so I am still going to work. Notices have been sent out hourly by management telling us about some new procedure we’re supposed to be following, and it’s been pretty much impossible to keep up. Mostly I’ve been talking to my patients by phone, and their responses to this crisis range from abject terror to a sense that it all is likely going to be over soon, and is probably blown out of proportion. Personally, I don’t know what the truth is.

Here is what I do know: the US Healthcare system is not set up for this. Since I work for an HMO, I can report from first hand experience that healthcare companies have been putting more and more pressure on healthcare workers for years. These companies have been shortening appointment times, and increasing the number of appointments that each provider has to complete per day. The psychiatrists where I work have 20 minutes to see a patient, and they have 3 of those appointments per hour, leaving no time for breaks or charting. I suspect the setup is similar for medical doctors. For therapists, we see a patient every hour on the hour. There isn’t any time in between for notes or bathroom breaks, so most of us limit appointments to 45 minutes in order to keep from getting too behind.

I don’t even get breaks. I work 5 days per week, and I only get 4 days per week where I have 1/2 an hour where I don’t have an appointment with a patient. During that time, I’m expected to do notes, return phone calls, and consult with my colleagues about shared cases. This is not nearly enough time for these tasks, so I work through my break almost every day, eating my lunch while I type case notes. Healthcare workers are exhausted, and they aren’t provided essential time to think about their cases, or research patient histories. Patients who don’t understand the situation that the healthcare workers are in due to their over-packed schedules are often frustrated and make the healthcare workers’ stress even worse by yelling at them for being late to appointments or not knowing their histories.

Healthcare providers don’t have time in their schedules for anything extra to happen. If a patient of mine is suicidal and needs hospitalization, the biggest problem for me to manage isn’t the emotional needs of my sick patient, it’s how I’m going to get them hospitalized before my next patient shows up. It’s not unheard of for me to be managing the hospitalization of one patient, while in session with another. The stress of trying to keep on top of my appointments added to the stress of dealing with a mental health crisis is exhausting, and I’ve seen more cases of psychotherapist burnout than I can count.

I’m not telling you this to try to get sympathy. The truth is that I love my work, and wouldn’t trade it for anything. I am telling you this because adding a pandemic to this already stressed system is a serious problem. Healthcare providers are already at their maximum capacity for patient care, and adding hundreds or thousands of sick people to an already unmanageable situation is too much for the system, and the workers, to bear.

Since I’m not just a healthcare worker, I’m also a healthcare consumer, I definitely know the frustration of waiting weeks for an appointment, only to find a frenzied healthcare provider who doesn’t have time to truly listen to what I have to say, and leaving without answers to my questions. This pressure on everyone’s schedules isn’t helping anyone, and I can’t imagine what is going to happen when COVID-19 shows up in force. I’m quite concerned that the system may collapse like a house of cards.

I don’t know what the solution is, but I urge you to be sensitive to what the healthcare workers are dealing with and only seek care if you absolutely must. If you find out that you’ve been exposed, and you aren’t sick, it will likely over-stress the system if you go in and try to get tested. If you do go in, recognize that you may need to wait to be seen, and remember that the healthcare workers are truly trying to do their best to help as many people as possible.

A pandemic is a situation unprecedented in my lifetime, and likely yours as well. It is my sincere hope that you and your family will remain healthy and whole throughout this crisis. Remember to take good care of yourself, not just physically, but also emotionally. Meditate, do yoga, take deep breaths, read things that nurture your spirit, and try to stay away from absorbing too much of the fear spread by the news media. I truly believe that we will get through this more quickly if we work together as a community.

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