Robotic surgery, gene therapy, and deep brain stimulation are so-called "frontiers" of medicine. Now there's a new frontier--telemedicine. "Research firm IHS Markit estimates that telemedicine visits will soar from 23 million in 2017 to 105 million by 2022" (Associated Press, 2/6/19). By then, one in ten doctors' visits could be via telemedicine. This could be an understatement if practitioners, health systems, and investors keep discovering new ways to expand telemedicine's reach.
Despite reports of burned out doctors abandoning their careers, many other doctors simply want some time off -- perhaps a year or more -- to take a breather, spend time with family, or take a sabbatical abroad. The AMA warns that leaving clinical practice for an extended period of time should not be taken lightly: "Lack of retraining before reentry raises questions about patient safety and the clinical competence of reentered physicians." Doctors need to be aware that, "getting back in the game is expensive, time-consuming, and sometimes nearly impossible. So before you take a hiatus from medicine, ask yourself--can you afford it?" (medpage.com)
Office visits to primary care physicians declined by 18 percent between 2012 and 2016, according to a recent study by the Health Care Cost Institute. The HCCI analysts limited their observations to adults younger than age 65 with employer-sponsored health insurance. When other patients were included, "they noted a 2 percent decrease in all PCP office visits from 2012 to 2016" (medscape.com). The question is "Why?"
Approximately one in 25 patients will contract at least one infection during their stay in the hospital. That’s the bad news. The good news is that the number of hospital acquired infections has dropped slightly since 2011, according to a recent survey by the Centers for Disease Control and Prevention. In 2011 about 4 percent of patients developed an infection while in the hospital. That number is now down to 3.2 percent (2015 data). (The CDC’s findings were published in the New England Journal of Medicine, November 1, 2018.)
Telling burned out physicians they need to learn how to cope better with stress is not working. Despite numerous programs designed to improve physician "resilience," the rate of physician burnout keeps climbing. With overall burnout estimates ranging from 30% to 68%, a recent study reveals that there's one subset of physicians with a rate of only 13.5% -- primary care physicians in solo or small practices (Journal American Board of Family Medicine, July-August 2018).
Doctors can add another risk factor when taking a patient's history--loneliness. A strong body of evidence now shows that lonely people are more likely to become ill and die early. Heart disease, diabetes, anxiety, depression, and suicide have all been linked to chronic loneliness. And studies show that Americans, young and old alike, are lonelier than ever.