A Letter to the Editor entitled Dermatology practices as vectors for COVID-19 transmission: a call for immediate cessation of non-emergent dermatology visits was published online Monday in the Journal of the American Academy of Dermatology. It calls for all dermatologists and practices to immediately cease all non-urgent care and implement TeleDerm to bridge the gap. The last line of the article asks,

“Instead of being reactive, we urge dermatology departments and practices to show leadership. If not now, when?“

I am proud that QualDerm Partners has answered that question already.  As the situation continues to evolve, I am gratified by the rapid response by all our teams and practice sites as they tackle the logistics of adopting our Quality Council recommendations regarding urgent and necessary care. I am also impressed by the integration of TeleDerm into our workflows in such an accelerated manner. We know there will be technical challenges to address, but to transition from no TeleDerm platform to effective e-visits in less than 2 weeks is a remarkable testament to everyone’s efforts. TeleDerm will be very important for some time in providing needed care and maintaining practice viability.

A situation arose in one NC practice Monday in which an asymptomatic patient had fever documented during vital signs measurement prior to Mohs surgery. The asymptomatic family member escort also had a fever after consenting to be checked. The patient was referred elsewhere, and the front desk staff, nurse and doctor were using appropriate PPE. In an effort to enhance screening of asymptomatic patients, our local Operations Directors and site managers will work with each clinic to determine how and if this could be performed by potentially using clinical personnel. CDC does not currently recommend these temperature checks, but it is an extra layer of screening to consider if staffing and resources allow. Practices may also consider voluntary temperature checks for employees prior to work, although consent must be obtained, and this cannot be required of any employee or discrimination shown for anyone declining.

We continue to closely monitor local conditions, federal and state guidelines and specialty society recommendations, but feel our comprehensive Quality Council policies to date are responsible and appropriate. As states enforce more stringent ‘shelter-in-place’ mandates we will adapt our services accordingly. Please continue to stay safe: practice social distancing at work and at home; good hand and cough hygiene; proper use and storage of PPE; report any symptoms immediately; and stay or go home if sick. Also please continue to help each other, support your co-workers, and provide the high quality, safe care and exceptional service to our patients. These are the factors we can control now.

I conclude with links to two short articles that I found very helpful today from a mental health and resilience perspective, entitled “Coping with fatigue, fear and panic during a crisis” https://hbr.org/2020/03/coping-with-fatigue-fear-and-panic-during-a-crisis?utm_medium=email&utm_source=newsletter_daily&utm_campaign=dailyalert_not_activesubs&referral=00563&deliveryName=DM73690  and

“That discomfort your feeling is grief. ” https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief?ab=hero-subleft-3

 

Sincerely,

John G. Albertini, MD