An update from our Chief Medical Officer:

This has been a strange week; bookended on Monday by a Labor Day holiday during which we all relax, celebrate, and honor the American workforce responsible for the achievements of the United States, and on Friday by a somber reflection on the tragic events of the 9/11 attacks and a recognition of the many heroes who performed selfless acts of courage in the aftermath.

Someday, I anticipate that our offspring will honor the multitude of health care heroes that have responded to the challenge of this current COVID-19 pandemic, and our entire company and all teammates should feel proud of the QualDerm response. It is certainly not over yet, but we are very responsibly taking care of our patients and each other. For that I thank you all.

• U.S. case counts and deaths continue falling, although Midwest states and many college towns remain hot spots

I participated in a very informative and enlightening webinar this week entitled “The Opportunity of Trust” in which a health care consulting firm reviewed the findings of its August 2020 nationwide survey of public perceptions regarding the pandemic and related issues. I share some highlights and key findings, especially as they impact how we continue navigating this crisis.

• The public trusts health care workers (87% for doctors; 88% for nurses), although trust is declining slightly as the crisis becomes prolonged
  • Trust = 75% for CDC; 71% state/local health departments; 55% media; 54% insurance companies; 36% Trump
  • PROTECTING THIS SACRED TRUST IS PARAMOUNT; recommendations must be based in science, facts, data and then communicated with transparency
  • Trust is hard to win and easily lost

• Using scale of 1-10, how safe do you feel at doctor’s office? = 5.8 (moderately)
  • 25% rating of <3.0 meaning they feel quite unsafe

• Safety perception generally unchanged since poll in April; patients remain anxious about in-person office visits
  • Screening, masks, distancing, enhanced cleaning improve patient perceptions of safety – reinforced by our own QDP surveys

• 90% support health care workers educating the public = greatest opportunity to leverage this trust to reinforce the science for masks and vaccines!
  • Masking resistance now very low, but vaccine resistance growing
  • 78% always wear mask when outside home/interactions
  • ONLY 53% very or somewhat likely to get COVID-19 vaccine when approved
    • Women, minorities, reside in South = more vaccine hesitant
• Another poll shows that public trust in a C-19 vaccine has diminished from 32% in July to only 21% in September, likely related to distrust of government officials
• 2/3 of Americans believe that vaccine by Jan 2021 will have insufficient safety testing
  • In response to this growing concern, on Tuesday chief executives from 9 pharmaceutical companies with vaccine candidates signed a pledge promising to not file for regulatory approval or authorization of their Covid-19 vaccines until safety established through late-stage clinical testing. The heads of AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck, Moderna, Novavax, Sanofi, BioNTech and Pfizer said “the safety and well-being of vaccinated individuals” would always be their top priority. They also pledged to ensure equitable supply across the world.
    o Remember that smallpox and polio have been eradicated by effective safe vaccines and the science supporting immunizations is amongst the strongest in the history of medicine
    o All health care providers can positively influence patient perception of vaccine safety, help our economy rebound and save lives

• AstraZeneca paused clinical trials of an experimental Covid-19 vaccine after a U.K. participant developed an unexplained neurologic illness. The voluntary pause will allow an independent committee to review safety data. AstraZeneca called the pause a “routine action which has to happen whenever there is a potentially unexplained illness in one of the trials, while it is investigated, ensuring we maintain the integrity of the trials.”
• Wednesday I reviewed the transcript of the Senate Health, Education, Labor & Pensions (HELP) Committee hearing “Vaccines: Saving Lives, Ensuring Confidence, and Protecting Public Health.” The witnesses were Dr. Francis Collins (NIH Director) and Dr. Jerome Adams (Surgeon General) and it definitely confirmed to me that no vaccine will be approved without a completely transparent, scientifically rigorous, non-political process to ensure safety and efficacy. A link is included for those interested.
• Avoid “super-spreader” scenarios
  • Many states are now further reopening gyms, bars, restaurants, theaters and sports and entertainment venues with variable restrictions on size of gatherings
  • Many events such as political rallies, protests, tailgating, festivals combine “many of the ‘worst-case scenarios’ for superspreading” e.g. lasting for hours/days, pack people together, bring many visitors from out of town, and have lower compliance with safety measures including wearing masks. PLEASE AVOID THESE TYPE OF SITUATIONS!!

Most providers are aware, but all employees should also note that the 2021 Medicare Physician Fee Schedule was released recently, which dictates the payment rates for all visits and procedures. If finalized, it unfortunately would negatively impact reimbursement for most specialties, including dermatology. Along with the American Academy of Dermatology and other specialty societies and industry groups, QualDerm is developing a grassroots outreach effort to contact all our elected members of Congress to request an exemption to the rule that would finalize the Fee Schedule, thus retaining current rates of reimbursement through 2021. This effort will require all providers to send letters/emails to their Representative and Senators and our management team is developing a painless and efficient process with a templated letter. Please help us help you in maintaining fair payment for our services, especially during this time of the COVID-19 pandemic when all physician practices have already suffered significant financial loss. Be on the lookout for our communications in this regard.

Please continue taking care of yourselves, your families, patients and co-workers by remaining vigilant and compliant with the established safety protocols. Don’t let your guards down as we move into cooler weather and the increased risks of indoor living. Get your Flu shot, which has been ordered and will be distributed in our clinics and encourage your families and patients to do the same. Co-infection with both influenza and COVID-19 could be very serious.

Sincerely,

John Albertini, MD