I generally don’t like to rock the boat on anything, this applies to what I wear, eat, the people I co-locate with and work. It should therefore come as no surprise that my response to our changing practice if anything luke warm. I understand fully (more so than you may credit) the impact that COVID-19 has had on hospitals, and continues to do so. But, in my opinion this should be temporary and not the way forward in healthcare delivery henceforth.
Being a doctor is not something to be practiced at a distance, and as doctors we are at our trained best in the thick of it. So don’t be surprised if my eyes gloss over as I try to listen patiently to the next person expouting how amazing telehealth, and virtual consultations are. In my opinion you’re more likely to learn of the postman’s name (this has truly happened to me) than what is wrong with the person before you with remote consultations.
Hence, I read with some interest the results of this consensus survey from group of Spanish neurologists on how they think the neurology practice will change over the next five years. Agreement is not easy to come by and you may not agree with some of the more popular responses.
“Despite consensus about these statements, the degree of inter-rater agreement was low”.
Review article DOI: 10.1016/j.nrleng.2020.04.010
Will neurological care change over the next 5 years due to the COVID-19 pandemic? Key informant consensus survey
J. Matías-Guiu,, J.A. Matias-Guiu, J. Alvarez-Sabin, J. Ramon Ara, J. Arenillas, I. Casado-Naranjo, M. Castellanos, M.D. Jimenez-Hernandez, J.M. Lainez-Andres, E. Moral, A. Morales, A. Rodriguez-Antigüedad, T. Segura, P. Serrano-Castro, E. Diez-Tejedor
The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable.
Material and methods
A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic.
Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination.
The key informant survey identified the foreseeable changes in neurological care after the pandemic.