After putting my five-year-old daughter to bed tonight, I proceeded to my garage to fill a bucket with diluted bleach and sanitize my respirator, again. This is my new normal.
My practice has morphed into providing almost exclusively emergency care. I am a frontline worker. I am regularly caring for high-risk patients in high-risk scenarios. When I operate now, it is through the lens of a respirator, under the cover of a full hood, while wearing protective lead. It is hot. It is hard to breathe. It is hard to see. It is extremely uncomfortable and physically exhausting. It is, however, essential.
I, like many of my colleagues, leave my wife and two young children at home, while willingly walking into the lion’s den. My hospital has had 25 patient deaths to date and has had at least three infected health care workers. Two of five surgeons in my group, myself included, have already been required to self-isolate for two weeks. During my two weeks of self-isolation I spent thousands of dollars procuring personal protective equipment, including elastomeric respirators, face shields and hoods, fearing that the inevitable shortage of hospital supply would leave me vulnerable while still feeling an obligation to provide this essential care.
My only source of income at this time is providing on-call musculoskeletal service. The overall volumes have declined substantially, while the time frames required to provide both clinical care and surgical care have expanded exponentially. Personal risk has increased immensely.
I am struggling to cover my overhead in this current situation. My office is now physically closed and I may need to lay off my office assistant. This translates into significantly compromised care for patients.
Office assistants act as liaisons between patients and health care providers. They inform and advise patients, where appropriate, guiding them through our often complex health care system. Without access to our offices, patients will be effectively left abandoned.
Access to care would default to emergency departments and with this, much of our investment in painstaking public health measures is lost. The alternative is that patients will neglect their health concerns, which are unfortunately, at times, serious in nature.
Our offices must continue to address new patient referrals, ignoring them will only compound the foreseeable disruptions in clinical care when distancing measures are lifted.
Further, virtual assessments would not be feasible without the assistance of office administration staff.
It seems unconscionable that financial stress should be an added part to physicians' daily equation. This is an equation which already includes tremendous risk and potential sacrifice.
Dr. Nathan Sacevich
Niagara Health System