Heroes fighting on pandemic’s frontline

We are bombarded daily with shocking images of the wrath of COVID-19 around the world. We are anxious and afraid about what will happen to us.

Our hospital in East Hawaii, Hilo Medical Center, is preparing for the worst. It has well-thought-out medical emergency disaster preparedness plans in place to address the potential threats of this pandemic.

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Our hope is that this viral tsunami never reaches our shores. We can never overprepare for a disaster of this magnitude, and we need to strongly support our hospital in this effort.

Meanwhile, we have a cadre of 50-plus private, individual community physicians in the trenches trying to manage and educate 50,000-plus patients on Hawaii Island so the tsunami never overwhelms our hospital.

These physicians have not shied away from seeing their patients. They have not closed their doors. Our most recent survey shows that the majority of primary care clinics are open during regular business hours and providers are available by phone, Facetime and telehealth.

Most clinics are small independent businesses running on very tight budgets. These physicians cannot afford to close their doors and are also committed to taking care of patients they have known for decades. They are working smart by screening patients by phone in advance of appointments and seeing those who absolutely need to be seen.

Offices are small so some have patients wait in their cars instead of their waiting rooms to distance them from other patients. They provide customized education and counseling to patients on whether and/or how to get the COVID-19 test, how patients can protect themselves and their families and how to handle anxiety and stress.

A significant number of our providers are over 60 years old, and despite the risk to themselves and their staff, remain on the frontline filling prescriptions, seeing patients who have chronic health problems and acute illnesses, ordering COVID-19 tests and rescheduling and coordinating care for patients forced to forgo needed procedures and specialist consultations. They are transforming their offices by changing operational work flows and quickly implementing new technologies.

These clinics are reassessing their financial conditions and deciphering how to get reimbursed for new types of “remote” patient visits. Some have applied for small business loans to avoid furloughing staff who will be difficult to replace due to their specialized skills. Providers who are dependent on a certain volume of fee-for-service face-to-face visits are suffering financially. Physicians who receive capitated payments from HMSA worry that massive worker layoffs will mean fewer patients and significant losses in income.

Our small independent clinics are scrambling to find PPE (personal protective equipment) such as surgical masks, face shields and gowns, as well as sanitizers, cleaning supplies and even toilet paper. Most PPE is being donated to larger entities such as hospitals, while our community physicians have been left to fend for themselves. Most need to rearrange their offices to have proper distancing for patients as well as staff.

As expressed by Dr. Lynda Dolan, East Hawaii Independent Physicians Association president, “Our independent physicians are working hard to keep patients from being admitted to the hospital. They will continue to persevere in the trenches to flatten the pandemic curve. We rely on them to be our barrier reef to prevent COVID-19 second or third waves. Our physicians know their patients well and are in the best position to provide personalized education, advice and treatment.”

Please recognize and honor our independent physician heroes who, without fanfare, have worked tirelessly for decades to maintain the health of our community. They will quietly help us get through the peaking of this pandemic. We need them to help keep COVID-19 at bay now and in the future.

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Mahalo for your understanding and support.

Susan Mochizuki is executive director of the East Hawaii Independent Physicians Association.

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