Physician practices are losing out in the scramble for PPE

Kevin B. O'Reilly , News Editor

What’s the news: As the nation sees single-day record numbers of COVID-19 cases being reported, physician practices continue to report persistent and severe difficulties in obtaining the personal protective equipment (PPE) they need to safely provide patient care and keep their offices open for business.

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In letters to Vice President Mike Pence and the Federal Emergency Management Agency (FEMA), the AMA urged immediate action to address ongoing shortages and access issues related to PPE.

“The AMA now believes the situation with PPE in ambulatory settings is so challenging that the only way to address it is for the administration to use the Defense Production Act (DPA) so the much needed N95 masks and gowns are available so patients, physicians and their staffs can safely treat as many patients as possible,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to Pence, who heads the White House coronavirus task force.

The problem is that office-based physicians don’t have “existing relationships with vendors or ability to source these critical items. Furthermore, physician offices do not need the same quantity of PPE that large institutions do. As a result, even when physicians find a vendor with available supply, they end up losing to larger institutions with more bargaining power and placing more substantial orders. PPE is needed for all types of health care sites, including ambulatory settings. We need to ensure the safety of patients, physicians and their staff,” says the AMA’s letter to Pence.

Dr. Madara wrote separately to FEMA Administrator Peter Gaynor noting that the need for PPE, disinfectants and hand sanitizer goes beyond hospitals and nursing homes.

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“As non-hospital-based physicians return to work and reopen their practices, the need for these supplies is rapidly expanding to other care sites,” the AMA’s CEO wrote, urging FEMA to work with the AMA to gather and mine the data to “ascertain whether the central problem is in the availability of raw material, production backlogs, gaps in the distribution systems, or some combination of all three.”

Why it’s important: Physician practice revenue fell by half during the early months of the pandemic, from March to May, surveys and claims analyses show. That means a $70.6 billion drop in revenue for physician practices.

“This is a challenge for any small business to absorb,” Dr. Madara wrote to the vice president. “For the sake of our patients’ health and to ensure we do not drastically reduce the number of site available to provide health care services, we need to make sure practices remain open and able to provide care.

“Physician practices should be the first line of defense in caring for patients,” he added. “Delayed care often means sicker patients. We do not want patients to unnecessarily end up in a hospital when they could have been effectively cared for by their personal physician. Furthermore, closure of practices would have a long-term negative impact on access to care, especially for those patients in underserved areas that do not have ready access to a choice of physician practices.”

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Learn more: Just as physicians are pressing federal officials for the help they need to safely operate their practices, so too are they urging patients to do their part this Independence Day weekend to take essential steps to limit the spread of COVID-19.

“To protect themselves and others, people must limit the size of gatherings, exercise physical distancing, wear masks, and wash their hands or use hand sanitizer regularly,” says a joint statement from AMA President Susan R. Bailey, MD, Association of State and Territorial Health Officials president Nathaniel Smith, MD, MPH, and National Association of County and City Health Officials President Jennifer C. Kertanis, MPH. “Consider limiting celebration gatherings to those you are already in close contact with, like family members and housemates. Failure to exercise these basic steps will result in a rise in COVID-19 cases, additional hotspots, and larger hurdles in the way of reopening,”

“COVID-19 remains contagious and shows no signs of disappearing,” the physician and public health leaders added. “We strongly urge everyone in the U.S. to stay vigilant in taking the necessary precautions to prevent the further spread of COVID-19. Without a safe and effective vaccine or therapy, our only option is to continue taking these precautionary measures to protect ourselves, our communities, and the most vulnerable among us.”

Stay current on the AMA’s COVID-19 advocacy efforts and track the pandemic with the AMA's COVID-19 resource center, which offers resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.