News

3/23 Membership Meeting Postponed

03/12/2020

As a precautionary and protective measure, OCMS is postponing its March 23 Membership Meeting and 50-Year Physician Recognition. Guidance from our leadership is that this is an important measure to protect the health of our member physicians and community. We will schedule at a later date.

COVID-19 Novel Coronavirus: What Physicians Must Know

03/11/2020

COVID-19 Novel Coronavirus:
What Physicians Must Know

The following guidance is drawn primarily from the Centers for Disease Control and Prevention’s (CDC) resources for health care professionals on COVID-19.  Additional information is provided based on resources from the American Medical Association, the Oklahoma State Department of Health, and the Oklahoma City-County Health Department. We recommend always referring to both OSDH and the CDC guidance for the most recent information. As of Wednesday, March 11: 2 confirmed cases, 15 negative cases, and 11 pending cases.

For Healthcare Providers
OSDH developed recommendations for healthcare providers. Includes recommendations and how to report known or suspected COVID-19 cases.

For Businesses/Employers
The interim guidance may help prevent workplace exposures to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19.

Oklahoma COVID-19 Call Center: 877-215-8336
Hours: Monday - Friday: 9:00 a.m. - 7:00 p.m. and Saturday: 9:00 a.m. - 3:00 p.m.
Call Center has the capability to connect callers to Spanish speaking interpreters.

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What to Look For
The CDC’s clinical criteria for a “patient under investigation” (PUI) for possible COVID-19 infection are based on what is known about the Middle Eastern respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-CoV). The key is to look for both clinical features and epidemiologic risks before calling our local or state public health department to sound the alarm.

Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as influenza.

Epidemiologic factors that may help guide decisions on whether to test include: any persons, including healthcare workers, who have had close contact with a laboratory-confirmed4 COVID-19 patient within 14 days of symptom onset, or a history of travel from affected geographic areas within 14 days of symptom onset.

Additionally, the CDC’s guidance notes that “fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications” and urges physicians to use their clinical judgement in such cases.

This clinical criteria is from the CDC as of March 10, 2020. Check their clinical criteria page for the most up to date information.
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Practice Protocols & Preparedness

Pre-Screening: When scheduling appointments, instruct patients and persons who accompany them to call ahead or inform staff upon arrival if they have symptoms of any respiratory infection (e.g., cough, runny nose, fever) and to take appropriate preventive actions (e.g., wear a facemask upon entry to contain cough, follow triage procedures).

Promote Respiratory Hygiene: Take steps to ensure all persons with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) adhere to respiratory hygiene and cough etiquette, hand hygiene, and triage procedures throughout the duration of the visit. Consider posting visual alerts (e.g., signs, posters) at the entrance and in strategic places (e.g., waiting areas, elevators) to provide patients and health care personnel with instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette.

Instructions should include how to use facemasks or tissues to cover nose and mouth when coughing or sneezing, to dispose of tissues and contaminated items in waste receptacles, and how and when to perform hand hygiene.

Provide supplies for respiratory hygiene and cough etiquette, including 60%-95% alcohol-based hand sanitizer, tissues, no touch receptacles for disposal and facemasks upon request.

Limit Exposure: Ensure that patients with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) are not allowed to wait among other patients seeking care.

Rapid Triage: Ensure rapid triage and isolation of patients with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) if possible.

  • Identify patients at risk for having COVID-19 infection before or immediately upon arrival to the healthcare facility.
  • Implement triage procedures to detect persons under investigation (PUI) for COVID-19  during or before patient triage or registration (e.g., at the time of patient check-in) and ensure that all patients are asked about the presence of symptoms of a respiratory infection and history of travel to areas experiencing transmission of SARS-CoV-2, the virus that causes COVID-19,  or contact with possible COVID-19 patients.
  • Implement respiratory hygiene and cough etiquette (i.e., placing a facemask over the patient’s nose and mouth if that has not already been done) and isolate the PUI for COVID-19 in an Airborne Infection Isolation Room (AIIR), if available. Additional guidance for evaluating patients in U.S. for COVID-19 infection can be found on the CDC COVID-19 website.
  • Inform infection prevention and control services, local and state public health authorities, and other healthcare facility staff as appropriate about the presence of a person under investigation for COVID-19.

Physicians: Here's what to do if you're exposed to COVID-19

03/09/2020

From the AMA Senior News Writer Sara Berg:

Physicians and other health professionals are on the front lines of care for patients with COVID-19. And as multiple health workers in the U.S. have been sickened by COVID-19, it raises questions and concerns. What should physicians and other health professionals do if they are exposed to COVID-19? The Centers for Disease Control and Prevention (CDC) has advice for clinicians.  

To answer questions about possible exposure to COVID-19, the CDC has updated their guidance for risk assessment. This guidance is available for health personnel with potential exposure in a health care setting to patients with COVID-19. It details risk levels and what to do if exposure occurs. However, the risk of transmission of SARS-CoV-2, which causes COVID-19, is currently incomplete and the precision of current risk assignment is limited.  

When assigning risk, identify duration of exposure, clinical symptoms of the patient and whether the patient was wearing a facemask. It’s also important to note if an aerosol generating procedure was performed and the type of personal protection equipment (PPE) used by health personnel.  

The AMA encourages physicians to stay up to date on this evolving situation and has provided COVID-19 resources for doctors, other health professionals and the public. The AMA will provide continual updates. 

Access to test kits for COVID-19 are now becoming more widely available in the U.S. The CDC is shipping tests to laboratories designated as qualified, including U.S. state and local public health laboratories, Department of Defense laboratories and select international laboratories. 

Here are five epidemiologic risk factors—listed from high to no identifiable risk—and what the CDC recommends for physicians and other health professionals who might have been exposed to COVID-19.  

Present in the room 

Think about the patient with COVID-19 and the procedure being performed. If a physician or other health professional is not wearing proper PPE (their eyes, nose, or mouth were not protected) and is present in the room or performed a procedure that generated higher concentrations of respirator secretions, they are at high-risk.  

The CDC recommends monitoring for COVID-19 until 14 days after the last potential exposure. These individuals should also be excluded from work during the monitoring period. If a fever or respiratory symptoms consistent with COVID-19 develop, immediately self-isolate and notify your local or state public health authority and health care facility promptly.   

Prolonged close contact 

Similarly, if a physician or other health care professional had prolonged close contact with a patient with COVID-19 where the patient was wearing a facemask, but the health care provider was not wearing a facemask or respirator, the health care provider should be actively monitored for COVID-19 and be excluded from work for 14 days after the last exposure.

Learn more from the CDC about what health personnel should know about caring for patients with confirmed or possible COVID-19 infection.  

Proper adherence to infection control 

A physician wearing all recommended PPE including a facemask or respirator while having prolonged close contact with a patient who was also wearing a facemask is at low risk. It is important to note, though, that a respirator confers a higher level of protection than a facemask. Learn more about the CDC’s interim infection prevention and control recommendations

 

Full text from the AMA here.

Support Physician Counseling

02/19/2020

Rustic Cuff bracelets are available to support physician suicide awareness and counseling of physicians, resident members and students in the OKC metro area.  

Three options are available.

  • Option 1- A silver cuff inscribed with “Be The Change You Want To See “
  • Option 2-A dark blue leather snap calf inscribed with “Be The Change”
  • Option 3- A turquoise, orchid, and silver beaded bracelet with OCMS logo medallion (only a few left!)

Ordering is not currently available online, so please mail a check to OCMS and stop by the office to pick up your bracelets.

For more info, contact Alison Fink. 

Physician Suicide Awareness Fundraiser

08/12/2019

The OCMS Physician Wellness Program is selling bracelets that recognize physician suicide awareness. Order your bracelet online here: https://www.okcountymed.org/rc-fundraiser/! The logo bracelet features teal and purple beads, the colors of physician suicide awareness.The cuff has an inspirational message, “Be the Change You Want to See” – reminding us of the importance of helping others in our profession succeed. The leather cuff, for men and women, features the ribbon and "Be the Change" - cementing the desire to change the future of physicians.