My lovely wife is a Family Practice MD, entering her 3rd week working 14 hour days here in NY... the situation is not fun.
Here's some thoughts she shared - give people a snapshot of a day in her life..
"So lots of problems with someone who has a cough. It is covid 19, the flu, a cold, allergies, asthma, a smoker, heartburn, congestive heart failure? Who knows? How about someone who has a fever? So many possibilities! So we are screening people over the phone before they come in. Then we are screening them at the front desk and taking their temperature, and asking if they have been exposed to covid or a person under investigation. Then if they pass they can go into a room and we can see them.
What if they have a cough/fever at the front desk? We send the patient home and then talk to them on the phone (and have to figure out: should them be tested for covid? Should they be quarantined? What about keeping them out of work? What about medically treating them for whatever they do have but without being able to examine them?)but now has the front desk staff been exposed? Do they need to be quarantined for 7 to 14 days? Now the front staff is worried about exposing their family to covid. We didn’t even have masks for the front staff until yesterday although now we do.
So let’s say the patient passed screening and the provider is in the room with them. What if they were not honest with the front staff and now say they have a cough? Or they honestly didn’t think about it and now they remember? Now has the provider been exposed and needs to be quarantined for 7 to 14 days, and now can’t work with patients for that time? And the exam room needs to be decontaminated for a few hours. The medical director said that we should be wearing masks for all patients with a cough, but again we didn’t have enough masks until yesterday.
And now the kids. Kids come down with sudden fever and cough all the time, something we routinely see every week in normal circumstances, but now the parent is nervous about Covid? Go back to step one and apply to kids, the same treatment problems, with the added dimension of a freaked out parent, who isn't or can't be clear about the kid's symptoms.
And all these questions come up in various permutations about 50 times a day. And I haven’t even gotten into the decision whether they need/ can be tested...
So actually I think it’s easier to treat covid patients. You KNOW the situation - you have to wear personal protective equipment with them. With the general population who knows?
Yeah. And there are no right answers to a lot of these questions and the guidelines can change every day.
And still taking care of all the regular medical problems but trying to do much of it over the phone which has its challenges.
Sometimes crisis bring out the best in people and sometimes it brings out the worst. Patients are generally lovely as I said before but I had one complain that she had to wait 20 minutes to see me. Really?!"
