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Old 03-13-2020, 09:52 AM
blueash's Avatar
blueash blueash is offline
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Originally Posted by villagerjack View Post
I understand you can have the virus and not show any symptoms so do you think doctors have some responsibility to arrange appointments better so fewer patients are waiting in their office?
Actually that's a great question. It is not reasonable to deny medical care to people who need or want it. But it is reasonable to ask how can the operation of the office and design of patient flow lessen, not eliminate, possible contagion.

If I were a person with a diminished immune system [or just a very cautious person] I'd ask if I could check in by phone, wait in my car until it is my turn for care, and return to my car rather than any secondary waiting areas between steps in my visit. I'll be happy to fill in the paperwork in the exam room. Please don't bring it in on a clipboard which has passed thru 50 other hands that day. Just the paper, and I'll use my own pen. Or better yet, I'll verbally tell you that my name, insurance and contacts are all the same as last time.

The flip side of this is to hope that patients understand that these next few weeks may be overwhelming for primary care offices. The ill and the worried well and the phones will be swarming. I am understanding of all those instructions to "Call your doctor" for every concern. But how is the doctor's office supposed to handle all those calls?

Who in an adult practice do you think is trained in how to obtain a viral naso-pharyngeal swab correctly for the patient while protecting themselves? Do you think your GP has a haz-mat suit like you see on TV? Most office nurses and certainly most medical assistants have never seen a viral culture sample being collected. But that's who the system is expecting to do the work for those not seriously ill enough to have the overwhelmed public health department involved.

At this time your doctor cannot just send an order to Quest to have them do the Covid test. Quest and others do NOT collect the sample. But they will run the sample if someone else collects it. But your private doctor doesn't have the correct equipment to collect the sample, nor anyone trained in how to collect it.

The Sumter Co Health Dept has fewer than a dozen nurses and many of those are administrative not lab procedure trained. If the worst predictions are accurate the health care system will overwhelmed, completely. Both the outpatient and inpatient management will be easily criticized for its many inevitable failures. Lack of staff, lack of supplies, lack of beds, lack of respirators, lack of patience, but no lack of patients.

That is why the policies of containment and more importantly mitigation are critical now. I could be that if nothing is done everything will be fine. And maybe that is the most likely outcome. But the experience in Wuhan and Korea and Italy suggest that Covid can be a rapidly spreading killer. And once it has spread there is no going back to have a re-do.

Now off the soap box.
Men plug the dikes of their most needed beliefs with whatever mud they can find. - Clifford Geertz
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