Table 1.

Phases of preventive screening during and after the COVID-19 pandemic

  • 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

Screening activities to maintain
  • 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

Practice and financial implications
  • 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

  • COVID-19—coronavirus disease 2019, EMR—electronic medical record.