Learning from each other: lessons from COVID-19

As family physicians we spend much of our patient interactions trying to understand patients who present with undifferentiated problems. We live with the uncertainty associated with ambiguous symptoms, unusual clinical presentations, and diagnostic challenges. “Long COVID” is an exemplar of this uncertainty. There are no widely accepted definitions (although some have been proposed), patient presentations are noteworthy because of their diversity rather than their commonality, and even when we think we know the diagnosis there is no path to confirmation or treatment available.

It often takes time for new illnesses to be fully understood. Coronavirus disease 2019 has taught us that we do not always have that time. Many people died because of our lack of understanding about how severe acute respiratory syndrome coronavirus 2 spreads and because we did not know how useful high-dose steroids would be. Many people continue to suffer because of our lack of understanding of the syndrome that follows infection with the virus. We do not even have an agreed-upon name for this diverse group of symptoms. We do know that patients may struggle to get a diagnosis or feel heard by clinicians. We do not know how prevalent the syndrome is or how it is related to the severity of the initial infection. We do know that is causing an unknown amount of suffering.

While we learn about this syndrome, there are things we can do as family doctors. We can listen to our patients with empathy. We can undertake the journey of dealing with their symptoms with them rather than referring them to multiple specialists who are less comfortable with uncertainty and may have little to offer. We can build on our relationships with patients for their benefit. We can engage in joint decision making through honest discussion of the challenges they face and limited proven treatments. We can be there for our patients.

One of the foundations of learning health systems is that every encounter becomes an opportunity for improvement. We need to establish mechanisms where we can share our experiences as colleagues, both to support and to learn from each other. What works for one doctor-patient dyad may not work for another, but we will never know unless we share those experiences. The College of Family Physicians of Canada can and should provide the venue for this sharing.

• Copyright © the College of Family Physicians of Canada