The Aftermath of Coronavirus Disease 2019

Devastation or a New Dawn for Nephrology?

Rajiv Agarwal


Nephrol Dial Transplant. 2020;35(6):904-907. 

In This Article


The fight against COVID-19 was not just against the virus. The deliberate actions taken by large healthcare systems to fight the virus created another problem. In the face of the pandemic, most routine medical services were suspended. Because of the lack of access to routine medical care, patients with chronic illnesses were now exposed to potential harm. COVID-19 was pushing all other diseases by the wayside, and telemedicine rapidly emerged. Many of the rules that would have taken years to be approved were passed almost overnight. Visits to patients using cameras next to the dialysis machine or by phone were rapidly adopted. Many practices started seeing patients by telehealth visits.

Could this drive a change in the system? Will patients want to see their doctor in person or on camera? Or could we have a hybrid system where many visits might be via telehealth and a few in person. The answers to these questions are complex and may be decided by organizations that pay for these services. If insurance companies pay for these services at a lower rate, but this lower rate is offset by an increase in volume, it may drive more telemedicine in the future. However, the behaviors of physicians and patients will also decide if these changes are transient or more secular.