A new survey has found that 46{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} of primary care physician practices have no capacity for COVID-19 testing and 51{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} lack adequate personal protective equipment.
More than half, 52{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} of practices, report COVID-19 is having severe and near severe impact on their practice. Fifty-eight percent have cancelled well and chronic care visits to accommodate need and 17{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} lack enough available appointments.
Seventy-four percent of clinicians report their phone lines are flooded with patient concerns.
Time is being taken up on largely unpaid activities such as implementing new workflows, doing extensive phone triage and redesigning work areas/systems to limit exposure.
Staffing outages due to illness are already hitting 20{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} of clinicians, 17{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} of nursing staff and 13{312eb768b2a7ccb699e02fa64aff7eccd2b9f51f6a579147b7ed58dbcded82a2} of front desk support.
The findings are from a real-time survey of COVID-19 on practices by The Larry A. Green Center in partnership with the Primary Care Collaborative, which is expected to be conducted weekly.
WHAT’S THE IMPACT
The survey shows the results, but the 236 comments from respondents tells the story, with many literally crying for help.
Eighty-five percent said they lack personal protection clothing and testing ability. Providers expressed frustration at not having what they need to do their jobs, and concern that they could be infected and passing the coronavirus onto patients without knowing it.
“We have no face masks or respirators. They are on permanent back order,” said one. “I have no way to protect myself or my staff from infection. We reached out to the hospital and they have none to spare. We have no gowns or eye protection and no rapid test. We have been sending everyone to the ER. I need supplies yesterday.”
“It is appalling to me that we don’t have broader testing capabilities,” said another. “I had a patient two days ago who absolutely should have been tested. But because she hadn’t traveled internationally, or had a known contact with COVID, we couldn’t. She was flu negative. We know it’s here in our area, and we aren’t looking for it like we need to be. It’s maddening.”
“The state health department is telling residents that providers can choose to test through the commercial laboratories but we CANNOT GET SUPPLIES such as masks, gowns or gloves to do this properly,” one said.
Thirty percent blame failed leadership, constantly changing guidelines, and failed coordination between agencies and institutions.
“Help. I’m medical director at 2 nursing homes… can’t get my hospital or Public Health Dept to test febrile lower respiratory infection patients before sending them to my nursing homes. The nursing home staff have essentially NO PPE!!”
“Enormous time and stress it takes to train, then re-train, then re-train, then re-train on the constantly changing protocols. Asking staff to make complex algorithmic decisions when they are themselves under stress and worried.”
“Frustrated. Health dept telling everyone to see pcp for testing. We don’t have tests.”
Thirty-one percent fear the loss of employees, risk of financial collapse and helplessness.
“I am a solo practitioner. I am afraid we will get sick, have to close, and I will lose my practice.”
“I may have already been exposed and have no way to know if I am an asymptomatic carrier to others.”
“Difficulty determining clinically which patients should be tested, running out of personal protective equipment, looming sense of doom that cases will spike suddenly and healthcare system will be overrun.”
“Starting to have providers out so they can take care of kids out of school.”
“We are paid strictly on RVU so we are going to have a dramatic financial risk. I have 1 N95 mask and no eye protection or gowns at all even before this thing has started. We can’t test but it is clearly here. Please help us.”
“A single N95 being reused for days now. No guidance locally or otherwise. EMT volunteers are seniors with no protection.”
Others expressed concern that other types of care are being pushed aside, such as wellness visits and vaccinations, due to social distancing. And that the need for mental healthcare will increase.
THE LARGER TREND
Primary care is the first contact for most entering the healthcare system.
The Quick COVID-19 Primary Care Survey was distributed to 9,000 PCPs nationwide and was open between Friday, March 13, and Monday, March 16. Responses came from 534 clinicians.
Twitter: @SusanJMorse
Email the writer: [email protected]