Physician viewpoint: Pandemic spotlights cracks in US chronic care system

The COVID-19 pandemic revealed significant flaws in the U.S. healthcare system's approach to managing chronic diseases that must be addressed, Marshall Chin, MD, an internist and professor at UChicago Medicine, wrote in an Oct. 23 op-ed published in The New England Journal of Medicine.

The current chronic care system doesn't support optimal patient health and experience, especially for marginalized populations, Dr. Chin said. This is because the system financially rewards interventions such as surgery and medical devices over chronic disease management practices such as coaching and behavior change. 

Dr. Chin outlined several actions to improve chronic disease systems in the U.S., including creating teams focused on longitudinal primary care, coaching patients in self-management and behavior change, and transitioning telehealth payment to value-based models. 

"The COVID-19 pandemic has forced us to step back, and the wider scenery has revealed uncomfortable truths about our chronic-disease systems," he concluded. "We can design and implement effective chronic-disease systems if we lock on to the North Star goals of patient health, health equity and justice. The healthcare system encourages and rewards what is valued — which should be supporting the health of all people with chronic disease."

View the full op-ed here.

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