Finding Joy: An Interview With Avance Care’s Chief Medical Officer, Joanne Fruth

Promoting holistic physician well-being is a key pillar of Curi’s mission to help physicians in medicine, business, and life—and it has assumed even greater importance as healthcare workers face the stresses of the COVID-19 pandemic. To better understand how physicians are maintaining resiliency during this trying time, we sat down with Dr. Joanne Fruth, the Chief Medical Officer of Avance Care in North Carolina.

What were the early days of the COVID-19 pandemic like for your practice?

As the organization’s medical director at the time, during the start of the COVID-19 crisis, I was unable to continue patient care and began to focus all of my efforts towards guiding our 15 practices and 80 providers through the many challenges of providing care during a pandemic. Larger medical organizations have occupational health and infectious disease specialists who can write protocols and give direction, but for independent practices, this role falls to the medical director. My job was to build out the necessary toolkits and processes for independent practices that will help keep patients, providers, and staff safe during this frightening period.

After its development, it was particularly important to us that we share this toolkit publicly for smaller practices that may not have the resources that we have. My team published the toolkit on social media, posted to various public groups, and sent it to everyone we could.

Did you find the transition to telehealth particularly challenging?

Even before COVID, we already had a strong interest in further investing in telehealth, recognizing that it would likely be an important component of healthcare in the near future. So, when the pandemic hit, we were ready in the philosophic sense, but we simply didn’t have the processes In place to transform 15 practices.

In one week, we worked tirelessly to ramp up the entire organization for telehealth services by training all providers. This was extremely important, as ongoing, primary care is essential. While acute issues may have taken priority across many healthcare facilities, it was critical that we make sure our patients continue to receive the care that they need for chronic issues and avoid higher mortality rates due to untreated conditions.

How do you think COVID will impact patients in the future?

I expect there will be chronic downstream costs for many patients. Arising mental health issues may also become their own pandemic in a way, as emotional stability is threatened by food insecurity, lack of socialization, and unemployment. To help mitigate this, we have an expanded behavioral wellness service line and make it a point to connect with all patients via telehealth.

How has your organization prioritized mental health for providers?

Early on, we created recommendations for providers to take time for themselves and ensure they are rested, eating well, exercising, and remaining intentional. As external organizations made therapy and mental healthcare available for medical workers, such as employee assistance programs, we shared these services with our staff to ensure they are well aware of the offerings available to them.

We also worked toward recognizing our offices by teaming up with organizations that express gratitude to healthcare heroes, even in small ways such as yard signs outside our facilities. It sounds cliché to call providers and staff “healthcare heroes” but it’s truly fitting. These individuals are putting themselves at risk in order to serve the patients that need them.

Furthermore, we also began having regular meetings with representatives from each practice and hosted “town calls” with 80-90 attendees to hear what new measures we are taking to tackle the pandemic. Those town calls were key to alleviating fears and responding to questions by maintaining a two-way line of communication to meet the challenges that our providers and staff experience each day.

Did COVID affect your ability to establish connections with patients?

COVID has created a new barrier between providers and patients due to fear of exposure, but we have taken every precaution to mitigate spread with PPE, social distancing, and stringent cleaning protocols. We use a parking lot triage and perform tests outside of the facility itself to promote distance between patients and reduce any risk of spread.

We break down barriers by keeping lists of high-risk patients and reaching out to them regularly to ensure they are receiving the care that they need. Sometimes these outreaches are welcomed, but unfortunately, some patients are experiencing new barriers to care as unemployment causes many people to lose their health insurance.

Have you experienced a “silver lining” to our current situation?

I have experienced a quietness that I’ve enjoyed, which is something I believe I share with many other mothers with teenage children. Catching up with all of their activities can be challenging, and it’s been pleasant to have quietness in the evenings.

Another silver lining was my promotion to Chief Medical Officer, which allowed me to put my full focus on the administrative side of medical care. This has given me an incredible opportunity to be creative, work through new processes, and effectively organize the company in a way that benefits providers, staff, and patients.

I’ve also gained the opportunity to work with my son on remote learning as we developed practices for teaching physicians to use telehealth. He has experience in adult learning that was valuable during this time, and it’s been a great silver lining to have this chance to work together.