This article was co-written with Linda Wolfe-Stine, OTR/L

As the United States considers how to reopen the economy, the Governor of Illinois, J.B. Pritzker, has extended the stay at home order until at least May 30. During this unprecedented time of reentry and shelter-at-home, clinicians who are not on the front lines are thinking about innovative ways serve patients and families. Without telehealth, this would not be possible, and it has taught us valuable lessons about how to support our patients, our families, and each other.

As a developmental pediatrician and occupational therapist, the COVID-19 pandemic revolutionized how care was provided in the outpatient setting. The focus shifted from in-person visits to keeping healthy patients at home so our sickest members received essential acute and critical care. In the outpatient setting, this transformation propelled telemedicine to the forefront where it previously would have taken years to implement.

We are grateful for this transition, because we can still care for our patients and families. Through telehealth, we have been given the opportunity to be in families’ homes where times are stressful and real. Some children have medical conditions that heighten their worries. Siblings need attention and support for remote learning. Parents have lost their jobs or are trying to work from home. We are able to see, to listen, and to support them in real time.  

At the beginning of each visit, we both focus on how parents are doing and adjusting with the new world. Parents feel sad right now and worried if they are investing in their children’s needs the way they should. In contrast, we also hear they are grateful for how this collective global pause has allowed them to be together as a family. Certain daily activities that used to cause stress are no longer there. New stressors include access to food and diapers. We use our clinical time to listen, to reassure them they are not alone, and to encourage them that what they are doing is enough.

Because of technology, we now have a window to see how to guide and support their child’s development in more meaningful ways. For example, climbing over couch cushions and making forts, cutting up bananas for lunch, washing windows with a water spray bottle, tearing up lettuce for dinner, or sorting socks from the laundry – these are activities to contribute to family routines at home. But these activities also teach them new functional skills. For older kids, we show them how to create cards and art work to thank others in the community or show them how to turn on music and do animal walks with their siblings.

The pandemic has brutally humbled our healthcare system. To serve families past the pandemic, clinicians must be open to serving patients in new ways. Healthcare, schools, and community resources must work together to best serve our most vulnerable citizens, and technology facilitates this system transformation.

COVID-19 has distilled our practice into the essence of why we were called to practice in the first place – the healing relationship of clinical work. Philosopher and physician Maimonides described this as how “the physician should not treat the disease but the patient who is suffering from it.” We cannot fix what we cannot control, but we can be with patients and families during times of uncertainty.

For the collective sacrifices of our colleagues on the front lines to not be in vain, it is our duty as clinicians to move forward with practices that truly put our patients and families first. To continue these services requires insurance companies, both public and private, to expand telehealth, including mental and behavioral health and developmental and behavioral pediatrics.

In addition, it requires continued state and federal support of programs such as Project ECHO, including ECHO Autism, a telementoring program that provides access to specialists for providers and allows families to receive this care with their primary care clinicians. To be sure, technology has its limits and is not the panacea for what ails the healthcare system. But it is a new and welcome member of the healing relationship that defines clinical service.

These lessons have transformed us as individuals and are ones we will carry with us throughout our careers and well past the pandemic. We look forward to a new chapter that includes ways to support the development of young children and their families. As clinicians, we are grateful for how telehealth has offered a connection to families we have never experienced in our careers and in one of the hardest times of our lives.