Massachusetts Medical Society: Massachusetts Physician Organization Letter to Governor Baker Regarding COVID-19

Massachusetts Physician Organization Letter to Governor Baker Regarding COVID-19

His Excellency Charles D. Baker, Governor
Commonwealth of Massachusetts
Massachusetts State House
24 Beacon Street, Room 360
Boston, MA 02133

Dear Governor Baker:

On behalf of the Massachusetts Medical Society, representing over 25,000 physicians, residents, and medical students in the Commonwealth, and the undersigned, we want to thank you for your efforts to mitigate the negative health and economic effects of the COVID-19 pandemic. As you know, COVID-19 is testing the limits of our health care system—and the physicians of Massachusetts are on the front lines. This crisis has shed light on several key issues affecting these physicians and their ability to best care for patients that are of great concern to the undersigned organizations and require immediate action to address.

Personal Protective Equipment

As you are aware, Massachusetts is facing an imminent shortage of personal protective equipment (PPE) and ventilators, posing a substantial risk to our front-line health care workers and impeding the medical community’s collective ability to effectively respond to the crisis. We appreciate your diligent efforts and those of the Department of Public Health, both to preserve existing supplies, through expansion of the use of telehealth and mandated cancellation of non-essential elective procedures, and to secure additional PPE from the Strategic National Stockpile and directly from manufacturers. Despite these meaningful efforts, the shortage of PPE is becoming a critical threat, and will remain so until adequate supplies are acquired. It’s not just hospital systems that are facing shortages, as smaller physician practices are also experiencing shortages undermining testing efforts and risking staff safety. The health and safety of the Massachusetts healthcare workforce is a critical component to the health care system’s ability to respond to this crisis. At this time, we urge transparency at the state level and request further information to understand the level of PPE needed across the Commonwealth, the amount of supplies requested, and where and how that equipment is being distributed. Additionally, we urge you to continue calling on the federal government to release assets from the Strategic National Stockpile and to immediately increase the manufacture, production and distribution of supplies and prioritize distribution to health care workers and emergency workers.

Sustainability of Medical Practices

Importantly, many physician practices are under great strain and in need of support. Massachusetts has suspended non-essential elective procedures, which the undersigned support to ensure capacity to handle the COVID-19 surge, conserve protective equipment, and honor the social distancing standards to curb the spread of COVID-19. However, suspending of such procedures has and will create financial difficulties for physician practices and the Commonwealth needs these physicians to be available for COVID-19 related care and beyond. One such physician practice owner in Western Massachusetts has been financially “decimated” by reduced patient volume and the inability to perform surgical procedures, with a nearly 90% reduction. Additionally, some physician practices have been exposed to the virus and others have contracted the virus, requiring quarantine time away from work and short- or long-term loss of staff.

Physicians and their staff need financial help to maintain stability in their practices so they can get better and return to work, both to deal with this pandemic, and to ensure access and continuity of care in the future. While we fully understand that many small businesses in the Commonwealth are hard hit, please consider the physician workforce that is so vital to fighting the pandemic. As such, we urge you to consider direct financial support, grants, no-interest or forgivable small business loans for physician practices, deferment of medical student loan payments, and other health care business grants to assist practices. Alternatively, please consider a legislative solution that would ensure carriers continue to remit to physician practices monthly a reasonable percentage of historical average monthly payments for the duration of this public health emergency.

Liability Protections

The physicians of this Commonwealth have answered the call to meet an unprecedented need for their services and continue to do so despite risk to their own health and demands created by this virus that are outpacing the resources available within our health care system. While this resource deficit is being addressed with the utmost diligence, our physicians continue to serve the public under less than ideal conditions. There are weighty deterrents for physicians responding to the call to action: danger to the health of oneself and one’s family; moral distress of the circumstances; and sheer human capacity. During this public health emergency, physicians should not fear increased exposure to liability resulting from a standard that does not consider or reflect the extraordinary circumstances under which clinical care is being provided. Instead, we must support frontline health care professionals with increased protections from liability to ensure health care workforce capacity remains as close to the demand created by this public health crisis as possible while preserving the public’s potential causes of action for cases of gross negligence. This is consistent with the spirit of recommendations from U.S. HHS Secretary Alexander Azar to all state governors relative to varying state liability protections during the COVID-19 emergency. These demanding times necessitate action, as was taken in New York and other states, that protects both members of the public and the health care professionals who serve them at great risk to their own wellbeing. As such, we urge you to consider an executive order providing healthcare professionals with immunity from civil liability for alleged injury or death caused by an act or omission of such professionals in the provision of medical services in support of the Commonwealth’s response to the COVID-19 outbreak.

We, the undersigned, urgently request that you consider these concerns and corresponding requests. These challenges, if addressed quickly and comprehensively, can help physicians overcome supply shortages, health care staffing shortages and related financial challenges, and navigate providing essential care to patients during this pandemic. We welcome the opportunity to talk this through with your team and be a resource for you going forward.

Sincerely,

Maryanne C. Bombaugh, MD, MSc, MBA, FACOG
President, Massachusetts Medical Society

Brian P. Sutton, MD, FACEP
President, Massachusetts College of Emergency Physicians

Elisa I. Choi, MD, FACP, FIDSA
Governor, Massachusetts Chapter, American College of Physicians

James Wang, MD
President, American College of Obstetricians and Gynecologists, Massachusetts Section

David L. Gang, MD
President, Massachusetts Society of Pathologists

Walter Stanwood, MD
President, Massachusetts Orthopaedic Association

Marilyn Price, MD
President, Massachusetts Psychiatric Society

Derrick Lin, MD, FACS
President, Massachusetts Society of Otolaryngology – Head & Neck Surgery, Inc.

Elizabeth Goodman, MD, MBA, FAAP
President, Massachusetts Chapter, American Academy of Pediatrics

Nickolas Kiefer, MD, FASA
President, Massachusetts Society of Anesthesiologists

Rodrick Williams, MD
President, Massachusetts Radiological Society

Michael Constantine, MD
President, Massachusetts Society of Clinical Oncologists

Liam Hurley, MD
President, Massachusetts Association of Practicing Urologists

Raj Devarajan, MD
President, Massachusetts Gastroenterology Association

Anindita Deb, MD
President, Massachusetts Neurologic Association

Jennifer Sparks, MD, FAAFP
President, Massachusetts Academy of Family Physicians

Jeremy Kieval, MD
President, Massachusetts Society of Eye Physicians and Surgeons

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