Despite all of the despair brought on by the COVID-19 pandemic, it has been extraordinary to see an unprecedented level of collaboration among healthcare providers as we unite to treat patients and protect others from contracting the disease. There wasn’t a clear roadmap to follow or a large body of research on the nature of the novel coronavirus and its accompanying disease. Essentially, the healthcare community across the globe has been working in real-time to “crowdsource” best practices on what’s working or not.
Crowdsourcing is commonplace among some businesses and industries — the Waze app, for example, is only possible because of its ability to compile and process traffic data in real-time from commuters. Crowdsourcing is also a popular way to test product ideas, invent the next toy or game, or bring a new ice cream flavor to market. But in the medical community, crowdsourcing is less common and usually occurs through much more formal channels.
Collaboration among physicians typically happens at conferences or by partnering on research or academic papers, but clinical care is usually designated to a healthcare team at one medical institution. The rapid onset of the COVID-19 pandemic and the resulting worldwide devastation removed any sense of competition. Instead, we have seen unprecedented collaboration as medical providers have forged unique partnerships under the “we are all in this together” mentality. There has been no room for egos or competition — it is all hands on deck, all ideas welcome, all working toward the same common goals. My hope is that the shift from working in silos to unity and teamwork will be a lasting change in the medical community.
At the same time that there was significant decline in inpatient, outpatient, and emergency department revenues, teams were working across medical systems to start up new facilities. The focus was not on the financial bottom line, but instead on the urgent need to save lives. The push to bring the temporary state-funded L.A. Surge Hospital into operation practically overnight was extraordinary. I worked side by side with colleagues from other local health systems; although our systems are technically in competition, we all came together and shared all we knew in order to bring online a whole new hospital facility that could treat COVID patients.
There was also shoulder-to-shoulder clinical collaboration with providers across medical specialties. This has allowed for rapid dissemination of technical skills and clinical information as we all tried to figure out the best ways to treat this new disease.
In particular, anesthesiologists have been on the front lines because we specialize in placing, managing, and removing patients from ventilators, which is needed for critically ill COVID patients. We are also adept at initiating and managing infusions of powerful medications used to keep patients comfortable or control their blood pressure, and we routinely place invasive lines that allow for the safe delivery or measurement of treatments necessary to manage these complex patients. In a normal intensive care unit, such tasks would require a cadre of pharmacists, nurses, and respiratory technicians to assist the physicians, but in a resource-poor environment or critical scenario, they can all be performed by just one anesthesiologist. This expertise and ability to manage complex cardiac and respiratory physiology has put anesthesiologists in a leadership role for treating patients with COVID.
But even though many of the critical tasks required to care for COVID patients are ones we already perform every day, there has still been a learning curve for us with the unique nature of this disease. Because there was a lack of evidence-based information on some aspects of COVID treatment, we have been looking for and creating consensus-based guidance that could serve as best practices. This collaboration is a situation that you don’t get very often once you’re out of medical school training.
In addition, social media engagement among physicians has hit a new level in this crisis. Most physicians are rightly cautious in how they use social media. We must be wary of misinformation, be careful to not disclose sensitive patient information, and maintain professionalism at all times. But with this pandemic, social media groups sprung up overnight, with physicians from all over the world joining together to fight COVID by discussing tactics, research, trends, and observations, and getting other opinions on how to manage complex patients. Expanding physician voices in the social media world will increase collaboration in the long term and also will help reach patients where they are.
This pandemic has shown that we can come together quickly around shared goals when lives are on the line and everyone takes the threat seriously. We have accomplished extraordinary things in patient care — saving lives, starting up new hospitals, overcoming administrative red tape that would typically take months or years, and adopting creative solutions to resource management.
Looking ahead, I hope there are lasting impacts on how the healthcare community works together. If we maintain this level of dialogue, sharing of ideas, and prioritizing resources, we may be able to make faster progress on finding cures for debilitating diseases and solving patient care mysteries that have plagued us for too long. And we will be even better prepared for the next wave — whether it is another COVID surge, or a different type of public health threat.
Sachin “Sunny” Jha, MD, MS, is an assistant clinical professor of anesthesiology at the University of Southern California and a member of the California Society of Anesthesiologists Board of Directors.
Last Updated July 13, 2020