Public Health

Helping private practices navigate non-essential care during COVID-19 

Private practice physicians are currently facing new and unfamiliar challenges in safely delivering care to non-urgent patients. New for many practices is having to consider current and future needs for clinician services, the supply of laboratory test kits and access to personal protective equipment (PPE).

The Centers for Disease Control and Prevention (CDC) recommends that health care facilities and clinicians prioritize urgent and emergency visits and procedures now and for the coming several weeks.

The following actions can preserve staff, PPE, patient care supplies, ensure staff and patient safety and expand available hospital capacity during the COVID-19 pandemic:

  • Delay all elective ambulatory provider visits
  • Reschedule elective and non-urgent admissions
  • Delay inpatient and outpatient elective surgical and procedural cases
  • Postpone routine dental and eyecare visits
  • Tools and resources exist as part of healthcare system preparedness plans and are often referred to as Pandemic Plans. Consult your state or local health department about specific plans for your community.

The Centers for Medicare and Medicaid Services (CMS) has also issued guidance limiting all non-essential planned surgeries and procedures, including dental, until further notice. CMS has also released a COVID-19 Partner Toolkit with guidance for physicians and their teams working with various populations.

Recommendations:

  • Instruct patients to call in advance of their appointments if they have symptoms of illness, COVID-19 or otherwise, for clinical advice.
  • Review rescheduling and/or cancellation policies to ensure they are aligned with CDC and CMS guidance.
  • Utilize a recorded message where possible advising patients how to self-screen and to advise those who have recently traveled to self-quarantine if recommended by the CDC and/or their state or local department of health.
  • Discuss the need to reschedule a planned appointment or to be seen in a different setting, e.g. via telemedicine visit, if developing symptoms of a respiratory infection.
  • Follow CDC guidance and postpone elective procedures and medical visits in order to preserve staff resources, medical supplies and PPE.
  • Define a common language for staff to use when speaking to patients; enforcing the CDC guidance is necessary but should not arouse panic. Consider individual patient needs in the context of your practice’s and community’s capacity.
  • Patients in the high-risk category for severe illness, should they develop COVID-19, include older adults and those who have serious chronic medical conditions, e.g. heart disease, diabetes and lung disease.
  • Increase prescription medication refills to a 90-day supply where already allowed and appropriate for patients when doing so is consistent with their clinical status and where possible. They should contact their pharmacy to ensure this can be filled.
    • Encourage patients to contact their plan if refills are not initially approved. Several insurance companies have pledged to waive prescription refill limits on “maintenance medications."
    • SAMHSA has affirmed its support of Opioid Treatment Programs during this time and has issued guidance for both states that have a declared state of emergency and those that have not yet done so.
    • Remind patients to check their supply of over-the-counter medications such as acetaminophen and cough suppressants.

Disclaimer: The guidance provided represents information believed to be current and accurate at the time of posting, but it is not intended as, and should not be construed to be, legal, financial, medical or consulting advice. Physicians and other qualified health care practitioners should exercise their professional judgment in connection with the provision of services.