Infection control in your practice (AAFP annual scientific assembly)

Experts warn that primary care physicians will be at the center of detecting, treating and managing an outbreak when it hits.

By Victoria Stagg Elliott, AMNews staff. Nov. 19, 2007.

Reports from conferences important to physicians

The next big respiratory disease epidemic could be in the form of the annual flu or something more exotic. But it is coming, and doctors should change what their offices look like in order to ensure they don't contribute to its spread. Plans also need to be in place to make it more likely that care will be provided to the usual cadre of patients along with those infected by this pathogen, whatever it may be, according to several presentations at the American Academy of Family Physicians' annual scientific assembly last month in Chicago.

"The key message is start now," said Charles W. Mackett III, MD, associate professor and executive vice chair of the Dept. of Family Medicine at the University of Pittsburgh. "We don't want to plan for the next epidemic a week before it happens. Plan now, little bit by little bit."

In such a situation, waiting room signs should instruct patients to alert staff if they have a respiratory illness. In addition, patients should then be seated at least three feet away from each other and given surgical masks. Magazines and toys are to be removed. Upholstered furniture should be swapped for easier-to-disinfect plastic. The office should be cleaned with mops and buckets that are discarded after each use.

"During SARS, people came into the hospital. They didn't have SARS, but they left with SARS," Dr. Mackett said. "We don't want to spread things around."

Outbreak preparation is part of the AAFP's educational focus for the next year, along with more routine infectious disease issues. Experts want primary care physicians ready for these situations, ranging from an expected influenza pandemic to more remote possibilities, such as a return of SARS. After all, the vast majority of those infected never end up in a hospital. Rather, they end up in the office of their primary care doctor where, if precautions are not taken, these infections can spread to others.