Coronavirus in Context: What Does Post-COVID-19 Health Care Look Like?

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You're watching Coronavirus in Context. I'm Dr. John Whyte, Chief Medical Officer at WebMD. I'm joined today by my friend, Dr. Sachin Jain, Adjunct Professor of Medicine at Stanford University. Dr. Jain, thanks for joining me.

Great to be here with you, John. Nice to reconnect.

You've always been a leader in talking about what comes next. So my question for you today is, what are the three things that we're learning that are going to impact health care post-COVID-19?

I think, from a consumer perspective, one of the most dramatic changes that we're going to see is a move away from bricks and mortar health care. I think historically, we had a-- kind of a backwards health care system that required sick people to travel to medical offices and hospitals to congregate with other sick people, potentially exposing them to infectious diseases, as well as [INAUDIBLE] from the delivery of health care, medical errors from the delivery of health care. And I think what we're seeing now is that consumer preferences are changing dramatically, as a lot of office practices are moving to telemedicine. And so I think you're going to see much greater adoption of telemedicine among people who historically resisted it.

You know, I was talking to the folks at Kaiser a little while ago. And I know you're in California. They said 80% of all visits are telemedicine, or telehealth, right now. Is it going to be 80% a year from now? What's that number--

Yeah. I mean, I think Kaiser is a remarkable organization in that, you know, like many other organizations around the country, that they already had the plumbing to do this, right? So it was just a matter of flipping a switch and actually more people using that plumbing. And so I think it's been dramatic to see a lot of those investments in digital delivery of health care actually actualize and, you know, start to benefit patients.

I think, you know, in a couple of years, it'll be, you know, maybe not 80%, but it'll be 60%. And I think that we're going to move away from, you know, what I think we have right now, which is a visit-based model of health care, which is people coming in to see doctors, and that's how they see, you know, consuming health care, to instead being an asynchronous model, meaning more continuous delivery of health care, which means they may have continuous remote monitoring of their blood pressure or continuous remote monitoring of their weight. That type of-- which is then going to allow a lot of two-way feedback from the context of people's real lives.

So this movement to, in a sense, virtual care was a trend that we already were seeing. But now it's likely being accelerated by--

You got it.

OK.

You got it. That's great.

That's the first one. What's the second one?

I think the second thing is a much greater realization of the importance of social connectedness and health outcomes. I'm hearing-- you know, I've been a strong advocate for most of my career for the idea that people's social life actually has a huge impact on their quality of their life and the quality of their medical care, and that social isolation ends up being a key negative driver of people's health outcomes. I think, you know, the focus on this issue, the focus on loneliness and social isolation, has only become more profound.

I think we've now started to add, in a much more permanent way, the idea that people coming together with people is an important part of living a good and healthy life. And so I think we're going to start to see more deliberate focus on social connection and perhaps a return to a view of a world where community was something that was really important and highly relevant the context of one's health care.

Is this part of an overall discussion around social determinants of health? Or do you think this is a bit of a niche area?

I don't think of this as a niche area. I think this is like a fundamental question of like what it means to live a good life. I think it's far bigger than, kind of, our industry-specific discussions on social determinants of health. I think this is around--

There's a much more profound conversation that's going on right now. What does living a good life look like? And that's going to translate into how we, as medical professionals, support patients and actually ensuring that they do have a good life.

And what's that third change that you think we're going to see persist post-COVID?

Yeah, John, I think the American public is really waking up to something that those of us who, you know, learned medicine and practiced medicine for years have really known, which is that there's so much that we don't know, right? I think, you know, the number of questions that people have about COVID, and about treatments, about ventilators, about, you know, how care is organized, and structured, and delivered, you know, people are realizing there's far more art to medical care delivery than science. And I think there's a much greater realization that there is much more to be discovered, much more to be learned, much more to be understood.

And so I think that there is a-- going to be a profound return to the humility around our overall social knowledge around medicine. I think many people believe that there's-- that medical science is far more advanced than it is. And to be clear, it's very advanced. But it oftentimes falls short of people's expectations in terms of knowing exactly what to do in certain situations.

I think that this crisis has been very humbling for many of us. It's been humbling for all of us who are finding ourselves answering I don't know more than we're answering with any definitive confidence [INAUDIBLE].

Is there going to be greater trust in health care system? Over the years, there's been some erosion of trust by the public in terms of interacting with the health community. And we getting some of that back by our response?

Yeah, I think it's been, actually-- that's been remarkable is to see the restored respect for people who deliver health care. I think there is sort of an expectation that health care workers are just like everybody else. But now there's a realization that health care workers are more like soldiers than they are like anyone else. They put themselves in harm's way every single day to actually take care of other people. And there's something very noble in that.

But I think over the last 15, 20, 30 years, as health care has gotten more expensive, as it's gotten more complicated to receive health care in the United States, that, you know, there's been a lack of focus on that true humanity that people are actually bringing to their work every day. And you know, when you see things like, you know, health care worker being named Time Magazine's Person of the Year, that, to me, ends up being a refocus on the fact that there are really many heroes who come to work every day. And it's not just the doctors or the nurses. But it's literally everyone who's coming in to make health care happen for people who need it.

And so I agree with you 110% that there is going to be a recentering. And I think there's going to be a lot of young people who grew up in this era who are going to pursue careers in health care, and medicine, and pharmacy, in nursing. I think you're going to see a lot of folks decide that they want to devote their careers to infectious diseases, just as many people did in the era of HIV/AIDS, because of that sense of mission and wanting to solve society's biggest problems of which COVID-19 is clearly top of everyone's list right now.

What are you optimistic about?

I'm optimistic about American science. When people ask me-- you know, the number one question I get asked is, when is this all going to end. And I always say, it's going to end earlier than anyone thinks it is because I believe in the power of the American biopharmaceutical industrial complex, which has been, you know, kind of looked negatively upon for years. I believe that they have, time and time again, shown that there are problems that ultimately were seen as unsolvable that for which miraculous solutions are developed.

And so I'm very optimistic that, you know, the very brilliant people who've devoted their lives to virology, microbiology, infectious disease, immunology are going to take all of the genetics, they're getting to take all that they know to actually help us find a solution to this. And I also think the fact that there's now great focus on this and this is everyone's problem, that, you know, a lot of the regulatory barriers that might exist in the regulatory agencies that govern the development of vaccines and biopharmaceuticals are going to come down. And faster than anyone expects, I do believe that we're going to find solutions to this. And I know that everyone is hoping that I'm correct and not wrong.

Last question. What do you miss most as part of the lockdown?

Ooh. People. You know, more than anything, you know, I'm somebody who believes that our lives are lived to have great human connection with others. And I think the most challenging part of this time, whether you're an extrovert or an introvert, is not being able to connect in that same meaningful way that, you know, all of us value so much. I think to connect with others is really to be human. That's what I think about it. And so, you know, I can't wait till were able to all be together again.

Well, Dr. Jain, I want to thank you for taking time today to share your insights.

Thank you very much. Really appreciate it.

And I wanted to thank you for watching Coronavirus in Context I'm Dr. John Whyte.