As COVID-19 has swept the world, every industry has been at the mercy of its effects. Restaurants have had to find new ways of reaching customers or risk closing, airlines and travel companies have begun providing cargo-only flights while taking on the costs of massive cancellations, and entertainment professionals at all levels are either struggling or out of work entirely. We are also seeing a ripple effect across related industries as a shift in how people are shopping, communicating, and working takes place.
As people continue to stay home for the safety of themselves and others, online retail businesses have experienced a surge in orders. The USPS is responsible for handling the resulting shipping needs and is struggling to stay ahead of an order volume that far exceeds even holiday expectations. Even online communications companies such as Zoom and Skype have had to adjust to new call volumes, and rideshare services have had to adjust to new consumer patterns.
The sector that has experienced the greatest impact by far has been the medical sector. As hospitals and healthcare organizations struggle to keep up with testing, treatment, and diagnosis demands, the magnitude of the long term understaffing throughout the medical field is becoming startlingly clear. In response to the increased public need for accessible health services, many are turning to telemedicine, and to address the need for doctors, medical schools are offering to graduate some students early to aid COVID relief efforts across the country.
Across the United States, the American Association of Medical Colleges (AAMC) has approved a new option for graduating medical students. In the spring, just before the numbers of COVID infections were expected to climb drastically, schools in 13 states including California, Massachusetts, and Illinois, began to offer graduating last year med students the option to graduate early, allowing them to join the fight against COVID-19. While many have taken advantage of the chance to provide help to a heavily over-taxed healthcare system, the logistics of this offer are proving problematic.
Even though many of these young doctors are eager and willing to help, acquiring temporary licenses for thousands of new resident-doctors has left a number of these soon-to-be doctors in bureaucratic limbo. Many states are struggling with whether to push these residents to their planned positions months early, to have them on volunteer status with their local hospitals, or to find another path entirely. In some cases, the schools and the state have little or no support for medical students, leaving them on their own to figure out what their next steps are in an unprecedented situation.
The desire to join in on the fight to address a deadly pandemic is not only admirable but a passion and dedication that is desperately needed right now. With New York City having been short almost 1200 doctors earlier this year as the city’s health declined and the number of cases grew, having swaths of people dedicated to training as CNAs, doctors, and nurses in areas of all kinds is something that we cannot ignore. As increased stress is put on healthcare workers, we should be aware that medical students may feel pressure from society, administration, and even fellow students to jump into a high-stress, high-risk situation so early in their careers that they may not be prepared, professionally, psychologically or emotionally for the lasting impact it will have.
The Toll of Joining the Fight Against COVID
While telemedicine makes a certain level of care more accessible to the public, the doctors who go into their offices every day are still at high risk for contracting the virus. This is added to the current lack of available personal protective equipment (PPE), and in many cases, the availability of qualified doctors. This is pushing many schools to offer early graduation to medical students who have finished their required credits to help fill the expanding care gap. This has been a major decision in attempts to provide enough physicians to care for the expanding number of cases.
After graduation, medical students are usually looking at three to five years of resident work, during which they will be supervised, before practicing medicine on their own. The final months of medical school are often seen as a reprieve, a period of rest before jumping into ER rotations, residencies, and embarking on the next step of their career. Without that period of rest, preparation, and training, what are we setting our medical class of 2020 up for in the rest of their careers?
While no medical students will be required to graduate early, some have raised concerns about the communal pressure to finish early and the effects that working on the front lines will have in the long term. Some students are turning down this offer out of concern for their long-term mental and professional health, after seeing the long-term impact that these kinds of situations can have. Studies of those working during the SARS outbreak showed that frontline workers experienced higher levels of exhaustion, burn out, and even PTSD. We are already seeing the results of daily exposure to high-risk environments, scared patients and families, long hours, and losing large numbers of patients in a short period of time.
Technological Advancements and Accessibility
There has been a marked rise in the availability of telemedicine services that have made certain medical services more accessible than they have ever been before. Its use in providing mental healthcare, basic diagnosis services for early-stage COVID symptoms and common ailments, and simple followup appointments is helping to alleviate some of the difficulties of attending to long-term needs. Healthcare-related businesses like pharmacies and medical supply companies have also increased their online accessibility in response to increased demand.
With this heightened availability comes an increased need for staffing, a difficult ask in a time of struggling hospitals and healthcare centers. By bringing medical students into active practices, we can fill extremely necessary positions that are helping to provide testing for large populations. With staffing already a concern across multiple sectors, accessibility, efficiency, and high-quality customer service are key factors in ensuring that businesses can survive the pandemic while supporting a population in crisis, and healthcare is no exception.
One of the biggest reasons for this shift towards telemedicine has been an attempt to reduce infection rates at places like hospitals, private practices, and urgent care centers, especially for those considered high-risk. This has proven extremely beneficial for those receiving treatments, but doctors and nurses are still at extreme risk, even with these tools available.
The Long Term Implications
Many nurses and doctors are already experiencing PTSD symptoms, including chronic nightmares, depression, and anxiety, after having lost countless patients to the virus in only a matter of months. This type of mental toll and continued exhaustion can quickly lead to burnout, in a healthcare system already experiencing a massive overload. It has become difficult for even healthcare professionals to get the services that they need to cope and recover.
There is still a lot of speculation about what precisely caused the COVID-19 virus to develop and spread so quickly, but the effect that it is having on the United States and an ill-prepared healthcare system is clear. We are turning to our youngest doctors to come to the front-lines, to work in high-pressure, high-risk situations, at a time in their careers when they would just be learning how to handle situations far less intense. But with the pressure to jump into COVID relief efforts, some concerns have to be addressed about the mental, emotional, and even professional health of those that we are asking to take on heavy responsibilities in a time of great need.
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