The foundation of the Choosing Wisely campaign is the clinical conversation between provider and patient. During the month of May, the Choosing Wisely Learning Network asked members to share their thoughts and experiences about appropriate care during the COVID-19 surge. The majority of the responses from the Learning Network came from the clinical implementation group. In parallel, Bill Adams, a member of the Choosing Wisely Patient Engagement Advisory Committee, surveyed a network of 85 patients about their experience during the pandemic.
From the clinical perspective, several themes arose:
- Clinicians felt less low value care was happening in their setting.
- Clinicians were concerned that patients who needed care were not getting it.
- Telemedicine offered a new way to engage with patients, learn more about the way they live and engage them during a trying time. Concerns about telemedicine centered on care provided when the clinician and the patient did not have an existing relationship.
Patients offered a set of reactions that complemented and explained clinical themes:
- Patients felt confused about what care they should contact their clinician about and what they should hold off on, whether telemedicine would be helpful and how to get in touch with their clinician, and if they needed to take different precautions because of high-risk conditions.
- Patients also felt apprehensive and admitted to avoiding care because of fear for their health and uncertainty about what harm reduction strategies were in place at their care center.
- Patients were additionally concerned that seeking care would divert care from those “who legitimately need it” and worried about their doctor’s health and continued employment.
- Patients who had telehealth visits during the past few months overwhelmingly had a positive response. Some patients did have concerns that telehealth may deepen the digital divide and cause others to have access issues.