Rethinking screening during and after COVID-19

Disruption in medical practice

Rapid switch to virtual visits owing to the need for physical distancing

Access to preventive screening tests and investigations suspended by some provincial health agencies

Interruption to medical education

Increased use of telephone and virtual visits: further development of e-consultation

Resource limitations for preventive screening owing to economic effects of COVID-19

Focus on catch-up on elective procedures

Education is modified

Redefinition of role and organization of family physicians to meet the needs of patients

Practice includes more focused preventive screening activities

Continued resource limitations will focus type and frequency of preventive screening

New education processes in place

Maintain recall lists and patient disease registries

Reconsider role of family physicians in public health interventions such as vaccination

Services will be done more slowly, so capacity will be less

Reevaluate preventive screening guidelines and recommendations

Prioritize preventive screening activities by their effectiveness

Further evolution in roles of multidisciplinary health care team members to include preventive screening activities

Better integration of family physicians with public health to ensure increased capacity for the “next pandemic”

Continue developing and implementing reminders for screening guidelines, using EMRs and team members

Use patient self-administered screening tests

Better incorporate individual patient characteristics and preferences in determining screening need and intervals

Increase use of shared decision making in preventive health care

Further develop practice infrastructure to reduce the frequency of inappropriate screening

Fewer visits; most virtual, which are now paid by Medicare

Procedures halted

Income reduced

Need to reduce overhead costs, including staff

Increased visits but maintaining many virtual visits

Rebalance mix of prevention vs acute care

Limited procedures

Change threshold with non–family physician specialist care

Income rises

New normal of virtual visits

Fewer, more focused preventive visits

Income restored