HOT TOPICS IN FAMILY MEDICINE

Cohorting of Physicians during COVID:

With the COVID outbreak at University Hospital and in some of the area nursing homes, and with rising rates of community transmission there are calls for physicians to cohort at one location or institution as much as possible.

This can be challenging for family physicians as it is the nature of our practice scope to see our patients in various settings. However, we have to be mindful of the possibility of inadvertently transferring COVID from one location to another during the course of our work. This is where family doctors have to get together within or between clinics and collaborate on service provision to minimize the risk of virus transmission from one location to another. This may not always be possible. Family doctors provide essential services such as palliative care, seeing patients at home, or long term care, as well as in the office or clinic. It’s complicated but as much as possible try to adapt to the following:

1. Limit your movement between sites, perhaps by using more virtual care in some areas and collaborate with colleagues to cover services in different locations or sites.
2. If you have been working in a facility in outbreak you can’t go to a non-outbreak facility until after a 14 day quarantine.
3. Currently, if you are working in Long Term Care, not in outbreak, and/or doing community house call work, it is OK to work at Parkwood, for example, without 3-4 day COVID testing. If you are doing LTC work however you will be tested every 7 days. (These recommendations may change as the level of COVID increases).
4. If you are working in a hospital setting please note the guidelines around movement between hospital sites.

At the very least please remember and practice the following:

1. Outside of work follow MLHU guidelines around hand washing, physical distancing, mask wearing, and avoid crowds of people.
2. Have a low threshold for wearing full PPE when seeing patients in any setting.
3. As possible and in collaboration with colleagues restrict your physical presence to one work location as much as possible unless absolutely essential.

Integrated Primary Care Continuum:

At our FM Connections meeting in early Dec. we heard from Nash Syed, Interim Vice President for Integrated Care at LHSC. We had been discussing how a model of integrated primary care with the hospital would look.  At the meeting Nash presented some highlights of the model that is in the early stages of planning. The slides are available here for your review. We really want your feedback from the primary care perspective.

In summary an integrated care model should advance communication between the hospital and primary care, improve and streamline referral processes and transitions from hospital to home. Such a model should lead to improved patients care and experience as well as provider experience, thus meeting the Quadruple AIM.

The next FM Connections is on February 3, 2021 before Grand Rounds in Family Medicine. The topic will be improved access to patient care data for family doctors. Hope you can join us.

London Middlesex Primary Care Alliance:

For a good source of news, events and links to COVID-19 resources look to the Primary care Alliance website and latest newsletter.

Influenza Vaccination for Professional Staff:

Currently the influenza vaccination status of professional staff in Family Medicine at LHSC is only 62 per cent compared to an overall rate of 82 per cent. Seventy-seven percent of professional staff in Family Medicine at SJHC are vaccinated compared to 82 per cent of physicians overall. For Family Medicine this is a reporting issue as many doctors get their shots outside of the hospital but do not report. Please, if you have had your shot outside the hospital, notify LHSC or SJHC as the case may be.

LHSC Professional Staff can self-report by sending an email to: FluUpdate@lhsc.on.ca.

St. Joseph's Professional Staff are requested to fill out a "Proof of Flu Vaccination" form and send it to Occupational Health at Room E2-118, St. Joseph's Hospital.  The form can be obtained here.

Professional Staff who do not get vaccinated must complete an attestation form, available here.