The impending U.S. provider shortage has been generating headlines for years, but an overlooked specialty shortfall is a threat even scarier than the coronavirus turning into a pandemic.
Infectious disease (ID) specialists, who play a critical role in curtailing the spread of outbreaks, seem to be a dwindling breed. Between 2009 and 2017, the number of academic programs that filled their adult-infectious-disease training positions dropped by 41%, according to a report by Emory University.
A New York Times article maintains that infectious disease is one of only two medical subspecialties that routinely do not fill all of their training spots in the National Resident Matching Program.
(GlobalMed)
We are living in an age of antibiotic-resistant microbes, or “superbugs,” which means the possibility of widespread drug resistance has broad implications. Antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths annually, according to the U.S. Centers for Disease Control and Prevention.
However, from a health system perspective, infectious diseases such as coronavirus (including MERS and SARS), shingles, Lyme disease, and malaria don’t present a steady pipeline of patients. Because demand for ID specialists fluctuates to such a large extent, traditional ID practice is often difficult to sustain outside of large cities.
This presents a conundrum for rural or suburban providers who may lack familiarity with a new contagion and available treatment options for their local population. As a result, more provider organizations are investigating the viability of leveraging telehealth to treat infectious diseases—a move that holds the possibility of democratizing medical expertise across communities.
Keeping patients in their communities
Part of what’s driving demand for ID telehealth is the complexity of caring for patients experiencing these diseases. Often, these patients must be transferred to urban academic medical centers that boast more experience with drug-resistant organisms, which may cut into a smaller hospital’s revenues and burden patients with high travel costs.
Infectious disease telehealth creates collaboration opportunities for large and small health systems. Large systems can reduce crowding and share their expertise while enabling smaller systems to retain their own patients and improve care through gained experience.
Following are some additional benefits to providers that adopt telehealth infectious disease programs:
- Treat infections sooner, shorten hospital stays and reduce healthcare costs
- Limit outbreaks by helping doctors recognize and diagnose conditions faster
- Improve medication management protocols, decreasing the risk of harmful drug reactions and antibiotic resistance
- Manage capacity in facilities that already have ID specialists, instead of becoming overwhelmed during an outbreak
- Help providers monitor discharged patients to keep tabs on their recovery
While a solution to the overall provider shortage may not be on the horizon any time soon, the approach to reducing the shortfall of ID specialists requires much less complexity. By leveraging telehealth, the U.S. healthcare system can begin to reverse the supply-demand imbalance that costs patients time and money by forcing them to seek care outside of their communities and leads to lost revenues for small health systems that can use all the help they can get.
Joel E. Barthelemy is founder and CEO of GlobalMed, a virtual health company that is the telehealth provider to the White House, Department of Veterans Affairs and Defense Health Agency, as well as many commercial healthcare systems in the U.S. and around the world.