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The Future of Work in Healthcare

There’s no question that the pandemic changed how we work across the country.  From entire office buildings shifting to remote work, to take-out only at restaurants (including cocktails) to video meetings replacing in-person meetings. A recent article in the New York Times reflected that while the downtown has fewer office workers negatively impacting the local restaurants and businesses in Manhattan, the other boroughs have shown real growth in new businesses from remote workers shopping locally, so the landscape of our cities and towns is changing as well. Many businesses are rethinking their infrastructure for the future, and some may even stay remote for all employees. In healthcare there were smaller changes, since remote work is not always possible. We shifted to virtual meetings and telehealth visits, stopped traveling professionally for a time and got used to wearing masks.  Which of these changes is here to stay?

The American Medical Association did a large survey that showed many physicians and patients see benefit in continuing with telehealth.  Prior to 2020, our organization had very little ability to have video telehealth appointments and no structure for scheduling or billing them.  Now, there is widespread availability of the equipment and software needed, and some specialties such as Psychiatry have switched to telehealth as the primary method of scheduling visits. Clearly there are many visits that require a physical exam, especially in my field of obstetrics and gynecology, but we can now offer telehealth to anyone who doesn’t have transportation or isn’t feeling well. There are going to be challenges with continuing because there are no longer state mandates requiring telehealth visits to be reimbursed, and licensing restrictions on practicing across state lines may prevent us from embracing this as much as we would like.

The switch to virtual meetings has pros and cons.  For regular meetings, the advantage is that you can see and hear participants clearly and use the chat room for questions and comments. There is no travel time, so I have found a significant increase in attendance at early and late meetings, and even for those in the middle of the day when back-to-back schedules are now feasible.  That is also a significant downside.  Has anyone else felt like the number of meetings each day has exploded? Without built-in downtime between meetings, schedules are often packed. In-person meetings are much better for relationship building but, in our institution, we still have a requirement to mask and distance that creates a very different feel, especially with a large group.

Traditionally in healthcare, we’ve equated being at work to being physically present, distrusting the idea of working effectively from home. With younger generations of workers pushing for better work-life balance, we need to rethink how we structure our day to allow for administrative time at home, attending meetings remotely, and increasing the flexibility around hours. One change I intend to keep in our department is with grand rounds.  Currently we’re completely remote and we have seen a huge increase in regular attendance. We also have the ability to bring in a speaker as long as they have a couple of free hours to give a grand rounds rather than 2 or 3 days of travel with all of the expenses therein. Once we can meet again in person (waiting for our conference room to be remodeled), we will create a hybrid set-up where attendees may choose in-person or virtual and the speaker may be present in the room or remoting in. It will be interesting to discover how this balances out. Certainly, our named lectureships will be in person when possible, as well as those who are live locally.

Professional travel changed as well, with many institutions banning it completely. The AIAMC Annual Meeting and National Initiative VIII Meeting 2 offered both in-person and virtual attendance. While this optimized the opportunity for participation, it is expensive and complex to organize, so only the main sessions could be live-streamed. It would be great to continue this option for more meetings, but we may have to wait for technological advances that make it more cost effective.

My hope for the future is that the pandemic becomes endemic like the flu (or goes away completely!) and that we learn from our experience to keep the things that worked well even as we get back to “normal,” or rather the “new normal.” Perhaps we wear masks during a high influenza activity and wash our hands a little more often then we used to.  May the future be an improvement over the old ways of doing things.