As mask rules change, primary care is more important than ever | Expert Opinion

2022 was beginning to look like a year in which COVID-19 conversations would no longer consume such a large portion of office visit time. Many patients’ vaccine fears have abated, and the number of acute symptoms and reported exposures have declined. However, a few recent patient visits have shown a new trend.

“Doc, do I need a second COVID booster? The news is so confusing,” has become a common question, and is sometimes the entire reason for a visit.

Another patient that same day asked, “With so many places no longer requiring masks, why do I still need to wear one in your office?” To me, this question exemplifies how, for some, masking has become a nearly unbearable inconvenience, disconnected from its purpose as a public health safeguard. I explained that medical facilities have to protect staff and the many vulnerable people who visit every day.

Earlier in the pandemic, lockdowns and mandates generated debate, yet guidelines were more straightforward and prescriptive than they are now. Wear a mask indoors. Get the vaccine as soon as possible. Get tested if you have symptoms or a COVID exposure.

In the current phase, information has been more uncertain and potentially confusing. Some regions and settings have mask mandates while others have rolled them back, leaving many patients wondering how these decisions are made, and whether it is safe to gather indoors or use public transportation. Low-risk people feel liberated, but those with chronic illness and immunosuppression may feel even more vulnerable and abandoned.

Changing recommendations and disagreement among experts on vaccine booster doses has left more patients than ever in need of advice from an accessible, trusted source. Effective new antivirals are available, but their use and indications can be complex to sort out on your own. Outreach to your primary care clinician can help make sense of this morass of new and continuously changing information. Questions should be both expected and welcomed.

Primary care clinicians manage chronic illness, coordinate care with specialists, and evaluate and treat acute problems, as well as encourage preventive health screening and vaccination. Further, what brings the most meaning and reward for many of us are the long-term, trusting relationships within which this care takes place.

These connections with patients are foundational to all elements of care, and perhaps none more so than simply listening and providing guidance for shared decision making. I cannot recall a time when the primary care counseling and advisory role was more profound, or the need greater.

Jeffrey Millstein is a primary-care physician and regional medical director for Penn Primary Care.