Thomas J. Murphy, MD
Associate Dean for Health Policy, Medical School
Chief Medical Officer for Community Clinics
Stanley Family Distinguished Chair of Population Health and Community Medicine
There were a whole lot of things we learned in the past year. In the clinical arena, there were three significant lessons we learned: the value of the primary prevention, the importance of treating the entire population, and the importance of public health.
When it comes to prevention, this past year 6 million women in the United States did not get their mammograms, people didn’t get their colonoscopies, kids didn’t get their vaccinations. Delay of care is denial of care. This will catch up with us.
Future planning is critical. We need to be able to prepare for catastrophes and know how to deal with them. We also need to be able to deal with the stresses of our providers and learn how to care for them before they crater.
For my patients, it was a very different year with social isolation, depression, an increase in domestic violence, violence toward children, and an increase in alcoholism. The physical and behavioral health effects will reverberate for years to come.
In the practice of medicine, we introduced telemedicine. In primary care, we saw it had modest benefits. For instance, I had a severely obese patient that I saw in person. When I saw him, I told him I noticed he lost weight. He said yes, 40 lbs. and asked me how I knew. I replied that I could see he took his belt in by two notches. Now, if I saw this patient in a telemedicine consult, I would never have seen this.
How do we plan for the future? We need to re-emphasize the importance of primary care and support it financially and philosophically. We need to identify patients who have had care delayed and find a way to reach out to these patients to fill gaps. We have a lot of opportunities to improve health care.
We need to be prepared for the next challenge. We must deal with the problems that have been revealed by the social determinants of health. My work never slowed down over the past year.