Opinion | The Greatest Healthcare Hurdles for 2022

I hesitate to make predictions about healthcare in 2022, given the turbulence we have faced in the past 2 years. Yet, medical groups, health systems, and their physicians and staff must continue to develop forward-looking plans so they can provide high-quality, accessible healthcare to their patients and communities.

The leaders of healthcare delivery systems will face some unique and difficult challenges in 2022 and will need to be alert and flexible in their responses. Because of their experience dealing with the extraordinary changes we have seen since the pandemic began, I am confident they are up to the challenge of responding quickly and effectively to whatever 2022 may bring. These are the top challenges that will require their attention.

Recovery of People

Many physicians and care teams, facing the unrelenting impact of the COVID-19 pandemic, are exhausted. Some healthcare leaders have compared the situation to post-traumatic stress disorder, with the increased deaths, changing guidance, personal risks, and overwhelming workloads creating a workforce that is extremely distressed. And these new factors are being layered on top of preexisting burnout due to the usual burdens of working in healthcare — excessive paperwork, EHR dysfunction, regulations, and financial constraints.

I anticipate a renewed imperative to focus on recovery by fostering wellness and resilience for the workforce. Look for chief wellness officers playing an increasingly important role, more resources for mental health, more emphasis on safety and security, and heightened awareness of the needs of frontline workers.

Renewing Trust in Medical Care

Healthcare professionals — physicians, nurses, pharmacists, and other caregivers — have historically garnered high levels of respect. Their dedication to their patients afforded them the unique position as highly trusted members in their communities. However, this past year has seen an erosion of that trust, with disturbing reports of patient threats and confrontations, a proliferation of myths around diagnosis, treatment, and vaccines, and the politicization of public health measures and recommendations. This change in perception not only undermines the sense of purpose that drives the professionalism of medical providers, but could ultimately result in worse health outcomes in the future. For example, many experts are concerned that other vaccines, such as the flu vaccine, will have lower uptake if declining vaccine confidence becomes more generalized.

I predict that health systems and medical groups will be looking for new ways to rebuild trust by reaching out more to their patients and leveraging local networks. I also believe systems will provide additional training for medical providers in empathy and communications skills, which will focus on listening, avoiding confrontations, and promoting understanding.

Embracing New Roles in Public Health

During the pandemic, medical practices have adopted an increased role in public and community health. From education, testing, home care, mental health services, and vaccine administration, many care systems have become de facto public health departments for the COVID era. This role expansion required collaboration among usually competitive care systems across communities in order to coordinate scarce resources and plan large-scale health programs.

I believe these organizations will continue to organize around community needs and apply the lessons learned from the pandemic to tackle other unmet public health needs, including responding to disasters, promoting health equity, and addressing social determinants of health.

Creating Telehealth 2.0

Early in the pandemic, some were convinced that telehealth would rapidly replace a significant percentage of in-person visits. Over time, many of these predictions have not been realized, and I see a shift in 2022 to a more patient-centric approach. The technical issues that inhibit scaling — including connectivity, integration with medical practices, and scheduling — need to be fixed. I expect medical systems will take a careful look at which types of visits are most appropriate for virtual appointments and how to best integrate virtual care into clinical care pathways. For example, people with diabetes or other chronic conditions may benefit from virtual visits between in-person office visits to review medications and lab results, and receive coaching on how to manage their diseases. I also see further exploration of remote monitoring and other digital tools that promote patient engagement, self-management, self-diagnoses, and self-triage.

Recruiting and Retaining for Primary Care

The competition for a shrinking pool of primary care providers will heat up. Walmart, Walgreens/VillageMD, CVS, and private equity firms will all compete with existing medical groups and health systems to enlarge their primary care footprint. Retention and recruitment for primary care will be on most care delivery systems’ strategic priority list. Demand for primary care physicians and advanced practice clinicians will drive up salaries, benefits, and lifestyle accommodations. I also see, however, increased expectations for primary care around reducing variation in care, access, and consistency of the patient experience.

All said, 2022 will be an interesting year, with healthcare delivery systems applying the lessons learned from their COVID experience to build more sustainable, empathetic organizations. With increasing vigilance, they will focus internally on their people and externally on their local communities. I anticipate systems will continue to slowly adopt technology and new care models, all while focusing on core values that drive their mission.

Jerry Penso, MD, MBA, is president and CEO of AMGA, a trade association that represents medical groups and other organized systems of care, including some of the nation’s largest, most influential integrated healthcare delivery systems.