Abstract
BackgroundPrimary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak.MethodsTwo hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19.ResultsA total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors.ConclusionsPCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.
Highlights
Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic
The sampling frame comprised of all medical doctors who were either 1) a PCP practicing within an National University Polyclinics (NUP) polyclinic, or 2) a PCP practicing within an National University Health System (NUHS) Primary Care Network (PCN) private clinic, or 3) a Member or Fellow of the College of Family Physicians Singapore (CFPS), and 4) had a registered email address within the respective organizations
Work- and non-work-related concerns most PCPs felt that their job would put them at high risk of exposure to COVID-19 (89.9%), and the majority agreed or strongly agreed that they were worried about falling ill with the disease (69.0%)
Summary
Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. With 20 polyclinics and approximately 1700 private clinics, including eight family medicine clinics, the crucial role of primary care in managing the COVID-19 outbreak in Singapore is underscored by the Public Health Preparedness Clinic (PHPC) scheme, which provides government assistance to approximately 940 private practice PCPs with financial subventions, personal protective equipment (PPEs) and medical supplies from the national stockpile during public health emergencies, as well as continued professional training to build outbreak management capacity [4, 5] This support has not been misplaced; as of 17th March 2020, 108 of the 158 locally transmitted COVID-19 cases (68.4%) had visited a PCP before being diagnosed [6]. The role of primary care in this pandemic is highlighted elsewhere across the world in guidelines and literature that acknowledge how PCPs are often first points-of-contact between suspected cases and the healthcare system [7,8,9,10]
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