On March 2, the House Oversight and Investigative Subcommittee on Energy and Commerce held a hearing titled “Lessons from the Frontline: Impact of COVID-19 on American Health Care”. The hearing gave frontline workers the opportunity to share and reflect on their experiences caring for patients during the pandemic, as well as provide recommendations on how the nation can prepare for future emergencies. of public health.
In his opening statement, committee chair Frank Pallone (DN.J.) spoke of the inordinate strain that the COVID-19 pandemic and the highly virulent omicron variant have placed on the nation’s healthcare system. Pallone reflected on how COVID-19 surges have overwhelmed healthcare systems, leading to “overstretch, burnout and heightened anxiety or depression” among healthcare workers, as well as delayed and lost care. for patients.
Pallone also highlighted the efforts of Congress and the Biden administration to address these challenges with billions of dollars in funding through the US bailout and the CARES Act. He concluded by noting the key provisions of the Build Back Better Act (HR 5376) that will expand and improve the nation’s health workforce. AAMC President and CEO David J. Skorton, MD, and Director of Public Policy, Karen Fisher, JD, previously issued a statement welcoming the proposed Build Back Better Act investments in the higher medical education, including the creation of 4,000 new Medicare-supported GME positions and the establishment of the Pathways to Practice training program, which would strengthen and diversify the nation’s mental health workforce.
Echoing Pallone’s comments, subcommittee chair Diana DeGette (D-Colo.) discussed the immense impact of the COVID-19 pandemic and related mental health issues on the country’s health workforce capacity. DeGette explained how “labour pressures and capacity issues are further exacerbating historic inequities and health disparities,” calling on Congress and the Biden administration to invest in the workforce health and system support. She concluded, “As a nation, we have relied on health care workers to bear a significant burden over the past two years… We owe a debt of gratitude for their leadership and sacrifices.
Ranking Subcommittee Member Morgan Griffith (R-Va.) thought about the need to capture lessons learned from the COVID-19 pandemic to improve preparedness for future emergencies. Griffith pointed to the opportunity the pandemic has given providers to seek “creative solutions” in healthcare, such as telehealth flexibilities, monitoring patients at home and expanding pharmacists’ scope of practice. to administer COVID-19 vaccines.
The subcommittee heard from Megan Ranney, MD, MPH, an emergency physician and professor of emergency medicine at Rhode Island Hospital and academic dean of the Brown University School of Public Health. In his testimonyRanney cautioned against prematurely declaring the conclusion of the pandemic and instead encouraged the subcommittee to view this time as “a respite and a time to address the many issues that brought us here in the first place.”
Responding to questions about the role of vaccination mandates for healthcare providers, Ranney juxtaposed her own hospital’s experiences with staffing shortages to national statistics, which indicate that nearly one in five healthcare workers resigned since the start of the pandemic. Ranney attributed this high rate of attrition to “moral damage” resulting from the inability of health care providers to adequately care for their patients, emotional distress, workplace violence, retirement and, finally, the tendency of support staff to turn to highly paid “travellers”. posts. To address these challenges, Ranney made several recommendations such as expanded access to behavioral health supports for healthcare workers. Ranney expressed support for the recently passed Lorna Breen Healthcare Provider Protection Act (HR 1667), which was approved by the AAMC. [refer to Washington Highlights, March 12, 2021] and further highlighted the need for better job protection for providers seeking care.
The subcommittee also heard from Tawanda Austin, MSN, RN, chief nursing officer at Emory Midtown University Hospital. Austin ponders her own experience working as a nurse on the front lines of the COVID-19 pandemic. Austin noted the “extra pressure” the pandemic has placed on nurses, such as “personal protective equipment that is cumbersome to put on and take off,” the mental stress of watching his patients deteriorate, and verbal attacks from patients for the implementation of COVID-19 safety protocols.
Austin called on Congress to increase the health workforce by “founding[ing] pathways for more young people to enter the medical and nursing fields. Additionally, Austin shared Ranney’s concerns about the impact of travellers’ positions on the healthcare system as a whole, calling on Congress to “curb the predatory practices of these [travel-nursing] agencies to keep American hospitals financially viable. In late January, nearly 200 members of the House of Representatives, led by Reps. Peter Welch (D-Vt.) and Griffith, sent a letter to the White House COVID-19 Response Coordinator, Jeffrey Zients, calling for action to investigate the potentially anti-competitive activities of certain nurse recruitment agencies [refer to Washington Highlights, Jan. 28].
The subcommittee heard from Laura Riley, MD, chief obstetrician and gynecologist at New York-Presbyterian/Weill Cornell Medical Center and chair of the department of obstetrics and gynecology at Weill Cornell Medicine. In his testimony, Riley noted the devastating impact the pandemic has had on medical personnel, especially among those who identify as women and people of color, who “bear a disproportionate amount of child care burdens.” Speaking from her own experience as an obstetrician-gynecologist, Riley observed that in team care delivery models, “when staffing levels go down and team members are missing, it can have a negative impact on patient care”. To address these challenges, Riley recommended “greater investment and training in healthcare professionals and efforts to diversify our healthcare workforce,” as well as expanded telehealth flexibilities.
Riley concluded by reflecting on the exclusion of pregnant and breastfeeding women from the COVID-19 vaccine and therapeutic trials and how this decision “has fueled the proliferation of misinformation about vaccine safety in pregnancy.” To address this issue, Riley recommended that federal agencies prioritize the inclusion of pregnant and breastfeeding women in future clinical trials.