• A Front Line Forever Redefined

    Academy Reflects on Pandemic’s One-year Mark, What Lies Beyond

    March 11, 2021, 7:00 a.m. News Staff — Countless dreadful milestones have come and gone in the 365 days since the World Health Organization declared the COVID-19 outbreak a global pandemic. Too many firsts and not enough lasts.

    Calendar pages being flipped

    This has been especially true for medical workers on the front lines — including family physicians.

    Across the span of the crisis, AAFP members have counseled and treated patientsradically altered their practices, faced unprecedented administrative and financial pressures and, in the most harrowing circumstances, succumbed to the illness themselves.

    “Today marks a somber anniversary,” AAFP EVP and CEO Shawn Martin said on March 11. “A year ago, experts advised everyone to help flatten the curve. That failed to happen here, and the toll has been severe: 29 million cases and nearly 525,000 deaths in this country, including more than 3,500 health care workers

    “Through it all, family physicians have demonstrated that they are cornerstones of their communities. The AAFP remains committed to ensuring our members have the support they need to continue to provide compassionate care to patients through the pandemic and beyond.”

    Over the past year, the AAFP has kept pace with each step legislators and regulators have taken to address COVID-19 and its impacts, offering counsel and testimony and lobbying to ensure that primary care’s central role in defeating the pandemic is acknowledged and fully leveraged (including against future public health emergencies). 

    Last spring, that meant pushing for financial and diagnostic considerations in the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act. More recently, it meant similarly sharp advocacy ahead of Congress’ 2020 year-end deal

    Academy physicians forced by circumstances to the vanguard of virtual care soon reported high satisfaction. The meeting of this new challenge and the AAFP’s ongoing work to clear administrative hurdles and further advance telehealth as beneficial to family physicians and their patients — including the development of a toolkit to support family physicians building telehealth into their practice — is perhaps the most significant good to have emerged from so much bad. The elimination of patient cost-sharing for COVID-19-related diagnostic and treatment services, while allowing health plans to waive deductibles for telehealth services, has been crucial to the fight. Efforts are ongoing to make these and other changes permanent while at the same time promoting care continuity and preserving physician-patient relationships.

    Telehealth helped keep patients, physicians and their staffs safe. But there’s no getting around the need for personal protective equipment to fight COVID-19 — a need that came with its own ongoing battles. The Academy has spent the past year engaged on that issue as well, most successfully in its partnerships with Project N95 to make reliable PPE available to members at the best value possible.

    The AAFP also pushed to include primary care practices in HHS Provider Relief Funding, allowing recoupment of some pandemic-related financial losses, along with Paycheck Protection Program funds to provide short-term, forgivable loans to increase cash flow, and a technical fix to the tax treatment of the loans and Medicare Accelerated and Advance Payment Program funds to provide advance access to capital.

    As the scramble for a vaccine yielded three effective results in record time, the Academy had a seat at the table. AAFP member Jonathan Temte, M.D., Ph.D., of Madison, Wis., who chaired the CDC’s Advisory Committee on Immunization Practices from 2012 to 2015, served as the Academy’s liaison to the ACIP’s COVID-19 Vaccine Work Group, becoming a visible resource to family physicians as well as to the public.

    Too much has happened over the past year to limit reflection or learning to one day, and no small pause can be enough to process all the hardships, all the loss, all the grief. Everything is different now.

    In advocating for family medicine during the past year, the Academy has cautioned lawmakers that the old normal will no longer suffice. Yet primary care will remain at the center of whatever paradigm solidifies in the wake of the pandemic.

    Today, that’s visible in family physicians’ proven track record in vaccinating U.S. patients and counseling those who are vaccine-hesitant. With an administration timeline that suggests most people could receive doses by May, the AAFP continues to lobby for maximum family medicine inclusion in vaccine distribution plans, including at the state level.

    “Family physicians and health care workers everywhere have come together to care for patients, grieving families and one another,” said AAFP President Ada Stewart, M.D., of Columbia, S.C., “As we are starting to see light at the end of the tunnel in the form of vaccines, we have an important role to play in reducing vaccine hesitancy and ensuring that as many people as possible are immunized against COVID-19.”

    “As we move into the second year of this pandemic with new hope, I want to pause and say thank you on behalf of the AAFP to all of our members,” Martin said. “Your ongoing dedication, commitment and strength have demonstrated why family medicine is the country’s most crucial specialty.”