Impact of the Coved 19 Pandemic on the Core Functions of Primary Care: A Qualitative Study in the National Guard Primary Care Physicians at Western Region of Saudi Arabia 2021

Abstract

Introduction: The COVID-19 pandemic has shifted priorities of the health system, which is finding itself not only overwhelmed but also with restricted capacity to provide services it has been hitherto extending to communities. Logistics and supplies are disrupted especially of material and equipment that were imported till date (API of essential drugs, personal protective equipment, to name a few) adversely affecting the services.

Method: Qualitative descriptive study in primary healthcare centers at Western region of Saudi Arabia, where physicians who work in these centers were selected. Semi structured interviews were conducted by the investigators as a tool for data collection.

Results: About 97 physicians were participated in this study, 44 (45%) were males and 52 (55%) were females, 21(22%) were GPs or staff physicians, 3(3%) were Registrar Doctors, 12 (24%) were Assistant consultants, 54(56%) were consultants and 7 (7%) were family physicians consultants. In regard to the physicians’ opinion about system change due to COVID 19 pandemic in term of general practice core competencies; Most of participants mentioned that the collaboration with colleagues decreased to minimize direct contact with them and by applying the MOH protocol such as taking safety precautions with each other, by social distancing and decrease contact; Some mentioned that workload has increased while other mentioned that workload in the beginning of covid has decreased but responsibility increased; Majority of participants indicated that telephone consults are not enough, and they cannot depend on them 100%, they also agree that telemedicine consultations makes the job of doctors more difficult due to lack of non-verbal communication or body language, The faces difficulties in clinical decision-making due to variation of problem weather acute or chronic problem, they totally agree about importance health education and providing comprehensive care or patient centered care, some participants mentioned that they provide health education for their patients or families, while others support providing patient education but it’s too difficult to conduct health education for patient or comprehensive care due to lack of enough time and shortage of staff. All of participants are agree the importance of community orientation and community awareness because the Covid-19 pandemic is a global community event which has affected everyone in some way; Majority of participants are totally agree in providing holistic approach in dealing with covid 19 patient and consider all treatment aspects because the disease have physiological, social, psychological and economic impacts but they give special consideration in treating medical effects of the patients and finally all physicians were aware about the importance of protection their self, colleagues and patients and application of MOH protocol in managing COVID 19 pandemic.

Conclusion: There are various benefits in using technology of telehealth, especially in non-emergency /routine care and in cases where services do not require direct patient-provider interaction, such as providing psychological services.