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Progress Notes features doctors and medical students across the country on the frontlines of our health care system. Our views and experiences are diverse, but we share common goals and values. We speak up to move toward a future where everyone can have access to affordable, high-quality health care. Please share our posts, and follow us on Facebook and Twitter!


Weekly Rounds 4-5-20


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Please sign on to our letter calling for public health safeguards and protection of health workers.  We currently have just over 2,400 signatures - our goal is 3,200. It only takes 30 seconds to add your name to ensure that our health workers will continue to be healthy and available to take care of our patients and communities:   

FULL TEXT & SIGN HERE >>

If you've already signed, thank you, and please share the above link with friends and colleagues.

We remain so proud and thankful for the work you are doing.

DOCTORS FOR AMERICA SPEAKING OUT & GETTING PUBLISHED: 

DFA’s Drs. Vivek Murthy & Alice Chen: An Open Letter to Our Brothers and Sisters in Medicine - ... Thank you for choosing to be a healer. We are so proud of you. We are so grateful for you. And we, along with so many others worldwide, are praying for you, for your health, safety, and strength in the long days ahead. (Drs. Vivek Murthy & Alice Chen, Medium)

DFA's Dr. Elinore Kaufman: Please, Stop Shooting. We Need the Beds. - Firearm injuries are calamitous for the more than 120,000 people shot each year in the United States and their families. But the consequences for our health system are even more dire as we fight the coronavirus. (Dr. Elinore Kaufman - fellow in surgical critical care and trauma surgery at the University of Pennsylvania, New York Times)

DFA’s Drs. Goel & Goldstein: A Plea from NYC Physicians: Our Window of Opportunity Is Closing to Avoid Italy's Fate - We are two New York City physicians and public health advocates and are pleading with our municipal, state and federal leaders to take drastic public health measures to save lives. The house is on fire, and this is the alarm bell. … Now is not a time for partisan politics. (Dr. Akash Goel and Dr. Andrew Goldstein, The Hill)

DFA’s Dr. Patricia Kellner: Now It’s Your Turn to Save Lives: Patricia Kellner - I’m a retired family doctor and I know I saved lives and added years to many others. Now it’s your turn to save lives. The lives you save may be your own, your family’s, your friend’s, your doctor’s, their staff, first responders – and all of their families. How can you save lives? Shelter in place. (Dr. Patricia Kellner, a retired family doctor, was voted a “best doctor” in Cleveland Magazine for 20 years in a row., Cleveland Plain Dealer)

DFA Drs. Morris, Fischer & Fei: End Immigration Detention to Save Lives - The best way to dramatically reduce health risks for people currently navigating the U.S. immigration and asylum systems, including the risk of COVID-19, is to get people out of detention. (Shangnon Fei, Briah Fischer and Juliana E. Morris, The Bakersfield Californian)

DFA Dr. Cedric Dark: An ER Doctor Describes What It's Like to Treat Covid-19 - The novel coronavirus is hitting emergency rooms in the US—hard. Cedric Dark, a physician at the Baylor College of Medicine, recounts the struggle. - (Cedric Dark, MD, MPH, FACEP., WIRED)

DFA Dr. Cedric Dark: Congress Should Not Spring Legislation on Surprise Medical Bills While Doctors Fight Coronavirus Back in December, emergency physicians felt like we were fighting for our lives against potentially disastrous attacks from misinformed Washington D.C. think tanks and their insurance industry allies over the contentious issue of surprise billing. (Cedric Dark, MD, MPH, FACEP. Houston Chronicle)

DFA Mentioned: Over 900 Florida Healthcare Workers Sign Petition Asking Governor to Order People to Shelter in Place Amid Covid-19 - Meanwhile, another petition, created by Doctors for America and signed by over 500 Florida healthcare workers, asked DeSantis to "issue a stay-at-home order immediately to fight the COVID-19 pandemic."

REMINDER: If you get an opinion piece or letter to the editor published PLEASE send me (Pete Van Vranken - pete@drsforamerica.org ) an email with a link to your piece and I will include it in the next edition of the Physician Rounds.  - Pete

THE WEEK IN QUOTES:

WE NEED A NATIONAL RESPONSE: “We need a national stay at home order. Needed it weeks ago. It remains the most powerful tool we have at this moment to reduce the spread of #covid19. The reluctance to call for such a policy represents a critical failure of federal leadership that will cost lives”  - Vivek Murthy, Former Surgeon General of the United States, Founder Doctors for America

BILL GATES: “We need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. ... The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. - Bill Gates - Co-Founder Microsoft and a Co-Chair of the Bill & Melinda Gates Foundation

WORLD WIDE RESPONSE: COVID-19 is the greatest test that we have faced together since the formation of the United Nations, This human crisis demands coordinated, decisive, inclusive and innovative policy action from the world’s leading economies – and maximum financial and technical support for the poorest and most vulnerable people and countries.” - United Nations Secretary-General António Guterres

BOLSTER MEDICAID: “There is no moment in recent memory more critical than now to bolster Medicaid. Covering more people in Medicaid is a rapid way to bring needed resources into the health care system and infuse federal dollars into state economies on the verge of a major downturn. Medicaid expansion also requires no new infrastructure or federal oversight to achieve, unlike many other types of stimulus spending. Medicaid remains highly popular with voters from both parties. And most important, expanding Medicaid can save lives.”  - Jonathan Gruber, Ph.D., and Benjamin D. Sommers, M.D., Ph.D., New England Journal of Medicine

THE DARKEST MONTH: April is going to be very hard. But public health officials are in agreement that hunkering down — in our own homes — and weathering one of the darkest months in American history is the only way to prevent millions of American deaths. …. we've never all had such an important role to play, as individuals, in mitigating a national crisis: staying home, and stopping the spread. ” - Caitlin Owens, Axios 

OUR HEALTHCARE SYSTEM IS IN SURVIVAL MODE: Last night in the ICU of a #NYC hospital, I cared for 20 patients who were all on breathing machines due to #COVID19. Some REALLY young (20s), without comorbidities. Everyone is extremely sick. But sicker patients keep flooding in…We are REALLY feeling the strain. We don’t have enough ICU beds. Many patients are being intubated as soon as they show up to the Emergency Room. We are doing our best to take care of them on regular floor beds and in the ER itself. But it is HARD… Some of our sickest patients with #COVID19 really need dialysis, but we don’t have enough machines. We are actively rationing care - something I thought I would never see in our healthcare system… It is heartbreaking to have end-of-life discussions w/ family members. No part of me was prepared to convey that a family member can’t say goodbye. That their love one would have to be alone during their final moments. I cannot imagine how they feel...how painful it is... Hospital staff are exhausted & honestly - scared. Our healthcare system is in survival mode...But I have never been prouder to be a physician in #NewYorkCity. My incredible colleagues - everyone - is rising to the occasion. We are doing our best. We will get through this together.” - Prakriti Gaba - Internal Medicine Resident in #NYC 

MEDIA COVERAGE: 

COVID-19:

Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients With Coronavirus Disease - Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions. (CDC COVID-19 Response Team)

Essential Drug Supplies for Virus Patients Are Running Low - Medicines to alleviate breathing difficulty, relieve pain and sedate coronavirus patients are in very high demand, depleting stock around the country. (Knvul Sheikh, New York Times)

Infected but Feeling Fine: The Unwitting Coronavirus Spreaders - As many as 25 percent of people infected with the new coronavirus may not show symptoms, the director of the Centers for Disease Control and Prevention warns — a startlingly high number that complicates efforts to predict the pandemic’s course and strategies to mitigate its spread. In particular, the high level of symptom-free cases is leading the C.D.C. to consider broadening its guidelines on who should wear masks. (Apoorva Mandavilli, New York Times)

Covid-19 Changed How the World Does Science, Together - While political leaders have locked their borders, scientists have been shattering theirs, creating a global collaboration unlike any in history. Never before, researchers say, have so many experts in so many countries focused simultaneously on a single topic and with such urgency. (Matt Apuzzo and David D. Kirkpatrick, New York Times)

PERSONAL PROTECTIVE EQUIPMENT:

Inside America’s Mask Crunch: a Slow Government Reaction and an Industry Wary of Liability - The confluence of a slow initial response by the Trump administration, its wariness of compelling the industry to produce gear and a long-running debate about granting manufacturers legal protection in a health emergency contributed to a critical shortage of masks to front-line workers. (Jeanne Whalen, Rosalind S. Helderman and Tom Hamburger, Washington Post)

Trump Blames Hospitals for Mask and Ventilator Shortages - Trump’s boldest claim was about masks. He noted that current demand wasn’t commensurate with what hospitals typically use and suggested that masks were “going out the back door.” (Aaron Blake, Washington Post)

COVID-19 TESTING:

Piecemeal Testing Flusters Officials Tracking Coronavirus Pandemic - The surge in coronavirus testing was supposed to give public health officials a better grip on who’s sick and where. Instead, it’s exposing gaps in reporting, raising concern about whether complete results and basic information about patients that test positive is getting through to officials and health workers trying to contain the pandemic. (Darius Tahir, Politico)

The Scramble for the Rapid Coronavirus Tests Everybody Wants - As Abbott Laboratories began shipping its new rapid-response tests across the country Wednesday, a new flash point emerged in the nation’s handling of the pandemic: where to deploy the covid-19 diagnostics that could be one of the most effective tools in combating the outbreak. (Steven Mufson, Juliet Eilperin and Josh Dawsey, Washington Post)

Testing Coronavirus Survivors’ Blood Could Help Reopen U.S. - The theory is that such testing could be used to divide the world into people who’ve had it and aren’t at risk anymore — and those who are. Health-care workers with immunity could return to the front lines.. (Carolyn Y. Johnson, Washington Post)

HEALTH SYSTEM RESPONSE:

As Coronavirus Patients Surge, Medical Students Rushed Into Practice to Fight Pandemic - Despite the willingness of medical students to join responders on the front lines, the critical shortage of personal protective equipment to safeguard them from infection has frustrated that process. (Kelly Cannon, ABC News)

The COVID-19 Crisis Too Few Are Talking About: Health Care Workers’ Mental Health - In the midst of this global pandemic, people are talking about the urgent and critical need for personal protective equipment. They are sharing concerns about the impending lack of respirators and the need for testing. And they are encouraging people to #flattenthecurve through social distancing. But no one is talking about a potential mental health crisis facing health care workers on the frontlines of this pandemic. (Jessica Gold, STAT)

TRUMP ADMINISTRATION RESPONSE: 

Commander of Confusion: Trump Sows Uncertainty and Seeks to Cast Blame in Coronavirus Crisis - In the three weeks since declaring the novel coronavirus outbreak a national emergency, President Trump has delivered a dizzying array of rhetorical contortions, sowed confusion and repeatedly sought to cast blame on others. (Philip Rucker and Robert Costa, Washington Post)

Trump Set to Urge Americans to Wear Face Coverings When Outside - President Donald Trump is preparing to encourage Americans to wear face coverings, the latest effort to curb the spread of the coronavirus, according to three individuals with knowledge of the planned announcement. (Dan Diamond, Politico)

Days After Ventilator DPA Order, White House Has Done Little to Push General Motors - President Donald Trump invoked sweeping war powers last week to demand that General Motors start producing ventilators, but so far his administration has done little to enforce the order. (Gavin Bade and Megan Cassella, Politico)

Trump Ban on Fetal Tissue Research Blocks Coronavirus Treatment Effort - A senior scientist at a government biomedical research laboratory has been thwarted in his efforts to conduct experiments on possible treatments for the new coronavirus because of the Trump administration’s restrictions on research with human fetal tissue. (Amy Goldstein, Washington Post)

AFFORDABLE CARE ACT AND COVERAGE ISSUES:

Trump Rejects ObamaCare Special Enrollment Period Amid Pandemic - The Trump administration has decided against reopening Obamacare enrollment to uninsured Americans during the coronavirus pandemic, defying calls from health insurers and Democrats to create a special sign-up window amid the health crisis. .. The Trump administration oversees enrollment for about two-thirds of states. (Susannah Luthi, Politico)

Trump Hints at Using Federal Programs to Provide Coverage After ObamaCare Decision - President Donald Trump said he is considering using federal programs like Medicare and Medicaid to cover the rising ranks of the uninsured after his administration decided it would not reopen the Obamacare insurance markets to address the coronavirus crisis. (Susannah Luthi, Politico)

Affordable Care Act Sign-Ups Total 11.4 Million for This Year - ACA sign-ups steady for third straight year despite efforts by the Trump administration to roll back the Obama-era health law - About 11.4 million consumers signed up for health coverage on the Affordable Care Act’s exchanges in the 50 states and Washington, D.C., this year, according to data released Wednesday by the Trump administration, marking the third straight year sign-ups have remained steady. (Stephanie Armour, Wall Street Journal)

MEDICAID:

Medicaid Nearing ‘Eye Of The Storm’ As Newly Unemployed Look For Coverage - As the coronavirus roils the economy and throws millions of Americans out of work, Medicaid is emerging as a default insurance plan for many of the newly unemployed. That could produce unprecedented strains on the vital health insurance program, according to state officials and policy researchers. (Shefali Luthra and Phil Galewitz and Rachel Bluth, Kaiser Health News)

Medicare and Medicaid Patients Get Temporary Access to Telemedicine Amid Coronavirus Crisis, but Challenges Remain - President Donald Trump’s administration took the unprecedented step on Monday to temporarily waive rules for the nation's largest insurer -- Centers for Medicare & Medicaid Services (CMS) -- giving some healthcare providers the ability to have phone-only visits with their patients as the coronavirus crisis rages on. CMS covers at least 140 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program, and Federal Exchange. (Lauren Lantry, ABC News)

DRUG AFFORDABILITY:

Lawmakers’ Coronavirus Response Means Delays for Drug Pricing Legislation - Before the coronavirus pandemic became Congress’ sole focus, late May was widely viewed as a final 2020 deadline for lawmakers to take action on key health policy issues, including legislation to lower the price of prescription drugs. But with the Covid-19 crisis dominating every aspect of American politics, such legislation will have to wait. (Lev Facher, STAT)

 

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Enact Public Health Safeguards and Provide Support and Protection for Health Workers during the Coronavirus Outbreak


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Doctors for America Statement and Sign-on Letter Addressed to National, State, & Local Government Officials and Health System Leaders:

SIGN THE PETITION HERE: https://actionnetwork.org/petitions/enact-public-health-safeguards-and-provide-support-and-protection-for-health-workers-during-the-coronavirus-outbreak

The US is experiencing a national emergency due to the coronavirus outbreak that threatens not only the health of all Americans but our entire health care system. Outbreaks in China, Italy, Iran, Spain, and now New York have demonstrated the serious risk, where the pandemic has overwhelmed systems already stretched to the breaking point. Meanwhile, physicians, nurses, and other health workers and first responders who are on the front lines of saving lives both here and abroad are in one of the highest risk groups for contracting COVID-19 as a result.

When 1) our federal elected officials do not communicate a message consistent with scientific and medical realities, 2) our strategic stockpiles are not effectively accessed, and 3) public health recommendations for social distancing and shelter-in-place are not reinforced, then hospitals and health systems are stretched beyond their capacities and all people are threatened.

And when front-line doctors, nurses, and other health workers risk becoming patients themselves, the work of keeping the healthy from becoming sick, sick patients from becoming sicker, and the sickest patients from dying becomes even more difficult. The combined effects are disastrous to the personal and financial health of our patients, communities, and the nation.

We cannot combat COVID-19 without limiting the number of people who get sick in the first place. We also cannot combat COVID-19 without protecting health workers and supporting them so they can continue providing patient care, including through ensuring access to protective gear, providing support services such as childcare and mental health services, enacting protections such as work hour limitations and paid sick leave, and giving priority in confirmatory testing.

We call on federal, state, & local government officials and health systems to:

  1. Enact shelter-in-place nationwide through federal and/or state-level action.

We have already missed critical windows for action, but future scenarios of disease spread, illness, death, health system stress, and societal trauma can still be mitigated if our leaders enact public health measures now. An effective response to this unprecedented pandemic cannot occur without enacting stringent public health mandates now to reduce the number of patients needing care. Voluntary social distancing guidance is inadequate, and lockdowns reacting to disease flare-ups are not effective. A nationwide shelter-in-place order, maintained as long as is necessary to control the outbreak, identify and treat patients who need care, and protect the public’s health, is the best way to limit the number of people who are infected.

Thus, shelter-in-place should be implemented nationwide through federal and/or state-level action, and resources must be freed to pursue contact tracing and local containment once hotspots are identified. These shelter-in-place mandates should be sensitive to legitimate concerns regarding financial stressors, address basic needs of the communities affected, and avoid enforcement measures that would promote over-policing.

2. Ensure access to Personal Protective Equipment (PPE) & clear protocols on PPE use.

As an organization advocating for the health of our patients and communities, empowering physicians and other health professionals to be effective health advocates, Doctors for America (DFA) is also concerned about the health and safety of all health workers involved in managing the COVID-19 pandemic. Our teams include everyone — physicians, nurses, students, technicians, volunteers, environmental and food services workers, and more — working in hospitals, emergency rooms, outpatient clinics, nursing homes, long-term care and community-health centers, correctional facilities, and other locations. Many health workers in the US continue to have inadequate access to appropriate PPE (masks, respirators, gowns, gloves, face shields, and more).

We must protect and support health workers through the COVID-19 outbreak, and beyond, to ensure that patients have people to care for them. The US government must more effectively access and disperse National Strategic Stockpile supplies and contract with manufacturing directly via the Defense Protection Act to ensure that all workers are able to use PPE. Importantly, the US should not at this time of crisis loosen hospital safety rules and protections for essential health workers, forcing health workers to provide or feel pressure to provide care without adequately protecting and caring for themselves.

3. Ensure that our health workers will continue to be healthy and available to take care of our patients and communities.

In addition to immediate infection control through public health action and health care workforce protection, we call for measures to:

  • Set minimum standards for health worker shift length, rest, and whistleblower protections, including alternative sleeping quarters for those who may need to isolate themselves (to protect their families) and a health worker safety hotline to report unsafe conditions.
  • Make paid sick leave available to all health workers regardless of employment status.
  • Prioritize health worker access to COVID-19 testing and treatment to keep health care workers providing care to those who need it.
  • Provide safe child care options for health workers who may need them.
  • Provide freely-accessible, consequence-free mental health services to health workers.
  • Ensure that medical licensing and liability regulations are relaxed to allow health workers to provide care for patients wherever those patients might need them.
  • Ensure that health workers-in-training — residents, fellows, medical & nursing students, and volunteers — receive protections similar to those of other health workers, especially from exploitative working conditions.

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Doctors for America asks our physician and medical trainee colleagues, those in other health professions, organizations advocating for patients and communities, and our public health and science communities to join in our call for public health safeguards and protection of health workers.

Join our efforts to respond effectively to COVID-19 by signing on to this letter.

Signed,

Ranit Mishori, MD, MHS
Kate Tulenko, MD, MPH, MPhil, FAAP
Co-Authors, DFA Members

Justin Lowenthal, MD-PhD Candidate
Jeff Huebner, MD, FAAFP
Evan T. Saulino, MD, PhD
Co-Authors, DFA National Board of Directors

Dona Murphey, MD, PhD
Farheen Qurashi, MD
Julie Parsonnet, MD
Joe Kanter, MD, MPH
Christine Petrin, MPH, MD Candidate (recently matched!)
May Nguyen, MD, MPH, FAAFP
Cedric Dark, MD, MPH
Meenakshi Bewtra, MD, MPH, PhD
Meghana Rao, MD
Krishnan Narasimhan, MD
DFA National Board of Directors

View Our Member's Signatures

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In addition to the above and below organizations and individuals signing on to this letter, we would also like to highlight overlapping sign-on letters and petitions from our colleagues, listed below, and the number of signatures they have accumulated, to fully depict the support for these issues:

Doctors for America: Open Letter to Florida Leaders

449 signatures (as of 3/26/20 at 11:06AM)

Healthcare workers in Florida: Open letter to Florida Governor

713 signatures (as of 3/26/20 at 11:06 AM ET)

Committee to Protect Medicare: COVID-19 Letter to the Trump Administration & CDC

3,585 signatures (as of 3/26/20 10:25 AM ET)

Informal group of health providers nationwide: Open letter (& Sign-on Link) on Shelter-in-Place

5,000+ signatures (as of 3/25/20)

Massachusetts physicians: Letter (reported by WBUR) to Massachusetts Governor

1,000+ signatures (from report)

Tennessee health providers and TMA: Letter & Petition to Tennessee Governor

21,555 signatures (as of 3/26/20 at 11:06AM)

Petition: US Physicians/Healthcare Workers For Personal Protective Equipment in COVID-19 Pandemic

1,298,612 signatures (as of 3/26/20 at 11:21 AM)

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The undersigned organizations and individuals have signed on to endorse this letter.

Organizations:

Individuals: View Signatures

 

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Tell your story on social media today


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SHARE YOUR EXPERIENCE AND THOUGHTS AS A DOCTOR ON THE FRONTLINES: As the COVID-19 pandemic unfolds there just is not enough reliable information. It is critical that the public and policymakers understand the REAL story of what is going on from a frontline caregiver perspective across our nation as this crisis evolves!!

Please share with the DFA community and the world your stories from the frontlines of the US COVID-19 epidemic.

Share your feelings, a thought, or concerns. Post a video. Let the world know how you’re doing and what you and your patients need!

What do you and your patients need to identify infection and treat that you don’t have? (PPEs? Ventilators? what else?)

How easy or hard is it to get patients tested?

What do you think the public and policymakers should be doing to help beat back this epidemic?

What did you do to prevent getting sick yourself? How did you feel when your colleague got sick?

Did you have a 100 - hour week – and if so what kept you going?

What actions or simple “healing” acts of kindness did you experience and witness?

Tell your story – OUR story - via social media:

Twitter: Tweet at us @DrsforAmerica or tag us in your tweets so we can “hear” you – and use the hashtag #COVID19Frontlines (and #HealingAmerica #DFAdocs if room) to amplify your voice.

Facebook: Tag us https://www.facebook.com/DoctorsforAmerica/

Instagram: Tag us @DrsforAmerica so we can “hear” you – and use the hashtag #COVID19Frontlines, #HealingAmerica and #DFAdocs to amplify your voice.

DFA will “retweet”, "like", and repost your important experiences – AND can also direct your information to policymakers.

Please also consider tagging, tweeting at, etc. key policymakers who should listen to doctors on the frontlines of this crisis: @realDonaldTrump , @your Governor, @your two Senators

Thank you for the critical work you are doing now.

 

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Weekly Rounds 3-29-20


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Please join our efforts to respond effectively to COVID-19 by signing on to our letter calling for public health safeguards and protection of health workers.

In the letter we call on federal, state, & local government officials and health systems to:

  1. Enact Shelter-in-Place Nationwide Through Federal And/or State-level Action.

  2. Ensure access to Personal Protective Equipment (PPE) & Clear Protocols on PPE Use.

  3. Ensure That Our Health Workers Will Continue to Be Healthy and Available to Take Care of Our Patients and Communities.

Read the full text of the open letter and add your name >>

If you've already signed, thank you, and please share it with friends and colleagues.

We remain so proud and thankful for the awe-inspiring work you are doing.

THE MUST READS:

What It’s Like Being a New York ER Doctor During This Pandemic - (Washington Post)

ER Doctor in NYC says ‘Everything is Transformed’ as COVID-19 Grips Hospitals - (PBS NewHour)

Note: Both of the above stories are about Dr Craig Spencer’s experience as an ER Doc. in NYC. Because Dr. Spencer tells his very personal story he has helped Americans to better understand the scope, reality and intensity of this pandemic. WE NEED MORE OF THIS. Please, If you can, tell your story on social media and tag @DrsforAmerica and use the hashtag #COVID19USFrontlines, and #DFAdocs

How the Pandemic Will End - (The Atlantic)

THE WEEK IN QUOTES:

 

THE EPICENTER: We (The United States) are the new global epicenter of the disease,” - Dr. Sara Keller, Johns Hopkins Medicine

 

FRONTLINES: "We are scared. We are stressed. And we are worried about ... our ability to take care of our patients and our communities. As well as our ability to take care of ourselves." - Dr. Megan Ranney

 

STAY HOME: If someone told me if I would be able to save 40 lives if I stayed home, missed school, lost income & missed socializing  for 6-10 weeks, I would do it in a second. Everyone would. If it was 4 lives or 1– someone’s mom— we would.Andy Slavitt - @ASlavitt - Former Medicare, Medicaid, ACA head for Obama 

 

A MESSAGE FROM ITALIAN DOCTORS: "We are learning that hospitals might be the main COVID-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patient," Italian Doctors - New England Journal of Medicine

 

THE ORIGINAL SIN: “The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases. None of that happened.Ed Yong - The Atlantic  - A MUST READ ARTICLE

 

PATCHWORK: The Trump administration declined to issue a national shelter-in-place order. The resulting patchwork across the country left enough economic hubs closed to crash the economy, but enough places up and running to allow the virus to continue to spread rampantly.” - Caitlin Owens, Axios

 

THE TIMELINE: "You don't make the timeline, the virus makes the timeline." - Dr. Anthony Fauci

 

BILL GATES: We’re entering into a tough period that if we do it right we’ll only have to do it once, for six to 10 weeks. It has to be the whole country, we have to raise the level of testing and the prioritization of that testing quite dramatically in order to make sure we go through one shutdown … Having states go at different things or thinking you can do it county-by-county, that will not work. The cases will be exponentially growing anywhere you don’t have a serious shutdown,” ... Basically the whole country needs to do what was done in the part of China where they had these infections.” - Bill Gates - Founder of Microsoft Corporation

 

YOU’RE MISSING THE MAGNITUDE OF THE PROBLEM: You want a pat on the back for sending 400 ventilators? What are we going to do with 400 ventilators when we need 30,000 ventilators? You’re missing the magnitude of the problem, and the problem is defined by the magnitude.”- New York Governor Andrew Cuomo

 

MEDIA COVERAGE: 

 

COVID-19:

 

Assessing Underlying State Conditions and Ramp-Up Challenges for the COVID-19 Response - (The Commonwealth Fund)

 

PERSONAL PROTECTIVE EQUIPMENT: 

 

Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment During the Covid-19 Pandemic - (New England Journal of Medicine)

 

Scramble for Medical Equipment Descends Into Chaos as U.S. States and Hospitals Compete for Rare Supplies - (Washington Post)

 

Governments and Companies Race to Make Masks Vital to Virus Fight (New York Times)

 

The Next Coronavirus Crisis Will Be a Shortage of Doctors and Nurses - (Vox)



COVID-19 TESTING:

 

CDC Coronavirus Testing Decision Likely To Haunt Nation For Months To Come - (Kaiser Health News)

 

FDA Approves Plasma Treatment for Coronavirus on Conditional Basis - (Wall Street Journal)

 

U.S. Communities Struggle to Deal With Coronavirus Testing Backlogs - (Wall Street Journal)

 

New Coronavirus Test Returns Results in 45 Minutes, but it May Be Limited to Hospitals - (STAT)

 

HEALTH SYSTEM RESPONSE:

 

Project N95 The National COVID-19 Medical Equipment Clearinghouse - (Project N95)

 

US Hospitals Brace for Another Challenge — an Unprecedented Shortage of Nurses - (NBC News)

 

The Hardest Questions Doctors May Face: Who Will Be Saved? Who Won’t? - (New York Times)

 

Health Workers Fear U.S. Hospitals Will Become Coronavirus Hot Spots - (Politico

 

CAPITAL HILL RESPONSE: 

 

What Exactly Is in This Massive $2 Trillion Senate Coronavirus Bill? - (Washington Post)

 

COVID-19 Economic Stimulus Deal Passes Senate With Billions in Hospital Funding - (Modern Healthcare)



TRUMP ADMINISTRATION RESPONSE:


Trump Team Failed to Follow NSC’s Pandemic Playbook - (Politico)

 

Exclusive: U.S. Axed CDC Expert Job in China Months Before Virus Outbreak - (Reuters)

 

AFFORDABLE CARE ACT AND COVID-19:

 

Could ObamaCare Save Jobless Americans from Coronavirus? - (Politico)

 

ACA Coverage Could Swell in Response to Coronavirus, Testing Health Law - (Wall Street Journal)

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REACH OUT:  If you get an opinion piece or letter to the editor published PLEASE send me (Pete Van Vranken - pete@drsforamerica.org) an email with a link to your piece and I will include it in the next edition of the Physician Rounds.  Also please send me any feedback you may have on the “Rounds” - Much Appreciated  - Pete

 

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Biweekly Rounds 3-22-20


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DFA’S WEEKLY ACTION ITEM:

As the COVID-19 pandemic continues to unfold and impact so many of you deeply, we ask that you take a few minutes to share with the DFA community and the world your stories. Tell us your frontline experiences so that we can amplify them to educate the world about what you are facing in order to care for your patients. Team DFA is working on statements and developing actions to address the dramatic risks faced by you and your provider colleagues while working on the frontlines including the shortage of PPE, access to testing, mental health services, paid sick leave, access to rest areas, and so many other issues. There is further ongoing work dedicated to developing actions designed to assist our vulnerable patients across all of the issues DFA has held central to its work to ensure that health – and health care --  is accessible to everyone in our country, equitably and affordably.

Post a video - Tweet a few lines. Please tag @DrsforAmerica and

Use the hashtags #COVIDUS19Frontlines, and #DFAdocs

 

AN ALL-IN MOMENT FOR AMERICA:Hospital systems across the U.S. are struggling right now … We know that masks and gowns and visors to protect our eyes are especially important right now, particularly for our health care workers, I’m talking to folks in hospitals across the country -- doctors and nurses who are having to reuse masks. “We’re now seeing in Atlanta and more cities around the country that doctors are now getting sick with COVID-19 and it’s taking them out of the workforce at exactly the time when we need them.  .. This is hard, really hard for all of us," "But this is really an all-in moment for America. This is one of those moments where unless all of us are stepping up to do our part, we cannot keep each other safe. If we do so, I believe we can come out stronger than before." - Vivek H. Murthy - Former U.S. Surgeon General & Founder - Doctors For America

Lawmaker Requests Probe Into Government Failure to Deliver Coronavirus Tests

OUR LIVES DEPEND ON IT:It’s not a matter of “if” or “when” - It’s not a matter of politics or ideology.  We need a massive increase in personal protective equipment NOW Our patients, our healthcare system, and our lives depend on it.”  Matt Klein MD

NOT GOOD: “The bottom line: We're only at the beginning of our fight against the coronavirus, and our most important line of defense — health care workers — increasingly don't have the tools they need. That's not good.” - Caitlin Owens, Axios

PROTECTION:  “I just think this has been atrocious. On January 21 the first patient was diagnosed in the U.S. Now it’s two months later and we still don’t have these methods of protecting patients, doctors and care workers.” - Eric Topol, Cardiologist at Scripps Research

FLYING BLIND: "The testing capacity remains extraordinarily limited compared to where we should be. And in many ways we are absolutely flying blind at the moment," - Michael Mina, Epidemiologist at the Harvard T.H. Chan School of Public Health

NY ASKING FOR SOME HELP: “URGENT! New York State is calling on recently retired health care professionals to sign up to be part of a reserve staff if the need arises. We also need qualified medical and nursing school students & staff. Enlist today: http://health.ny.gov/assistance”  - Governor Andrew Cuomo (D-NY)

IBUPROFEN: "There’s no good scientific evidence that says ibuprofen can make coronavirus worse," - Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease

“WE’RE NOT A SHIPPING CLERK”:Governors are supposed to be doing a lot of this work, and they are doing a lot of this work,  The Federal government is not supposed to be out there buying vast amounts of items and then shipping. You know, we’re not a shipping clerk.” - The President of the United States of America

MEDIA COVERAGE:

COVID-19:

Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S. - New C.D.C. data shows that nearly 40 percent of patients sick enough to be hospitalized were age 20 to 54. But the risk of dying was significantly higher in older people - American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 of the first recorded cases in the United States. (Pam Belluck, New York Times)

Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State - In this case series, we describe the clinical presentation, characteristics, and outcomes of incident cases of COVID-19 admitted to the intensive care unit (ICU) at Evergreen Hospital to inform other clinicians treating critically ill patients with COVID-19. (Matt Arentz, Eric Yim, Lindy Klaff, Sharukh Lokhandwala, Francis X. Riedo, Maria Chong, Melissa Lee,  JAMA Network)

Before Virus Outbreak, a Cascade of Warnings Went Unheeded - The work done over the past five years, however, demonstrates that the government had considerable knowledge about the risks of a pandemic and accurately predicted the very types of problems Mr. Trump is now scrambling belatedly to address.. (David E. Sanger, Eric Lipton, Eileen Sullivan and Michael Crowley, New York Times)

The Coronavirus Is Killing Far More Men Than Women - Upward of 70 percent of deaths in Italy have been men. The question is: Why? (Chris Mooney,  Sarah Kaplan and  Min Joo Kim, Washington Post)

Understanding What Works: How Some Countries Are Beating Back the Coronavirus -Here’s a look at some of the techniques these governments employed, and how they stack up to steps being taken in the United States as well as the United Kingdom, which has come under heavy scrutiny for its approach, fairly or not. (Helen Branswell, STAT)

PERSONAL PROTECTION EQUIPMENT (P.P.E)

Doctors Using TV and Social Media to Sound the Alarm: 'We Need Masks Today' - Right now I want to hear less from politicians, and much more from doctors. Covid-19 hospitalizations are surging, as expected. ER doctors, nurses and health care experts are using traditional media and social media to sound alarms about supply shortages and other serious problems. "DOCTORS SOUND ALARM AS A NATION STRUGGLES" is the banner headline in Friday's NYT. (Brian Stelter, CNN Business)

Strategies for Optimizing the Supply of Facemasks - Purpose: This document offers a series of strategies or options to optimize supplies of facemasks in healthcare settings when there is limited supply. It does not address other aspects of pandemic planning; for those, healthcare facilities can refer to COVID-19 preparedness plans. (Centers for Disease Control & Prevention)

‘At War With No Ammo’: Doctors Say Shortage of Protective Gear Is Dire - With coronavirus cases soaring, doctors, nurses and other front-line medical workers across the United States are confronting a dire shortage of masks, surgical gowns and eye gear to protect them from the virus. (Andrew Jacobs, Matt Richtel and Mike Baker, New York Times)

Hospital Workers Battling Coronavirus Turn to Bandannas, Sports Goggles and Homemade Face Shields Amid Shortages - Just 11 weeks into a pandemic crisis expected to last months, the nightmare of medical equipment shortages is no longer theoretical. Health-care workers, already uneasy about their risk of infection amid reports of colleagues getting sick and new data showing even relatively young people may become seriously ill, are frustrated and fearful. “That has really freaked everybody out,” said Elissa Perkins, an emergency medicine physician at Boston Medical Center. (Ariana Eunjung Cha, Michael E. Miller, Christopher Rowland and Lena H. Sun, Washington Post)

Change in U.S. Law Will Make Millions More Masks Available to Doctors and Nurses, White House Says - Vice President Mike Pence said Thursday that new legislation will allow tens of millions more protective masks to reach U.S. healthcare workers each month, beginning immediately, but it was still unclear whether total production will be enough to meet demand. (Jeanne Whalen, Washington Post)

COVID-19 TESTING:

TOOL: COVID-19 Self Triage Tool - The USC Gehr Family Center for Health Systems Sciences & Innovation

Special Report: How Korea Trounced the U.S. in Race to Test People for Coronavirus - South Korea’s swift action stands in stark contrast to what has transpired in the United States. Seven weeks after the train station meeting, the Koreans have tested well over 290,000 people and identified over 8,000 infections. New cases are falling off: Ninety-three were reported Wednesday, down from a daily peak of 909 two weeks earlier. The United States, whose first case was detected the same day as South Korea’s, is not even close to meeting demand for testing. About 60,000 tests have been run by public and private labs in a country of 330 million, federal officials said Tuesday. (Chad Terhune, Dan Levine, Hyunjoo Jin, Jane Lanhee Lee. Reuters)

U.S. Coronavirus Testing Starts To Ramp Up But Still Lags - More than 71,000 tests have been done so far in the U.S., according to the Covid Tracking Project, and thousands more are being conducted each week by federal and state labs, hospitals and private companies, officials say. (Rob Stein, National Public Radio)

The Latest Obstacle to Getting Tested? A Shortage of Swabs and Face Masks - Hospitals and doctors say they are critically low on swabs needed to test patients for the coronavirus, as well as face masks and other gear to protect health care workers. - (Katie Thomas, New York Times)

Coronavirus Testing Chaos Across America - As cases of Covid-19 have exploded across the U.S., state and local governments are taking on the task of testing for the coronavirus that causes it—and they have been quickly overwhelmed. Slowed by equipment shortages and struggling to keep pace, officials have set up a chaotic patchwork of testing sites, with access varying wildly from one place to another. Now some states and counties are pulling back, using their limited resources to test only the most vulnerable. (Dan Frosch, Ian Lovett, Deanna Paul, Wall Street Journal)

HEALTH SYSTEM RESPONSE:

Hospitals Need a Surge — of Doctors - Hospitals are struggling to find enough doctors, nurses and other health care workers to care for mounting numbers of critically ill coronavirus patients. The staffing problems are on top of the equipment problems — the lack of ICU beds, ventilators, and masks and other protective equipment needed to prevent the healers from becoming patients. Hospitals are taking extraordinary measures to bulk up the workforce, from calling on retirees for help to assigning medical students to answer the phones. (Rachel Roubein and Joanne Kenen, Politico)

A View From The Front Lines Of California’s COVID-19 Battle - Interviews with California physicians on the front lines of COVID-19 offer a sobering portrait of a health care system preparing for the worst of a pandemic that could be months from peaking. In the Bay Area, the battle is being waged hospital by hospital, with wide variations in resources. (Anna Maria Barry-Jester, Kaiser Health News)

TRACKING THE SPREAD:

State Data and Policy Actions to Address Coronavirus - To date, states have taken a number of actions aimed at reducing existing barriers to testing and treatment for those affected. These specific policy actions are compiled below, along with data on current cases and deaths as well as additional state-level data on health coverage and provider capacity within each state, important factors that may play a role in how effectively states respond to this outbreak. These data will be updated regularly and new information will be added in response to the evolving situation. (Kaiser Family Foundation)

Coronavirus Deaths Top 10,000 Globally - Governments move with urgency to contain pandemic, as death tolls rise sharply in Iran and Italy - Deaths from the pneumonia-causing pathogen have more than quadrupled in the U.S. over the past week to 205, while confirmed infections in the country have surged to 14,250 from around 1,700 on March 13. The majority of U.S. cases are in three states: New York, Washington and California. (Jennifer Calfas, Stella Yifan Xie and Sune Engel Rasmussen, Wall Street Journal)

TRUMP ADMINISTRATION RESPONSE:

‘We’re Not a Shipping Clerk’: Trump Tells Governors to Step up Efforts to Get Medical Supplies - President Donald Trump on Thursday put the onus on governors to obtain the critical equipment their states need to fight the coronavirus pandemic, telling reporters that the federal government is “not a shipping clerk” for the potentially life-saving supplies. (Quint Forgey, Politico)

Frustration Mounts at Trump's Reluctance to Use Emergency Production Powers - But in a subsequent tweet on Wednesday evening, Trump indicated that even though he invoked the act, he is in no rush to use it. "I only signed the Defense Production Act to combat the Chinese Virus should we need to invoke it in a worst- case scenario in the future," he said. "Hopefully there will be no need" (Nathaniel Weixel, The Hill)

Facing Medical Supply Shortages, Trump Invokes Wartime Law That Could Give Government Authority Over Private Manufacturing - President Trump on Wednesday said he would invoke the Defense Production Act, a law that gives the federal government sweeping power to ramp up manufacturing capacity during a national crisis, as a response to the coronavirus pandemic. The law could allow the president to effectively force private companies to manufacture specific goods necessary to the government’s efforts to stem the pandemic. (Lev Facher, STAT)

The Defense Production Act, the Law Trump Is Using to Boost Coronavirus Supplies, Briefly Explained - This is what military and crisis response experts as well as top politicians have been pushing for as the outbreak spread across the country. The reason is simple: Invoking this act gives the president broad authorities to order domestic manufacturing industries to make products the nation needs in a time of crisis.  (Alex Ward, Vox)

With Minimal Evidence, Trump Asks F.D.A. to Study Malaria Drugs for Coronavirus - President Trump on Thursday exaggerated the potential of drugs available to treat the new coronavirus, including an experimental antiviral treatment and decades-old malaria remedies that hint of promise but so far show limited evidence of healing the sick. (Denise Grady and Katie Thomas, New York Times)

Coronavirus: State Department Tells Americans: 'do Not Travel' Abroad, Come Home If Overseas - The State Department told Americans not to travel abroad at all, the strongest U.S. alert yet as the novel coronavirus continued its steady march across the globe. The department on Thursday issued a Level 4 advisory for travel abroad – "do not travel" – only four days after it issued a Level 3 advisory that urged Americans to "reconsider travel."  (Curtis Tate, Deirdre Shesgreen, USA Today)

COVID-19 & IMMIGRATION:

What Coronavirus Means for Tens of Thousands of People In ICE Custody - There are nearly 40,000 people in ICE custody across the United States. And there's a big question looming as the novel coronavirus spreads. What will happen if there's an outbreak inside one of Immigration and Customs Enforcement's detention facilities, which have long faced criticism for how they handle even routine medical care? (Catherine E. Shoichet, CNN)

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REACH OUT:  If you get an opinion piece or letter to the editor published PLEASE send me (Pete Van Vranken - pete@drsforamerica.org) an email with a link to your piece and I will include it in the next edition of the Physician Rounds.  Also please send me any feedback you may have on the “Rounds” - Much Appreciated  - Pete

 

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On COVID-19


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It is hard to put into words the magnitude of the challenge facing the world and our nation today. But you know, the thousands of Doctors for America members across all 50 states are on the front lines. You are caring for patients who are worried for themselves, for people they love, and for their livelihoods. You are working to do whatever we can to serve an influx of patients in primary care clinics and community health centers, in care facilities, at major academic centers and community hospitals, not to mention those of you in key public health roles at the local, state, and federal level. You are fielding questions from patients, co-workers, family, and friends asking what will happen to them and how to keep people safe.

As sports leagues are cancelled, communities cancel mass public events, candidates transition to virtual rallies, and schools send their students home, we are mobilizing to do our jobs - provide the best care for the sick that we can, and prevent disease when we can. Our communities and nation need us as their trusted, informed voices now.

We have all envisioned the worst-case scenario, and we are all exasperated with the frustrating responses of our national leaders. We have watched colleagues across the planet struggling to keep up. But we at DFA also know there are solutions to these problems – working together, learning from and relying on each other, being innovating and comprehensive in our approaches, we can overcome these challenges – as other nations are demonstrating to us is possible.

While the crisis highlights the dysfunctions in our health care system and the institutional and administrative flaws, we cannot afford to be lost in our frustration. We must instead focus on solutions to the issues in front of us – effectively caring for our patients, our families, and our communities in a time of crisis.

DFA’s commitment is to provide our communities with well-reasoned, evidence-based, meaningful resources, as well as training, actions, and advice that is consistent with our mission focus and work. DFA wants to offer support to all of you – our members and colleagues, and our other health critical care team members working so hard to collaboratively design and implement strategies to treat patients, and to fight and control COVID-19.

In this public health emergency, just like around other important issues that affect us all, it is clear we must take effective advocacy action. DFA leaders across our organization are coordinating and developing specific actions around this issue as part of our Healing America Campaign - deciding how to dedicate resources that will offer you ways to engage and make a big-picture difference.

Access to timely, pertinent and reliable information is a challenge for us and for the public. To share (just) two reliable sources of information: the CDC has information around basic strategies for clinical practice and even provides detailed school recommendations. You also may find this infographic from Johns Hopkins University helpful – as well as the embedded link to additional resources and a map tracking new cases.

DFA’s response to this pandemic is evolving - if and when you can, please share with us your COVID-19 observations and concerns at info@drsforamerica.org in order to inform DFA actions, and so that we can contribute to a rational assessment and interventions around what is happening across our nation.

Expect to hear more from DFA about how you can engage as an advocate on these issues. Specifically look for a social media campaign launch in the coming days to share your frontline experiences, and provide input on solutions.

In the meantime, stay strong. Take time for self-care... give yourselves a “nature” or “exercise prescription”. And please reach out to us at info@drsforamerica.org with any suggestions or ideas on how we might help you weather the crisis.

 

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Become a Sustaining Member


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Doctors, medicine, and science itself is being ignored by too many politicians every day. Millions of Americans are suffering under cruel directives from Washington, and as doctors we are forced to watch, helpless. But it doesn't have to be this way. DFA will not allow it. By working together, we can heal America. And that starts with 2020.

Everything depends on next year, so with your help Doctors for America is stepping up to the plate. To end the year on target for 2020 and make sure doctors make the key difference next year, together we need to raise $55,000. To reach that goal, DFA is kicking off a new Sustaining Membership Campaign.

Will you stand with DFA, and help build the collective power and voices of doctors for the most crucial year ahead? Show your support of physicians' voices and activism in our democracy by becoming a sustaining member of Doctors for America today.

10 Years of Amplifying Our Voices. 50 DFA Doctors in the Rose Garden with President Obama to announce the ACA; Rallies at the Supreme Court opposing overturning the ACA; Bus tour from the Democratic to the Republican Convention; Nomination of Vivek Murthy as Surgeon General; National appearances on major media outlets regarding the ACA, Gun Violence and the list goes on; Engaging at the state level from CA to ME - MN to FL; members in every state; and DFA leadership embedded now at hundreds of major medical and governmental institutions pushing our agenda of putting patients over politics. Ten years of impact and thanks to each of you.

The energy, commitment, and leadership within the DFA community is growing and our commitment to the next 10 years is strong. Whether it's our White Coats Advocacy Boot Camp trainings (100 docs trained in 2019 and 250 - 500 to be trained 2020), the announcement of our Healing America campaign, the exciting merger of NPA and DFA, our expanded staff and board, the list goes on.

Help expand our reach, provide leadership opportunities for all through the training of more doctors, and for us to have a major impact in 2020. With your help, doctors can stand together and fight back against the attacks on our patients and our country. Click here to take that stand and become a sustaining member for 2020.

 

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2019 National Leadership Conference


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DOCTORS FOR AMERICA 10-YEAR ANNIVERSARY NATIONAL LEADERSHIP CONFERENCE

Friday, November 8 - Sunday, November 10, 2019

Johns Hopkins University School of Medicine, Baltimore, MD

The conference will feature:

  • “White Coats Boot Camp” half-day training programs (with special focus on gun violence and prescription drugs). Participation is limited. Training begins at 8:00 am. These are designed to build your advocacy and messaging skills.
  • Keynotes and plenary sessions featuring luminaries in medicine, public health, public policy, social justice, and advocacy
  • Medical trainee-focused organizing
  • An opportunity to welcome to our friends from NPA

Plenary Sessions and Workshops on topics from across public health, health equity, and social justice advocacy: 

  • Women’s reproductive health care and justice - the attack on women and the medical profession;
  • Prescription drug affordability - national and state efforts
  • Gun Violence Prevention - national and state efforts
  • Healthcare for ALL
  • Substance Use Disorder
  • Immigrant Health and Rights
  • Criminal Justice Reform
  • Physician Burnout, Patient Safety, and Strengthening the Physician Soul
  • and much more

Other Workshops Include: Organizing and Building Physician Advocacy Power at the Local/State level, Sharing Your Story, Writing Op-Eds, Running for office, and White Coat-driven voter mobilization

We will update the registration page and follow up with additional information on hotel discounts, speakers, CME information, a full agenda, and other important information.

 

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DFA Responds to Recent Gun Violence


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Doctors for America, the largest clinician advocacy organization in the nation, urges Congress to IMMEDIATELY RETURN for a special session to address gun violence

Health professionals nationwide are horrified by the recent mass shootings in El Paso, TX and Dayton, OH - but we are more than that. We are exhausted. Every day, 310 people suffer bullet wounds - and 100 die - in this country from bullet wounds. We are the ones who see the immediate results -   suturing up bullet wounds from recurring mass shootings, telling parents of the deaths of their children, caring for traumatized communities after the cameras leave. And we are angry. Especially angry that our elected officials and society have failed to address this national epidemic of violence while they fling thoughts, prayers, and empty rhetoric across social media, leaving doctors and nurses to heal the resulting carnage.

We represent those who spend every day safeguarding the lives and the health of people across the nation in demanding that gun violence be addressed as a public health emergency. This is a crisis of epidemic proportions, as Americans viscerally know - in places featured in headlines such as in Gilroy or Virginia Beach, and also in neighborhoods that don’t make the news but who suffer the thousands of firearm-inflicted suicides and other violent deaths and injuries. If the Senate chooses not to go back to work, taking a month-long vacation instead of taking IMMEDIATE action to save American lives, how many more will be dead or injured when they return? 

We call on the Senate to IMMEDIATELY return to Washington 
to address gun violence through three steps:

  1. Debate the gun violence reduction bills sitting in front of the Senate. HRs 8 and 1112, already passed by the House, will make background checks near-universal and close loopholes that allow those with violent histories to access guns. Expanded background checks are a necessary step with near-unanimous public support.

  2. Provide dedicated funding to the Center for Disease Control (CDC), National Institutes of Health (NIH), and other federal agencies directed specifically to support gun violence researchWith funding, these agencies can help us uncover causes and warning signs for gun violence; determine which laws, regulations, and technologies have been effective; and figure out how to care for those affected. Funding has already passed the House - the Senate must act.

  3. Consider a national Extreme Risk Protection Order (“red flag”) law allowing the temporary confiscation of guns (with due process) from those who are at acute risk for harming themselves or others. These laws have saved lives in states that have passed them.

Beyond these common sense steps, we also propose that our nation and Congress implement a much broader initiative to collectively address all of the different forms of gun violence using a comprehensive public health approach. One unique idea is to establish a National Bureau for Gun Safety. In 1966, faced with rapidly rising motor vehicle-related injuries and deaths on our roads, we created the National Highway Safety Bureau. The Bureau addressed auto deaths systematically by promoting and implementing safety technology and practices such as seat belt use as well as by supporting research into causes and contributing factors. This approach has been credited with reducing motor vehicle mortality by two-thirds over the subsequent thirty years. An analogous National Bureau for Gun Safety can use the best evidence and expertise to reduce firearm violence.

We call on all Americans to join us and our patients. Help policy makers think dutifully and act creatively to safeguard public health, and hold them accountable in implementing common sense strategies to heal America’s collective gaping wounds from gun violence. Join us to take steps away from absolutism and division toward courage, toward reducing gun violence, toward stopping this carnage, toward caring for our patients, toward bringing America together.

What actions will you take TODAY?

  1. Call (202) 224-3121 (1-877-960-2185) or text “MITCH” to 90975: tell your Senators to act now to #EndGunViolence. (You can use the toolkit in #3 below as a guide.)

  2. Click here to read the call to action from our colleagues across medicine and public health

  3. Click here to learn more about the issues and how you can help today with this toolkit.

  4. Join Doctors for America to take effective, direct action to address gun violence.

 

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DFA - April 2019 Round-Up


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 DFA Round Up - April 2019


NATIONAL

DFA hosted a Web-Talk with multiple experts to discuss federal and state initiatives to lower the cost of prescription drugs. Click to hear the recording

DFA joined Speaker Pelosi at a press conference celebrating the 9th anniversary of the ACA



DFA medical students
participated in the US House Labor Committee hearing titled "Addressing the Public Health Emergency of Gun Violence"

DFA Board Member and MD-PhD student Justin Lowenthal, AMSA National President Perry Tsai, MD, PhD, and Matt Moy, MDjoined Leana Wen, MD of Planned Parenthood calling on Congress to protect Title X


MARYLAND

DFA board member Don Mathispenned an op-ed in the Baltimore Sun on the effects drug courts have on curbing opioid use

Medical student Jenny Wen, a member of the DFA Maryland/Hopkins chapters and an MD and MPH student at Johns Hopkins University penned an op-ed in the Baltimore Sunand an LTE on treatment of substance use disorder in prisons 


TENNESEE

Dr Deruelle met with his US Senator to discuss observation status


TEXAS

Dr Luedecke joined the Giffords organization calling for universal background checks to help curb gun violence

Dr Lalani joined his colleagues to advocate for lower cost and health coverage expansion in the Texas Legislature

Dr Lalanipenned an op-ed in the Dallas News of the need to expand Medicaid in Texas


VIRGINIA

Dr Webbwill address graduates from the College and Graduate Schools of Arts & Sciences at the University of Virginia 


WASHINGTON

Medical student Jean Changtestified in support of SB 5822, which is a bill to create a pathway for universal health care in the state 

University of Washington medical students Tim Kelly and Jean Changjoined Dr Plymate, Dr Koshy, and Dr Weakland to testify in support ofuniversal health care in their state


Drug Pricing, Value, and Affordability Campaign

DFA joined several organizations calling for federal solutions to stem rising prescription costs

DFA signed on to a Fair Drug Pricing Statement of Principles 

 

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