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COVID-19's Perceived Impact on Primary Care in New England: A Qualitative Study
Erin E Sullivan1, Mylaine Breton2, Danielle McKinstry2
1From the Center for Primary Care, Harvard Medical School, Boston, MA (EES, RSP); Department of Healthcare Administration, Sawyer Business School, Suffolk University, Boston, MA (EES, DM); Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Canada (MB); Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (RSP). erin_sullivan@hms.harvard.edu.
Background:
COVID-19 impacted primary care delivery, as clinicians and practices implemented changes to respond to the pandemic while safely caring for patients. This study aimed to understand clinicians' perceptions of the positive and negative impacts of COVID-19 on primary care in New England.
Methods:
This qualitative interview study was conducted from October through December 2020. Participants included 22 physicians and 2 nurse practitioners practicing primary care in New England. Data were thematically coded and analyzed deductively and inductively using content analysis.
Results:
Through qualitative content analysis, 4 areas were identified in which clinicians perceived that COVID-19 impacted primary care: 1) bureaucracy, 2) leadership, 3) telemedicine and patient care, and 4) clinician work-life. Our findings suggest that the positive impacts of COVID-19 included changes in primary care delivery, new leadership opportunities for clinicians, flexible access to care for patients via telemedicine, and a better work-life balance for clinicians. Respondents identified negative impacts related to sustaining pandemic-inspired changes, the inability for some populations to access care via telemedicine, and the rapid implementation of telemedicine causing frustration for clinicians.
Conclusions:
Understanding clinician perspectives on how primary care transformed to respond to COVID-19 helps to identify beneficial pandemic-related changes that should be sustained and ideas for improvement that will support patient care and clinician engagement.
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