Burnout at Record High for Many Primary Care Clinicians, Survey Finds
Nearly half of primary care clinicians reported that their burnout is at an all-time high, largely due to financial pressures caused by the covid-19 pandemic, a new survey found. The Larry A. Green center and primary care collaborative surveyed 763 practicing clinicians in 49 states from June 12-15. Respondents represented a broad range of primary care specialties, practice settings and types.
Five Survey Findings:
- 44% of respondents reported high levels of personal burnout, and 48 percent reported high levels of office burnout.
- 36% said their physical well-being has suffered, while 45 percent said their psychological state has declined.
- 63% of respondents said they have had “severe” or “near severe” stress levels the last four weeks.
- 39% said they have had to lay off or furlough staff members in the last month.
- 25% of respondents said they have skipped or deferred their salaries.
To view the full survey, Click Here.
(Editor’s Note: This article was updated June 30 at 11:00 A.M. CDT. Becker’s Hospital Review)
California Among 8 States Added to Gov. Cuomo’s Quarantine Order
Travelers from eight additional states, including California, will be subjected to a mandatory two-week quarantine upon entering New York, Gov. Andrew Cuomo announced on Tuesday.
The other states are Georgia, Iowa, Idaho, Louisiana, Mississippi, Nevada, and Tennessee.
Key context: Since Texas and Florida were among the eight states already on the quarantine list, now travelers from the country’s three most-populous states will be restricted in their ability to travel to the fourth-most populous state.
What comes next: Cuomo’s order applies to any state where more than 1 out of every 10,000 residents has tested positive on a seven-day rolling average or more than 10 percent of the tests come back positive. New Jersey and Connecticut joined New York in issuing the same restrictions and thresholds last week. (Politico, 6/30)
Dr. Fauci Predicts COVID-19 Cases Could Top 100K Cases A Day
“We can’t just focus on the areas that are having the surge. It puts the entire country at risk,” Dr. Fauci told the Senate Health, Education, Labor and Pensions Committee on a hearing focused on whether schools could reopen. “We are now having 40-plus thousand new cases a day. I would not be surprised if we go up to 100K a day if this does not turn around so I’m very concerned … I think it’s important to tell you and the American public that I’m very concerned because it could get very bad.”
He suggested that people who ignored social distancing and didn’t wear face coverings have contributed to community spread, even in states that have closely followed reopening guidelines laid out by the Centers for Disease Control. “I think we need to emphasize the responsibility we have as individuals and as part of a societal effort to end the epidemic and that we all have to play a part in that,” Dr. Fauci said. (Politico 6/30)
“It is critical that we all take the personal responsibility to slow the transmission of COVID-19, and embrace the universal use of face coverings,” Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said during his testimony Tuesday. “Specifically, I’m addressing the younger members of our society, the millennials and Generation Zs,” Redfield said. (KHN, 6/30)
AHA Says: Hospitals Will Take $320B Hit This Year
Hospitals and health systems will lose over $320 billion in 2020 due to the COVID-19 pandemic, according to an American Hospital Association report Tuesday. More than $200 billion in financial losses occurred from March to June. But the AHA expects hospitals to lose another $120 billion—about $20 billion per month—through year-end, mostly driven by lower patient volumes. (Modern Healthcare, 6/30)
Local and state public health departments across the country work to ensure that people in their communities have healthy water to drink, their restaurants do not serve contaminated food and outbreaks of infectious diseases don’t spread. Those departments now find themselves at the forefront of fighting the coronavirus pandemic.
But years of budget and staffing cuts have left them unprepared to face the worst health crisis in a century.
KHN and The Associated Press sought to understand the scale of the cuts and how the decades-long starvation of public health departments by federal, state, and local governments has affected the system meant to protect the nation’s health. (Modern Healthcare)
Six Takeaways of KHN-AP Investigation into the Erosion of Public Health
Here are six key takeaways from the KHN-AP investigation:
- Since 2010, spending for state public health departments has dropped by 16% per capita, and for local health departments by 18%. Local public health spending varies widely by county or town, even within the same state.
- At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeletal workforce in what was once viewed as one of the world’s top public health systems.
- Nearly two-thirds of Americans live in counties that spend more than twice as much on policing as they spend on non-hospital health care, which includes public health.
- More than three-quarters of Americans live in states that spend less than $100 per person annually on public health. Spending ranges from $32 in Louisiana to $263 in Delaware.
- Some public health workers earn so little that they qualify for government assistance. During the pandemic, many have found themselves disrespected, ignored or even vilified. At least 34 state and local public health leaders have announced their resignations, retired, or been fired in 17 states since April.
- States, cities, and counties whose tax revenues have declined during the current recession have begun laying off and furloughing public health staffers. At least 14 states have cut health department budgets or positions, or were actively considering such cuts in June, even as coronavirus cases surged in several states.
Dr. Richard Izquierdo, 2019 AMA Nathan Davis Awardee, Dies at Age 90
The American Medical Association (AMA) presented Richard “Doc” Izquierdo, M.D., with the Dr. Nathan Davis Award for Outstanding Public Service. Dr. Izquierdo has served his Bronx community for nearly six decades as a physician, health care innovator, community leader and Medical Society advocate. He was chosen for the AMA’s top public service award for his lifetime of work, serving generations of Bronx residents.
Dr. Izquierdo has dedicated his entire career to furthering health and opportunity in his Bronx community. With a $3,000 down payment, he founded the San Juan Health Center, which in 1974 became Urban Health plan, Inc., and today is one of the largest health centers in New York State. Dr. Izquierdo also served as the first chairman of the Community Planning Board and as Chairman of the 41st Precinct Community Council for 14 years.
In 2010 Dr. Izquierdo fulfilled a lifelong dream when he opened the Dr. Richard Izquierdo Health and Science Charter School. The first school of its kind, it provides technical education geared specifically toward preparing students for jobs in the health care sector, including Emergency Medical Technician (EMT) certification.
“Dr. Izquierdo put down roots for good nearly 60 years ago when he opened his first practice two blocks from where he grew up in the Bronx,” said AMA Board Chair Jack Resneck, Jr., M.D. “Not only has he treated generations of patients from his community, but he has built, in his charter school and health center, a legacy that will serve the Bronx for years to come.”
Dr. Richard Izquierdo was one of eight honorees chosen this year to receive the Dr. Nathan Davis Award for Outstanding Public Service. The award, named for Dr. Nathan Davis, a member of the Medical Society for the State of New York, and the founding father of the AMA, recognizes those in service whose outstanding contributions have promoted the art and science of medicine and the betterment of public health.
Dr. Izquierdo attended University of Lausanne Medical School and completed his internship and residency at Fordham Hospital in New York. The AMA presented Dr. Izquierdo with the Dr. Nathan Davis Award last night at a ceremony in Washington, D.C. as part of the AMA’s National Advocacy Conference.
Dr. Izquierdo (known as “The People’s Doctor of the Bronx and Founder of the Urban Plan, Dead at 90)”) was also featured in the Bronx Journal.
Dr. Fauci: Contact-Tracing ‘Not Going Well;’ Other Updates
- National contact-tracing efforts are “not going well,”Anthony Fauci, MD, told CNBC.. Instead of creating a national contract-tracing strategy, the White House instructed states to develop infrastructure for broad COVID-19 testing and contact-tracing before reopening. Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, said some states have been slow to ramp up this capacity, which will be crucial before a potential second wave of coronavirus cases this fall.
- Federal officials are warning of fake mask exemption cards that say their owners are exempt from ordinances requiring masks in public due to a health condition, according to The New York Times. Some versions of the card feature a fake U.S. Justice Department logo and list a phone number to report violations of the Americans with Disabilities Act. A group called the Freedom to Breathe Agency was selling 500-count boxes of the fake cards online for $49.99, officials said.
US Warns that 2nd COVID-19 Wave Could Worsen Generic Drug Shortages
A federal intelligence report found that the U.S. is likely to see a worsening shortage of generic drugs if another round of shutdowns occurs due to the COVID-19 pandemic, according to ABC News. The federal report, created by the Department of Homeland Security and distributed to government agencies last week, found that the U.S. already is seeing shortages of more than 200 drugs and supplies due to international shutdowns. The report is warning that another round of shutdowns could further strain the system in a way that many U.S.-based drugmakers would be “unable to quickly offset,” according to ABC.
“Chinese factories that produce raw ingredients for common antibiotics closed for weeks as of March, and India’s lockdown extended until the end of May,” the report said, according to ABC. “France, Germany, and China have also considered reimposing lockdown measures as COVID-19 cases have begun to reemerge.”
NEJM Study: 300 Cases Rare Inflammatory Disorder in COVID-19 Children
U.S. researchers have found nearly 300 cases of a rare inflammatory disorder linked to COVID-19 in children, according to two new studies cited by STAT. In the first study, researchers from Boston Children’s Hospital identified 186 children with the condition in 26 states. Eighty percent required intensive care, 20 percent were put on a ventilator, and 2 percent (four children) died. In a second study examining 99 cases in New York state, 63 percent needed mechanical ventilation, and two children died. Both studies were published in The New England Journal of Medicine.
AMA Statement on U.S. Supreme Court Ruling in Louisiana Abortion Access Case
Statement Attributable to:
Susan R. Bailey, M.D.
President, American Medical Association
“Today’s decision is a victory for patients and a strike against government interference in the patient-physician relationship. There is no evidence that Louisiana’s admitting privileges requirement improves patients’ safety, and we are pleased by the U.S. Supreme Court’s finding that such regulations are constitutionally invalid.
“The AMA joined other leading national health organizations in an amicus brief to the Supreme Court, urging it to strike down a Louisiana law that interferes with clinical judgment and obstructs women’s access to abortion services in the state. We will always fight government intrusion that compromises access to safe clinical care.
Gilead Sets Remdesivir Price, Allocation Plan
Gilead Sciences will charge the U.S. government and other developed countries $2,340 for a five-day course of remdesivir. Commercial insurers in the U.S. will pay 33 percent more, or $3,120 for a five-day course, the drugmaker said June 29.
Most patients treated with remdesivir receive a five-day treatment course using six vials of remdesivir. The cost breaks down to $390 per vial for government insurers like Medicaid and $520 per vial for private insurers.
Gilead said while deciding on a pricing strategy for remdesivir, it wanted to create a one-price model to curb the need for country-by-country negotiations on price. While there are still no COVID-19 treatments approved by the FDA, remdesivir has been shown to shorten recovery time of hospitalized patients by about four days. Due to its potential to save lives and cut hospital spending, Gilead said its pricing is well below value. Gilead said due to the earlier hospital discharge, hospitals could save about $12,000 per patient.
“As with many other aspects of this pandemic, we are in uncharted territory in pricing remdesivir,” Daniel O’Day, chair and CEO of Gilead, wrote in a statement on the pricing decision. “Ultimately, we were guided by the need to do things differently. As the world continues to reel from the human, social and economic impact of this pandemic, we believe that pricing remdesivir well below value is the right and responsible thing to do.”
Gilead also said July 29 that HHS will continue to manage the allocation of remdesivir to U.S. hospitals through September. After that period, HHS will no longer manage allocation. (Open letter from Gilead CEO Daniel O’Day)
MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.
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