Family Medicine in the Time of COVID-19

PRESIDENT’S MESSAGE to Members

By Dr. David Rinehart 2019–2020 NCAFP President

~ THE 2020 PANDEMIC ~

As I write this in early April, the news is full of talk of ventilator shortages, overcrowded hospitals and temporary hospitals being set up on soccer fields and in convention centers. On television, every few minutes a new infectious disease specialist or epidemiologist or ED physician is interviewed about their dire circumstances. We watch endless videos of health care workers in full protective attire moving sick patients around in hospitals. We listen carefully to Dr Birx and Dr Fauci. Everyone is trying to find a mask to wear. The whole country knows the acronym “PPE” and understands some basics about ventilators. The deaths are mounting rapidly. The spread seems to be inevitable.

Although a few family physicians are on the cutting edge of this pandemic and working with very sick hospital patients, most of us are not so involved with the intensive hospital care.

So, what is the role of Family Medicine during this unprecedented upheaval in our nation?

Dr. Rinehart attended the University of Virginia and earned his BA in 1978 (Phi Beta Kappa) and his MD in 1982 (Alpha Omega Alpha). He completed his residency in Family Medicine at Charlotte Memorial Hospital in 1985 and was recognized as a national Mead Johnson Outstanding Resident. Dr. Rinehart has enjoyed 34 years of community-based Family Medicine practice with South Point Family Practice in Belmont, NC, 22 years as an independent group practice and 12 years as part of CaroMont Health. He has been a preceptor for dozens of medical students and nurse practitioner students over the years. Dr. Rinehart has held several leadership and committee positions within CaroMont Health including past Chair of the Physician Leadership Council and immediate past Co-Administrative Physician Lead of the Primary Care Service Line. He is a past Board Chair of Presbyterian Samaritan Counseling Center in Charlotte and has participated in medical mission trips in Honduras and Ethiopia. He has served for the past 18 years as team physician for the local high school football team and has held several leadership positions in his church including Chair of the daycare facility. Dr. Rinehart lives in Belmont with his wife of 40 years and has three grown children and two grandchildren.

Prevention

As family physicians, we need to lead the way in evidence-based prevention measures for our patients. We do this by encouraging social distancing and CDC-approved isolation and quarantine measures. We do not ask patients to come to our offices if not absolutely required, although it will hurt our businesses. We follow PPE guidelines. We keep our offices clean and sanitized. We follow social distancing as best we can if patients must come to our offices. We will be there to deliver the vaccine when it becomes available someday.

Patient Education

We keep our patients informed about SARS-CoV-2, about how to socially distance, about how this is spread, what measures to take, how to quarantine

and isolate, how to safely manage to get groceries and other necessities. We encourage our patients to continue to manage their health with diet and exercise and supporting one another. We reach out through phone calls, portal messages, text messages, whatever way we have available. We will stay informed ourselves as to the latest guidelines and recommendations put forth by our public health experts and do our best to follow them and encourage our patients and colleagues to follow them.

Treatment of Non-COVID-19 Conditions

We will continue to follow our patients as they navigate their other health issues. We will find innovative ways to manage many more medical conditions at home than usual. We will be flexible with our requirements for office visits. We will extend many prescriptions when appropriate by weighing the risk of having patients out of social distancing with the benefit of person-to-person visits. We will treat some conditions by telemedicine that we would not have thought of a few months ago. We will be innovative and creative in treating our patients.

Telehealth

We will embrace this technology, new for most of us, for the good of our patients and our staff. We will encourage our staff and patients as we all embark on a steep learning curve as to how this technology will transform parts of our practices.

Leadership

We are fortunate in North Carolina to have many dedicated family physician leaders involved in making some of the decisions in our state regarding this pandemic. Family physicians hold prominent leadership roles in NC Medicaid, are active in various committees developing pandemic policy within our health systems, share leadership on a NCIOM task force committee submitting recommendations about the allocation of scarce resources, and help lead CCNC and AHEC with practice support and telehealth teaching.

Protect Our Staff, Our Families, Ourselves

We will practice careful protective measures to prevent viral spread for our patients, our staff, our families, and ourselves. It is evident that health care workers are very severely impacted by this pandemic, and we

See ‘COVID’ on Back Cover

Executive Officers President David R. Rinehart, MD President-Elect J essica Triche, MD Secretary/Treasurer Dimitrios “Takie” P. Hondros, MD Immediate Past President A lisa C. Nance, MD, RPh Executive Vice President Gregory K. Griggs, MPA, CAE

At-Large Directors

Talia M. Aron, MD

Elizabeth B. Baltaro, MD

Jewell P. Carr, MD

Garett R. Franklin, MD

Shauna L. Guthrie, MD, MPH

Brian McCollough, MD

Mark McNeill, MD

Ying Vang, MD

Academic Position Mark L. Higdon, DO (Novant FMR)

Resident Director Elizabeth Ferruzzi, MD (Novant)

Resident Director-Elect Clayton Cooper, MD, MBA (Duke)

Student Director Katelyn Turlington (WFSOM)

Student Director-Elect Hannah Smith (ECU)

AAFP Delegates & Alternates

AAFP Delegate AAFP Delegate AAFP Alternate AAFP Alternate Michelle F. Jones, MD

Karen L. Smith, MD Richard W. Lord, Jr., MD, MA Robert L. Rich, Jr., MD

2501 Blue Ridge Road, Suite 120, Raleigh, North Carolina 27607