We're all in this together
By Kathy McCarthy, TAFP COO
When TAFP was formed, the membership was largely homogenous. Not just in demographics, but in practice setting. Over the years, that has changed and while many members still own small practices, they are no longer the majority. The day-to-day practice of a family physician member of TAFP is varied, with some in larger groups with no ownership stake, some working in ERs and urgent care, some at FQHCs and public health clinics, some working as hospitalists, some focusing on providing palliative care, and, of course, some educating the next generation of family physicians. With that variety amongst our members, we know that the effect of COVID-19 pandemic on our membership is also varied.
There are some common threads that likely resonate with you. As scientists you are working to understand the virus and reading all you can. As physicians you are concerned about your patients and working on strategies to continue caring for them, often with limited PPE. As mothers and fathers, daughters and sons, sisters and brothers, you worry about your family – especially those who are more vulnerable. As leaders in whatever setting you practice, you worry about your health care team. You watch with alarm the percentage of the coronavirus positive cases who are health care providers, here and in other countries. If you are a parent of school-age children, you are scrambling to figure out how to keep them engaged and learning at a time when schools are closed with many are not reopening this term. You feel the loss of not being able to gather at churches and other community events.
We know that our small practices have an added layer of extreme financial pressure as patient volumes have dropped. Some are quickly adapting to provide telemedicine, but both lower volume and reimbursement will affect their ability to keep the doors open. Our members in ERs and hospitals are bracing for the spike in hospitalizations that we know is coming and worry about the lack of ventilators and PPE. Those involved in training the next generation of family physicians have the added stress of how this pandemic will impact their training.
TAFP can’t fix all these problems overnight. Here is what we are doing now:
- PPE. We know that the shortage is widespread and private practices are at the bottom of the distribution list. We are sharing your stories with the media. We bring your perspective to discussions with state leaders and the Texas Medical Association. Our CEO didn’t wait for the state or traditional suppliers as he obtained a supply of masks and distributed them to members around the state. He continues to work with Texas Organization of Rural and Community Hospitals to obtain and distribute materials as they become available.
- Telemedicine. TAFP launched a podcast Texas Family Doc Talk and the second episode focuses on telemedicine and provides resources. We are also advocating for better reimbursement across all payers.
- Practice viability. This crisis highlights long-standing problems with the way we pay for primary care services. The fee-for-service nature of most reimbursement means that when patients aren’t in the office, practices face cash flow problems. We are taking every opportunity to share that story with the media, legislators, and policy makers. To address the short-term issue, we are advocating for loans and advance payments. Medicare has expanded its accelerated and advance payments program to get funds to you sooner.
- Information. Our relationship with members and our ability to reach them is one of our strengths. We have a page on our website serving as a clearing house for all the information and resources coming at you and we are working to highlight the most relevant items.
None of us were fully prepared for this type of pandemic. We are learning as we go and doing the best we can. At TAFP, our goal is for family medicine to make it through and be better on the other side with stronger independent practices and a system that allows for a coordinated and integrated response to public health crises that includes family physicians. We want to hear from you. What are you experiencing? How can TAFP help? Share your story by emailing kmccarthy@tafp.org.
Stay well and thank you for all you do for your patients and your community.
Tamara Stout said
I am a solo Family Physician in Katy, Texas. I have what is called a micro-practice with only one employee. I have been able to maintain my practice in this way and it has allowed me to spend more time with my patients. Unfortunately, as urgent care facilities and walk up clinics have established have become more predominant in my area I have lost patients. But when these places fail them, my patients want me to treat them without coming in. Now, during the pandemic I am experiencing more patient loss due to fear and inability of the patient to access my telehealth option. I am unable to attend to sick patients as I have no access to PPE. Our supplier has cancelled our orders since we are not a larger medical entity. We take a risk attending to those routine patients that still want to be seen in person with only a mask as barrier. I honestly feel as if our local health department and area hospitals are offering no support, I began reaching out to them when this began in early March and I am always redirected elsewhere. I am unsure if I will survive this pandemic as a solo physician as I was struggling before it began. My office has cut it's hours in order to remain open to continue to care for my patients with other medical needs that will continue to need to be addressed.