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Chapter Affairs
CHAPTER AFFAIRS
By Gregory K. Griggs, MPA, CAE
NCAFP Executive Vice President
~ FIGHTING FOR YOU ~
AAFP coined the phrase “Fighting for Family Medicine” and I especially like it in the age of COVID. It seems we have had to fight for your rightful place in every step of this pandemic: in PPE distribution, in financial assistance, in testing, and now in vaccine distribution. But that has made me, and your entire NCAFP staff, even more determined to fight for our members. So, let me take the opportunity to outline some of the ways we have advocated for your role in both receiving and disseminating the COVID-19 vaccine.
On December 18th, your incoming and outgoing President (Dr. Jessica Triche and Dr. David Rinehart, respectively), wrote a letter to North Carolina State Health Director Dr. Betsey Tilson and NC Department of Health and Human Services Secretary Mandy Cohen, MD. The key messages in the letter included:
Family physicians are exposed to COVID-19 in their office daily, whether through known positive patients or unknowingly when a patient is there for another visit but subsequently tests positive. As a result, it is imperative that family physicians and their staff receive the vaccine as quickly as possible. I hope that by the time you receive this magazine, we will be beyond vaccinating family physicians.
Family physicians should receive the vaccine quickly whether they work in a health system or a private community clinic. Secretary Cohen ultimately sent several strongly-worded directives to our state’s health systems stating that they also bore responsibility for helping vaccinate community physicians, not just their own employees. We subsequently worked with many of our private practices to connect them to health systems or health departments to receive the vaccine.
Family physicians are ideally suited to vaccinate their own patients. They know who in their office fits into which risk stratification phase and are equipped at dealing with vaccine hesitancy due to the trusting relationship they have with their patients.
Also, in December, AAFP sent similarly-worded letters to federal health officials and the National Governor’s Association.
Through late December and early January, we remained in touch with North Carolina health officials, constantly bringing their attention to problems that family physicians were having. This included numerous phone calls and e-mails, even on Christmas Eve. In early January, the Department shifted some resources to begin unclogging the bottlenecks in order to move vaccines into the hands of primary care practices for your patients. As of writing this column in mid-January, quantities of vaccine were still not available for distribution beyond centralized locations (such as health departments and health systems), but much work was under way to prepare for more distribution sites as supplies became more available. Just as an example, in the week ending January 9, the state of North Carolina had only received about 200,000 doses of COVID-19 vaccine (Pfizer
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and Moderna product combined). Over 85,000 of the Pfizer doses were scheduled for booster immunizations, meaning the state received less than 120,000 first doses that week. Remember, North Carolina has a population of 10.5 million.
By mid-January, as I write this article, our focus has turned on getting primary care practices into the COVID-19 Vaccine Management System (CVMS), that is required to distribute vaccines. While the state was updating the system in hopes of making it easier, the NC-AHEC Program, Community Care of North Carolina, and specialty associations like the NCAFP, were redeploying staff to help practices onboard to CVMS. Two NCAFP staff members took extensive training about the system so that they could answer your questions and hopefully expedite the process. The absolute first step in private practices being able to vaccinate their own patients is onboarding onto CVMS.
We also continue to message about the need to simplify every step of vaccine distribution in North Carolina. While we agree that vaccine should first be distributed to priority populations, we also expressed to the state that an additional guiding principle should be getting our state’s residents vaccinated in a timely, efficient, and effective manner. And family physicians can help do just that.
Given that we write these columns approximately three-to-four weeks before the magazine lands in your mailbox, I am not sure what the situation will be when you are reading the article. But you can rest assured that we are fighting to make it as simple as possible for you to vaccinate your own patients. We have heard your concerns and have expressed them loudly to state officials. And we will continue to do so.
Another part of our advocacy efforts centered around education. We have worked with other associations, NC AHEC, CCNC and NC DHHS to bring you continuous webinars about COVID-19 and the COVID-19 vaccination process. Many of these webinars are occurring on an as-needed basis, so we can’t promote them in this magazine. So be sure to watch for our e-newsletter, NCAFPNotes, for the latest information.
Finally, we continue to add updated information to the COVID-19 resource page on our website (www. ncafp.com). Some of the information includes:
• Slides from numerous webinars on the COVID-19 vaccine distribution process.
• Details on the phases of the COVID-19 vaccine distribution plan.
• A COVID-19 Vaccination Guide for Medical Practices developed by the NC AHEC Program.
• A copy of the letter we sent the State Health Director, and a copy of the letter AAFP sent the National Governor’s Association.
So please keep using our website as a resource for you and your practice.
If you are continuing to have issues, please do not hesitate to reach out to me or another member of our staff. We continue to try to problem solve on the behalf of individual practices. Just remember, getting our state’s residents vaccinated for COVID-19 is a marathon, not a sprint. Vaccine supplies are likely to remain in short supply. Once supplies do get to private practices, they are likely to be limited. There are hoops, for better or worse, that you will have to jump through to vaccinate your own patients. And as of this writing, the state is still working on the details on how your practice will ultimately receive quantities of vaccine for your patients. It very well may be through your Local Health Department, so if you have not already established a strong relationship with your Local Health Department, now would be a good time to do so.
I am hopeful that by the time you are reading this article (likely mid-February) that you may have some vaccine in hand and the drip drop of vaccines will at least become a trickle. However, I doubt that the hose pipe will be open all the way, so remain patient, and keep us informed.
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