PracticalDermatology

It’s been a long 18 months, and while growing numbers of people are getting vaccinated against COVID-19, the pandemic is not over yet.

Don’t worry. I’m not going to talk about silver linings, as we are still in the thick of this. I am going to discuss some of the things we have learned about ourselves, our practices, our patient’s needs, and how technology has helped us.

1. Telederm works (sometimes).

When shelter-in-place orders took hold early in the pandemic, teledermatology was our lifeline. Many of us had dabbled in telederm pre-COVID-19, but the rest of us had to build the plane while in flight. We did it, though. We know teledermatology works, but it will never replace the human touch. Hopefully, all practices now have capability to see some patients virtually, as not all appointments need to be in person.

2. “Zero” touch offices are possible.

There’s technology that allows patients to check in on mobile phones, tablets, or portable kiosks. Patients can complete necessary forms in advance of appointments on their own devices, eliminating use of shared clipboards and pens and other high-touch practices. This is the future.

3. Vaccines work.

We’ve seen them help eradicate many diseases in our history, including polio, measles, and smallpox. My hope is that more people will get their COVID-19 shots so we can prevent more serious disease and hospitalization. The numbers don’t lie: Unvaccinated people are about 29 times more likely to be hospitalized with COVID-19 than those who are fully vaccinated, according to a CDC study. The study also showed that unvaccinated people were nearly five times more likely to be infected with COVID than vaccinated people.¹

4. AI has a role to play.

Artificial or augmented intelligence will also help advance teledermatology and assist with triaging and making accurate diagnoses. Machines won’t replace us, but this will be another way for us to provide care and counsel while minimizing face-to-face contact.

5. Virtual fellowships and residencies have merit.

They may never replace all that is accomplished during in-person programs, but virtual components of fellowships and residencies certainly have merit. They provide educational and social opportunities when travel or in-person contact is not possible. These programs may also be less expensive for students who have limited budgets and can’t afford to travel. I suspect the future holds hybrid models for these essential programs and for medical meetings, too.

6. We are vulnerable.

The pandemic taught us that we likely need an exit strategy or backup plan. What once seemed impossible—widespread lockdowns, shelter-in-place orders, and no in-person school—is possible. If it happened once, it can happen again. We also learned that most commercial casualty insurance plans have a well-defined exclusion for pandemics. In the future, riders may be available for a price to add such coverage to your plan. Now would be a good time to look into that.

7. Patient safety comes first, second, and third.

In many ways, the pandemic made us re-take the Hippocratic Oath. We had to envision new ways to help our patients without causing undue harm and risk. This included new safety and cleaning protocols, investments in PPE, and new guidelines for staff. We also had to make sure we conveyed all that we were doing to patients to earn their trust.

1. Griffin JB, Haddix M, Danza P, et al. SARS-CoV-2 Infections and Hospitalizations Among Persons Aged ≥16 Years, by Vaccination Status — Los Angeles County, California, May 1–July 25, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1170–1176.