[BostonCard]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC

[BostonCard]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC