That is a good news! That means things are improving, right?
Are Dr.s not on a contract? Mine is still in Residency so never thought about that.
Around here, it has nothing to do with COVID infection rate. Theyāre laying off the docs and nurses that treat all the things that are on hold due to COVID. Right now, pretty much the only thing being treated are true emergencies and COVID, nothing else.
My system is sending physicians and nurses to NY Presbyterian. We are still preparing for if not a surge, then a wave. We still donāt have enough tests.
I have several family members that work in different hospitals. One is a DO and is the only person on staff that is certified in doing ventilators at the small community hospital.
Another is a hospital pharmacist and is working 2 weeks on and 2 weeks off to save PPE and to be able to self quarantine for 14 days on a monthly basis.
And a third is finishing up their first year of residency, they are also doing 2 weeks on and 2 weeks off at a different hospital. I donāt quite understand what that will do for the residency requirements. No extra hours are being worked during the 2 weeks on.
Acuity is highā¦that means that the folks coming to the ED are quite sick. Itās the ones that arenāt so sick who are staying away.
Iām not sure this is totally good news.
There are reports of folks not seeking ED care when they really should be (thinkā¦feeling like you are having a heart attackā¦).
Just to be clear hear, the translation of this into laymanās language is, Not many people are showing up at the emergency room, but the ones who show up are very sick, is that right?
In my area Iām seeing a flattening of the curve, but new cases and ICU admissions have been steady for a couple weeks nowā¦ This is good: we donāt have an explosion of cases and deaths. But it is also bad: even with strict stay-at-home, we have not made the number of new cases each day go down. It keeps staying about the same, every day.
Right now I donāt see any room for error, or any room for relaxing. And now weāre seeing outbreaks in elder care facilities, which is awful.
Reduction of business in emergency rooms may be due to reduction in other reasons that people go to the emergency room:
- Car crashes.
- Violent crime (e.g. drunken bar fights).
- Workplace injuries.
Also, some people who would have otherwise gone to the emergency room may be afraid to for all but the most serious situations, due to fear of COVID-19. For example, headaches are a very common reason people go to the emergency room, but COVID-19 may deter people with headaches from doing so.
Compared to a few weeks ago when they were advertising for more docs, it is good news they are firing not needing however that may come about. Only a few weeks ago, states were waiving license requirement, etc to hire more HCWs. Now they are reducing it. Howās not represent improvement? As I said in the other thread, a county near me is now opening up their parks. Fingers crossed. It goes well.
@CottonTales Seattle area docs are paid mostly based on their billing with a complex schedule that includes number of patients, billing $, local and overall profitability. My wife, a primary care NP, was on the schedule for one of her jobs. I hated the math. Sometimes she would go in, work 8 hours, and end up owing the hospital money. It tended to work out over the long term.
On the good news front, a recent 48 hour shift for a Kirkland firefighter we know had only 1 Covid call, and the suspicion is it wasnāt really Covid at all. Infection rate has purportedly been dropping for more than a week though it is hidden behind more agressive testing.
This just came out, maybe there will be light at the end of tunnel soon.
https://www.cnbc.com/2020/04/16/sp-500-etf-jumps-2percent-after-hours-on-report-gilead-drug-showing-effectiveness-treating-coronavirus.html?__source=iosappshare%7Ccom.apple.UIKit.activity.Message
RE: waiving state licenses for HCWāit turned out that that didnāt exactly work as envisioned. CA said it would waive the requirements for OOS and foreign doctors, but in actuality, that plan didnāt work because of federal Medicare and Medicaid requirements. Unless a physician holds license for the state in which they are working, they are prohibit from both prescribing medications/tests and from admitting patients to hospitals under Medicare and Medicaid rulesāwhich make them essentially useless.
So states may have announced they were trying to hire OOS HCWs, but in practice they couldnāt.
And itās not good news that hospitals are furloughing and laying off staff. It means that hospital finances are crashing and they canāt afford to pay radiologists or janitors or occupational therapists or out-patient primary care docs. Most hospitals-even major academic centers which typically have deep pocketsāare hemorrhaging money. Smaller, rural hospitals are already going bankrupt. Beckers estimates that as many 425 smaller, more rural hospitals will go out of business before the end of the year.
BTW, as mentioned above the some of the reasons why the amount of ER traffic is down is worrisome. D1 reports sheās getting 3-4 DOA cardiac arrests every single day in her ER. That means people who might have otherwise survived a heart attack died because people are afraid to come to the hospital.
Hās hospital has said that they are guaranteeing salaries through July. After that, who knows? Iām hoping there will at least be a lull in the virus so that people can go in for regular screening and diagnostic care. I know I want to go for things that Iāve postponed.
Heās been working from home and said itās really slow. He works at night and mainly sees chest x-rays with the occasional accidental bone break or something similar. He can understand how people with back pain are avoiding the ER but no one can understand where all the strokes have gone to.
They couldnāt before, now they neednāt. Thatās an improvement. Howās that not a good news? Whatās wrong with having good news? We were homebound for a month. Is it surprising that it is getting better? Itās been so depressing hearing never ending doom and groom. Iād hold onto every bit of good news.
"And itās not good news that hospitals are furloughing and laying off staff. It means that hospital finances are crashing and they canāt afford to pay radiologists or janitors or occupational therapists or out-patient primary care docs. Most hospitals-even major academic centers which typically have deep pocketsāare hemorrhaging money. Smaller, rural hospitals are already going bankrupt. "
This is correct. At least correct in our area and in the health systems I work for/with. Health systems donāt just have hospitals - they have primary care offices in multitudes that are losing $$ left and right for visits not being made, visits being postponed, etc. Top that off with the fact that all tele health visits are not currently billable (at least in our state) and you have one $$$$ mess.
The MDs I know who are not seeing patients and are employed by the hospital are expecting their paychecks to go way down with so few cases. Many are doing very little telemedicine and just in a holding pattern like everyone else.
Fire departments in some areas are reporting a much higher rate of cardiac arrest medical calls, with a higher percentage of them unrevivable.
Some of the MDs I know are looking forward to receiving their $2400 stimulus funds. My dentist is paying insurance premiums for all her staff but canāt pay anyone wages as they are only handling emergencies right now. She applied for both loans but when I spoke with her she had no idea if sheād get anything.
DH is reporting and hearing from other docs that even as their sickest patients get well enough to go home, many seem to have some cognitive impairment. They are unusually fuzzy and out of it. Brain scans do not show anything obvious.
Fingers crossed this is temporary.
Better news:
- DH says they are figuring out that the hypercoagulability (clots in blood vessels) they are seeing has different origins depending on the patient, and thus needs to be treated with different drugs. The right drug at the right time prevents further problems. One more step towards effective treatment.
- No one is dying for lack of resources at any of the hospitals where DH works, which is very good news considering we are in metro NYC. This is also the first week since the epidemic started that the hospitals have a little extra capacity.
- Shortages in the paralytic drugs they use for patients on ventilators have eased, partly because supply is back and partly because they are keeping more patients off vents.
- Doctors are talking to each other more than DH has ever experienced in his 30 years of medicine, across departments and across hospitals.
We are planning to make rainbow art for our windows this weekend because weāve noticed them around our neighborhood, and they do cheer us up. Also thinking of doing chalk drawings on the sidewalk in front of houses of friends who are healthcare workers (while they are at work).
Best wishes going out to all.
@3SailAway, thanks so much for the information. When do you think the paper you helped pull together will be published and become common knowledge in the medical community? Those on the front end of this disaster clearly have invaluable information to offer.