Home Therapeutic relationship Neurologists Express Key Community Patient Care Challenges During COVID-19

Neurologists Express Key Community Patient Care Challenges During COVID-19


Community neurologists have reported that their biggest challenges brought on by the COVID-19 pandemic include isolation, trust and providing quality care, according to a study published in Neurology.

Along with other health care providers, neurologists quickly adopted World Health Organization and Institute of Medicine strategies to treat patients during the pandemic while limiting the spread of the virus. Researchers in the current study (ClinicalTrials.gov Identifier: NCT03076671) sought to learn directly from community neurologists about their experiences on the front line.

From July to November 2020, researchers individually interviewed 20 community neurologists who provided outpatient palliative care to patients with Parkinson’s disease and were willing to refer at least 6 patients per year over 3.5 years of enrollment to the clinic. ‘study and receive 8 hours of additional training in palliative care. clinical training in care. Neurologists who worked primarily in academic medical institutions were excluded from the study.

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The researchers conducted the interviews by phone or teleconference and performed a matrix analysis of the responses to their questions about how the pandemic affected them, their practice, and the lives of their patients.

Four themes emerged: political and pandemic-specific stressors, stressors involved in the rise of telehealth, hopelessness, and limited means to cope with stress.

During the pandemic, clinical hours decreased and patients experienced more stress, isolation and confusion. This confusion included the limited knowledge that care partners reported having about the well-being of loved ones who were in nursing homes.

As healthcare systems shifted to remote care, neurologists have adapted to the use of the technology involved, separated from their colleagues and patients, without training or institutional support, they said. There were often adjustments in procedures and patients who needed help navigating virtual care.

The impact of social isolation on the health of patients was “unsettling and unsettling” for neurologists. Neurologists have experienced an increase in burnout during the pandemic because their responsibilities increased, their self-care options decreased, and they felt isolated from their colleagues.

“Neurology providers struggle to maintain a therapeutic relationship with patients during a period of politicized medicine and misinformation and believe there is a lack of support for new models of care,” the researchers said.

Limitations of the study included generalization to areas outside Colorado, changes in pandemic response and institution, and the method of conducting interviews.

“Our study suggests that strategies to promote engagement and reduce systematic contributors to burnout are essential for maintaining quality of care and supporting neurological staff during and after the pandemic,” the researchers concluded.


Ayele R, Macchi ZA, Dini M, et al. Experience of community neurologists providing care to patients with neurodegenerative diseases during the COVID-19 pandemic. Neurology. Posted on June 14, 2021. doi: 10.1212 / WNL.00000000000012363