One of the images that remains sharp in specialty physicians’ minds from the first year of the pandemic is that of empty waiting rooms.

Across the country, patients and providers sought to prevent the spread of disease by limiting in-person encounters to the sickest patients. Now, amid signs that patients are continuing to delay or skip care while physicians are leaving the profession at record rates, specialty practices must consider: “What will it take to spark a return to normal—for our patients and our team?”

It’s a question that was top of mind for urologists during the LUGPA (Large Urology Group Practice Association) regional meeting this past spring. When asked to consider the pain points that are holding urology practices back from adapting to a post-Covid-19 environment, 69% of urologists and administrators cited challenges with staff and physician recruitment and retention, while two out of three pointed to rising costs and decreasing reimbursement. Also top of mind: staff and physician burnout (57%).

Combine these insights with a recent survey that reveals nearly one-quarter of prostate and bladder cancer patients faced care delays, changes or cancellations during the pandemic, and it’s clear: The comprehensive impact of the pandemic on specialty outcomes and operations is just beginning to be uncovered.

How can specialty practices most effectively engage undertreated and underserved patients while navigating rising rates of workforce shortages, burnout and the financial pressures that come with operating a practice during a pandemic? Leaning into systemized care pathways and novel ways to improve care access will be key. Here are three considerations for navigating top-of-mind challenges in specialty care.

1. Tighten triage protocols. When medical assistants receive calls from patients who are experiencing discomfort or are concerned about a new symptom—such as new or worsening difficulties with overactive bladder, a phenomenon that may be related to Covid-19—would they know when to bring these calls to physicians’ attention? At a time when workforce pressures have constrained specialty practice resources, ensuring all providers and clinical staff are working at the top of their license is crucial. One approach to consider: Use condition-specific tools to guide medical assistants’ conversations with patients. For instance, care navigation platforms with condition-specific questionnaires prompt medical assistants to ask specific questions regarding the patient’s health. They also alert medical assistants when a response indicates the need for physician intervention, such as when a bladder cancer patient has a fever within 24 hours of a bladder cancer treatment. Such an approach elevates higher-risk patients to physicians’ attention, easing access challenges for those who most need in-person care.
2. Look for ways to ease call volume pressures for physicians and clinicians. It’s astounding how much time specialty teams spend on the phone, whether answering patients’ questions, helping them gain access to medications or treatments, or scheduling next steps in care. More and more, urology practices are exploring options for leveraging nurse practitioners, physician assistants and other healthcare professionals to respond to patient inquiries in ways that they find professionally fulfilling. One approach is to empower nurse practitioners and physician assistants to record videos that provide answers to the most commonly asked questions by condition—such as treatment and management options for overactive bladder or what to expect following a vasectomy—in language most patients will understand. Nurse practitioners and physician assistants are well-versed in answering questions from family members and caregivers. These video FAQs and their corresponding answers can be provided to the appropriate patients and their caregivers. By leveraging data from practice management systems and the EHR, specialty practices can identify which patients might be interested in certain videos and send them in real time via patient portal, email or SMS. Resources such as these give patients greater confidence in navigating their condition. They also ease the administrative pressures, including call volume, that can lead to burnout.
3. Leverage data-based tools to identify which patients would most benefit from follow-up with a specialist. As a former director of a cancer center, I remember poring over Excel spreadsheets, trying to ensure we were getting the right care to the right people at the right time. When I spoke with other cancer center directors, I discovered they were doing the same thing: hunting for data. Today, AI-based software applications can comb through a specialty practice’s patient records to identify patients who are most in need of follow-up care, such as those who have missed recommended screenings or appointments. From there, these applications alert medical assistants to patients who would benefit most from a live touch. When armed with questions that seek not just to understand the patient’s health status, but also the social determinants of health that present barriers to sustained health, medical assistants are empowered to reduce barriers to care. Providers can then make meaningful connections that improve outcomes as well as health equity.

By leaning into non-physician expertise and automated, condition-specific support, specialty practices can more effectively navigate the challenges that put pressure on specialty care resources while increasing efficiency, building trust with patients and strengthening revenue.

Photo: VectorInspiration, Getty Images