Health care goes mobile: COVID-19 experience speeds doctors’ transition to

With more than 664,000 deaths nationally, rising at more than 1,800 per day, and 21,841-plus in Michigan over at least four surges of the disease, families of the stricken are heartbroken and health care providers are exhausted — both physically and mentally.

During the crisis, physicians also have learned many lessons that will forever change the way they practice, evaluate patients in office settings and in hospital emergency departments, doctors say.

For Drs. Charles Shanley and Phillip Levy, two leaders at Wayne Health, a 400-provider multi-specialty group affiliated with Wayne State University in Detroit, COVID-19 sped up the group’s change to preventive medicine they felt necessary to serve their inner-city patients, many of those with multiple chronic diseases.

The COVID-19 pandemic forced providers to put more resources into patient outreach, Shanley, a vascular surgeon now CEO of Wayne Health, said: “There’s an old quote from Wayne Gretzky: ‘Why were you so great?’ (He said) because ‘I skate to where the puck is going.'”

By the 2030s, Shanley predicts, “hospitals are going to be intensive care units and operating rooms.” To meet patient needs, he said, Wayne Health and the health care industry must evolve into an integrated ambulatory platform that links directly to specialty care, community health workers, pharmacists, dentists, social workers and behavioral health providers.

“Phil and I sat down and discussed the fact that he being in emergency medicine and me in vascular surgery, we’ve always been frustrated that we’re dealing with the end consequences (of chronic diseases),” said Shanley.

“Unfortunately, over 25 years I’ve taken care of a lot of people with end-stage disease that I know was preventable if we got to them sooner,” Shanley said.

“It might be severe vascular disease; it might even result in an amputation, or kidney disease or heart attacks or stroke,” he said. “But it’s the result of not doing the things that we needed to be doing when the person was 25 to 30 years old, the unrecognized hypertension that after 20 years, presents as a stroke.”

Levy, an ER doctor and Wayne State professor who practices at Detroit Medical Center, said the lethal mix of chronic diseases and COVID-19 caused him to rethink the reason he got into medicine.

“Like a lot of other ER physicians I was driven by the adrenaline of acuity, seeing and helping people in extreme (situations) with whatever they were presenting with,” said Levy, who is Wayne Health’s chief innovation officer.

But day after day in the DMC ER, Levy said, he saw many people in their 50s and younger, predominantly Black, come in with severe heart disease, kidney disease, diabetes, uncontrolled hypertension and those with strokes and heart attacks.

“I researched it and found many with strokes and heart attacks, and other diseases, start with uncontrolled blood pressure, mixed with uncontrolled diabetes,” said Levy

Shanley and Levy said COVID-19 — either by contracting it or delaying care because of it — will make patients with chronic diseases worse for years to come.

COVID-19 presented Wayne Health with a unique opportunity to accelerate the group’s move toward…