Swine Flu Blues

From my husband, a family physician who is handling the Swine Flu panic. It is the first time he has asked me to send something to "my blogger friends". It took Swine Flu to bring him to Social Media. Comments express his personal opinion in a frustrating situation.

>>Swine Flu Blues

Had dozens of calls from patients in the past two days wanting Tamiflu for themselves and their families just in case - none of the local pharmacies have it in stock. Most pharmacies sent back their supplies at the end of flu season. Now what if someone really needs it? The pharmacy says;

Send patient to the ER

I spoke with the ER. If someone has flu symtoms they have a limited number of NP swabs to culture for rapid testing and then if positive, plan on sending the specimen to a state lab as per state and CDC recommendations....but will only do the highest risk febrile types. All the others get a written prescription for Tamiflu and are "streeted". But wait, the pharmacies don't have Tamiflu so the patient calls me to problem solve another unsolvable problem.

If a patient is sick and tests positive likewise they are now in an extreme panic and have a written prescription for appropriate Tamiflu but nowhere to fill it - more calls to me to problem solve these unsolvable problems.

I am ready and willing to do the testing of my patients in my office but I don't have the NP swabs. I called Quest (the lab), they are on "global backorder". Try again in a few weeks.

They suggest if someone calls or shows up -

Send them to the ER.

I ask the ER where I too can get swabs for rapid testing and possible culture - I am told to "go to central supply, they have lots". I go to central supply, they have none. "These are a special order item".

The ER only has a limited supply on campus - Hmmm.

I call my own Health System's (smaller) clinical labs - they do have a limited supply. They will let me pick up 5. If I do one, I will have to immediately leave the office and drive the specimen 20 minutes to the lab and spend another 20 minutes processing the patient insurance so they can do the rapid test. Not very tenable for a busy primary care practitioner - so I am told to;

Send them to the ER

I read the info from the State and CDC about the OSHA requirement that states anyone (myself or staff) obtaining specimens needs to be "Fit Tested" in a special lab periodically to ensure that we are wearing the N95 mask of the right size appropriately. I go to Occupational Health and they tell me there are only two sizes of the mask, small and regular and if I want to be "fit tested" I will have to schedule a visit and pay a handsome sum to get it done. They suggest anyone who has a cold or flu symptoms be sent to???

The ER!!!

I ask them what eye protection is considered adequate as per the CDC and State guidelines - I have reading glasses which I use with all my exams as I am now middle-aged, are these OSHA sufficient while getting a culture/specimen? They don't know.

Send all colds and flu to the ER.

I do have non-sterile exam gloves and splash gowns left over from years ago when I did flexible sigmoidoscopies so at least I can keep my shirtsleeves and hands up to regulation.

I finally get them to agree to do special pickups of specimens here on an as-needed basis and suggest they send out a memo to all primary care offices that they will supply and pick up from our offices in this current situation - we will see what happens.

I also asked some other local primary care practices what they are doing and the universal response is....

Send them to the ER

I cannot get Tamiflu for myself, or staff or family who are directly or indirectly on the front line here. So what would a prudent medical professional do if someone calls with a cold or flu?

Send everyone to the ER????

Thank goodness our government is in control and has so wisely spent billions making many special interest groups very rich and others employed doing important preparations for our current situation, a possible pandemic.

Looking for sanity in an unsanitary world. >>