How can Health Systems become more resilient during crises and how can medical students advocate for and support it?

This article was exclusively written for The European Sting by Ms. Sadia Khalid, Junior researcher, and a PhD candidate at Tallinn University of Technology (TalTech), Estonia. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

During the previous two years in a pandemic, it has been clearly demonstrated that medical systems are optimized to a degree that the significant influxes of patients have a detrimental effect on the availability and quality of accessible health care for the general populace.

This issue of accessibility is demonstrated in both lack of space for inpatient care and to an even larger degree of the lack of medical personnel to attend to patients in case of a crisis in particular infectious diseases. This situation could be eased through a higher level of inclusion of medical staff in training and smart solutions in diagnosis and aftercare.

We are facing a situation where even fully staffed hospitals lack the adequate resources to keep standard levels of patient care in a crisis where doctors and nurses have the highest likelihood due to exposure to being sidelined from work at any given time. Due to this, we have seen a lack of access to palliative care, screenings, postponement of surveillance and planned treatments, anything „non-essential“ to the primary purpose of getting the immediate pandemic under control.

Nonetheless, this was also influenced by hospitals prioritizing the need to keep people out of situations where they could possibly catch the disease but the adverse effect being added on preventable illness statistics and quality of life for patients in waiting lines is detrimental for health care optimal performance. While it is unlikely that all of these issues could be resolved in a short effective manner, it is possible to alleviate the situation by incorporating medically trained students, to the degree that their training and education allows.

Adding medical students to existing General Practitioner offices to alleviate the influx of calls, administer advice, give guidance, and solve the simpler issues. This will enable the licensed doctors and other healthcare staff to have time to focus on giving medical attention to the people who need it the most. Ultimately, This could be expanded to other parts of care, with added governmental or private funding that could bolster the lines of medical institutions with a willing workforce and avoid burnout of trained professionals by taking over all of the minor repetitive tasks, also taking away a lot of the risk of infection by limiting the contact of the essential healthcare providers in health institutions with infected patients.

In a situation where every trek outside carries a certain amount of infectious danger, especially if that trip is to a medical facility, it is clear that we need a more modern approach. Most medical issues that do not require personal presence nor a thorough inspection should be dealt with via the modern methods of health communication such as Telemedicine.

The increased financing of telediagnosis infrastructure, combined with the added workforce in the previous proposal, alone could significantly minimize the patient load in the health care centers and will also reduce the waiting time for medical advice, and also minimize the exposure to unnecessary infection. Legal issues with prescriptions and diagnosis online need to be looked over by governments around the world, as telecommunication has evolved while the legislation has not.

A situation where someone complaining of a stomach ache needs to go to an emergency room, only to get prescribed a simple painkiller without any real examination could be avoided completely by taking the entire health system online and only focusing in-person on real emergencies. The success of the Estonian digital health system is an example of its own. And similar systems should be tested in other countries to meet the evolving needs of the modern world.

We are at the precipes of great change, the world has discovered a lot of problems previously hidden in a situation of continuous crisis. With a bit of help and support from both medical communities and legislation, the system could at least be made more accommodating to a stressful situation, and levels of care can be maintained without putting both healthcare staff and patients at increased risk.

About the author

Sadia Khalid, Junior researcher, and a PhD candidate at Tallinn University of Technology (TalTech), Estonia. She has been working on her research project “The role of Helicobacter pylori intestinal microbiota in the development of liver diseases” under supervision of Dr. Pirjo Spuul at Faculty of Science, Institute of Chemistry and Biotechnology, TalTech. Previously, she has worked as a research specialist in biomedicine and translational medicine department in the university of Tartu, Estonia. She obtained her MD in emergency medicine in 2017 from the Dalian Medical university, China and MBChB in 2013 from the Weifang Medical university, China. Her current research interests include infectious diseases, bacteriology, hepatology, and gastroenterology.