Message from our WCMS Foundation Chair, Carol Coulson, MD

March 23, 2020

Dear WCMS members,

My introductory letter as chair of the WCMS Foundation Board will not strike the timbre I intended when I first thought about topics of interest to our members and municipal partners. This message often centers on advocacy for our under- and un-insured patients. In the face of the current viral pandemic, I would like to expand that focus today to include us and our support staff.

Only 2 months ago or so, Corona referred to a cold beverage best served with a wedge of lime. Now even my smart phone knows that corona should be followed by the word virus. In contrast to many of the patients we serve, we are well-informed and well-resourced. We can access and understand the information on reputable websites (CDC COVID-19 Information for healthcare Professionals, NC DPH Coronavirus Disease 2019, Mission and Me/COVID-19).  So it seems part of our responsibility right now is to keep ourselves and our staff well enough to treat others who are infected or will still need urgent or emergent care for other conditions during the pandemic.

Here are some very practical measures that I suspect may of you have already implemented in your offices:

  1. Screen all patients on arrival and triage those with possible exposure or disease to appropriate resources
  2. Let the “new” waiting room be the patient’s vehicle
  3. Restrict visitors accompanying patients to none if possible. Others can join by phone from the parking lot
  4. Defer any routine medical care, such as annual wellness exams, indefinitely
  5. Perform medication,  behavioral health, and other rechecks by phone if possible
  6. STAY HOME IF YOU DO NOT FEEL WELL- this means providers too!
  7. Allow and encourage employees to work remotely when able
  8. Do as much as you can in a single visit and in the same exam room (labs, imaging, therapy, etc)
  9. Hold all office meetings by webex or other remote platform
  10. Allow office staff at high risk, such as those over age 60, to stay home, use accrued paid time off, or have leave without pay if necessary
  11. Close all staff common areas such as break and lunch rooms
  12. Engage (at a safe social distance!) with other providers in your area of expertise to see how you might cover hospital and call obligations creatively to limit exposure (devise 2 teams and rotate them every 2 weeks so some are healthy at all times hopefully)
  13. Leverage changing guidelines for telehealth coding and billing( including video and phone visits) since many insurers have liberalized reimbursement policies

This pandemic continues to be a huge disruptor for our lives, our practices, and our community. It promises to change the delivery of healthcare globally and for the foreseeable future. Now more than ever, we must foster professional and personal relationships, use our knowledge to promote safety and wellness, and fight to contain this latest contagion.

With gratitude for all you do,

Carol Coulson, MD