US Betrays Healthcare Workers in Coronavirus Disaster
medscape.com
medscape.com
I understand why you wouldn’t want that happening in normal times, but to hold firm on that policy now seems like utter madness.
> On a widespread basis, doctors and nurses are being gagged and muzzled by administrators for expressing their concerns, and penalized or even fired when they do speak out.
That text links to: https://www.seattletimes.com/seattle-news/health/er-doctor-w...
Why?
So it could have deviated on mask guidance, too.
This issue was due to the ineptness and hubris of the current administration, which defunded relevant initiatives, ignored the warnings, and refused to learn lessons from other nations' experience with the virus.
Our medical system is fully capable of managing this with the proper preparation and supportive social policy. In fact, there is not a medical system in the world that could manage a pandemic of this scale without those things.
I mean, what evidence is there that having a dedicated pandemic team would have helped? This is the same government you just said was incompetent, so why would this have helped? The botched initial testing came from the CDC and FDA, so how did the admin make that happen? And the CDC would have been the same group that had a dedicated pandemic team. You might be able to point at some Trump appointee and say that person was directly responsible for the testing disaster, but I think that's unlikely. What if it turns out an Obama appointee caused the problem? I certainly wouldn't blame Obama for that.
Also, the federal government is not supposed to be this dictator that controls everything in the US. Each state, each county is better equipped to figure out how to handle the crisis. The feds should be helping with logistics and guidelines, but what else? A nationwide lock down might not be good for the entire country. For example, a very rural state, might not really need a lock down. Or it might need a more measured lock down of a few very urban city centers. And would it even be legal for the federal government to order a lock down?
As for leadership at the federal level, the coronavirus task force was created at the end of January. Should it have been created earlier? Maybe if the WHO and the CCP weren't lying their asses off about the disease it would have been. The only thing that allowed Taiwan to handle this better was that they knew the CCP would be lying, so when they heard about a new disease in December, they immediately went into disease protocol mode.
Look, do I think the current US admin is handling this perfectly, no. But they are not doing this horrible job that many people seem to want them to be doing. Maybe if all you ever see is the negative articles you would believe that, but I would urge you to dig deeper. You don't even need to go to some fringe websites to see people saying the admin is doing a good job. And I don't mean looking at Fox News, I mean people on MSNBC and other left leaning networks are not all completely negative.
Relatively good administration my ass, that bar is a chalk line on the ground.
The US has a truly terrible tendency to start speeches about itself with "The US is the greatest country on earth when it comes to X ..." whatever X may be.
To the point that I suspect even the people uttering it truly believe what they're peddling.
If there's a country that has understood at a gut level that good marketing trumps honesty every time, it's the US.
Unfortunately, good marketing and truth are very rarely compatible [1].
I don't know what to do.
What is the crime being committed? If none, what should it be according to new law given the body count that's really only just started.
I'm just thankful they exist at this point, given how this has all unfolded.
Is it in the US? Spending 10+ years in school, all while drowning in 200k+ debt before you enter your practice is hardly what I'd call assured upward mobility. And then you still have to work those crazy 60+ hour weeks in the hopes that after your debt is paid off you can start to live as an established MD well into your middle age.
Honestly, with all of that in mind being a dentist makes sense, being a physician does not. But then neither is being a founder at a startup, and we're all drawn to that for various reasons, too.
We need to train corpsman. Now. Specifically in the essential skills is to handle the average duties involved with COVID-19 hospitalization and care. Make sure they have enough skill to generally handle things, and if possible, prefer training/drafting in those who have already developed immunity.
I understand it isn't a trivial feat by a long shot; but right now medical expertise is to specialized in the sense that "general care" is beyond the reach of even a modestly trained individual; making the loss of one fully trained and licensed medical practitioner being lost devastating.
I'd propose the following:
A) Expedited training programs for conducting hospital intake, data entry, basic vitals taking, basic equipment checking/operations, and familiarity with COVID specific complications, and an escalation process.
B) Medical apprenticeship programs minus the 8 years of pre-schooling. We can get back to that once things have settled down enough. Hours spent count toward eventual medical training/licensure...somehow...
C) Same apprenticeship system should exist for ventilator operators
D) Expedited training in I industrial manufacturing aimed toward a medical device manufacturing specialization.
E) Insurance companies get to pound sand. Someone has to pay for it all sadly, if we're staying true to form; not necessarily saying we should.
F) Doctors/nurses/LPN's get assigned a squad of these gophers to manage patients, only popping in to handle abnormalities/specific complications.
G) Practicing doctor's are highly encouraged to train and guide anyone willing to at least provide some help.
Short of something like that, and I think we may start to see a pinch where as things peak, medical professionals start dropping like flies or burning through donated antibody laden serum transplants to cope with the absurd viral loads they're being forced to endure by necessity.
If we can figure out a way to dilute that by spreading out repeated exposure between different people (again, preferably those who have recovered), I think the system will stand a much better chance of coping. Furthermore, it decentralizes the very basics of medical care, builds/reinforces community bonds, gives everyone a potential way to help out once they've recovered, and will likely increase the quality of medical care for everyone by decreasing the severity of overwork our artificially constrained supply of fully trained medical personnel causes.
Short of doing something like that, I don't see any way to avoid losing a hell of a lot of skilled, hard-working, and invaluable people during this time of crisis. Hell, if I knew I'd already had the stuff and developed immunity, I'd volunteer. Throw in some modest compensation, and I bet you'd get even more. Or better yet, enstate a program of cost of care deferral by putting in hours after recovery. It's not the most easy thing to get off the ground, but it's better than nothing.
What is required is a new class of regulation to surround those (temporary?) healthcare workers, providing licensure during public health emergencies. The difficult situation is that this means a lowering of the standard of care given, which I believe many doctors may not support, although desperate patients most certainly will. Due to the protective nature of the multiple boards/colleges of physicians, it may be better to create an independent organization for certification. However, would we be willing to subsequently dismantle these organizations?
Aren't we really already lowering the standard of care given in the case of being overly reliant on chronically overwhelmed physicians?
And I don't think there would actually be any appreciable drop in standards of care, as the entire process would revolve around basically focusing the lightly trained on a hyper-specific subset of statistically relevant medical issues with the assumption of "escalate if something we didn't train you on happens."
You're still getting care from fully licensed professionals. Eventually. They just have more hands to be where they can't.
>Due to the protective nature of the multiple boards/colleges of physicians, it may be better to create an independent organization for certification. However, would we be willing to subsequently dismantle these organizations?
Good question. I'd air on the side of not dismantling the program if for no other reason than it seems to me we're already having trouble getting medical practitioners out of schools and into the field doing good with our current system. (Limited rotation slots for entrants per year, the securitization of the debts of hopefuls being made worse by getting unlucky with being delayed multiple-cycles from entry into the industry). The primary concern I have is that I think that the college/board systems may be too fragile to the point they represent more of an economic gatekeeper (by artificially constraining supply) rather than a balloon holding up the standard of care. Then again, I have no numbers whatsoever with regards to how many "bad practitioners" are weeded out of the system by virtue of licensing authorities with which to back that up; merely a vague personal hunch probably fuelled by a dislike for needlessly rigorous licensure systems. Plus I have no idea the social/career advancement issues such an organization would create. Would long enough service in this context translate to full licensure after a time? How long should that take? Does it make sense to maybe integrate the two disparate systems as one at some point and maybe formulate a way where highly restrictive entry-level licensure has a proof of experience based and continuing education process by which further advancement toward unsupervised, independent practice is slowly developed toward? What would that look like? Is it feasible? Is it worse than we have now?
I don't know. I do know that in our current predicament though, we may be literally killing off our societal immune system through overwork; and the only way to overcome that, is through more hands.
The failures here are disgraceful.
When the dust settles, let's please remove the leaders who suck at this.
The GOP want to run everything as a business, this went down exactly like a business does things. Public safety is not the problem of The healthcare industry.