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Primary Care is Public Health

This morning I was quoted in the Portland Press Herald along with Dr. Linville of Brunswick in a piece titled, “Health care providers outside of hospitals feel “neglected” in vaccine rollout.”

The piece summarizes the frustration of hundreds of frontline providers that are being ignored by hospital systems. I offered an opinion that trusting hospitals with the rollout led to many nonclinical, lower tier staff employed by hospitals receiving the vaccine before nonaffiliated independent physicians. The hospitals wouldn’t return our calls stating they were awaiting guidance. The Maine CDC told us to call the hospitals and trusted that they were still vaccinating Tier 1a (inner circle). The truth is many nonclinical staff including administrative and researchers were being vaccinated and many have moved to Tier 2. Now their outpatient practices that don’t provide testing are vaccinated.

Physicians are Tier 1. I understand we received less vaccine from the federal government, but we should have been included by now. It is clear we have been overlooked and the state has no plan. I would gladly go to my local fire department or hospital to receive my vaccine. It doesn’t have to be more complicated than that.

We used the proper channels including the Maine Osteopathic Association and Maine Medical Association, but we were unable to get answers. After yesterday’s CDC briefing suggested a 2-week timeline and no structure to offer us vaccines, I answered the call from the Herald and explained what was really going on.

Hospital infrastructure and emergency personnel must be preserved. Nursing homes should be offered vaccine to protect our most vulnerable. Neglecting primary care, a group that sees everyone and exposes themselves to asymptomatic carriers as well as swabbing those with possible COVID was an oversight. Maine needs to improve their health department infrastructure and truly support a more structured network of primary care. This pandemic exposed our inability to organize and thus truly flatten the curve.

Primary care physicians are small businesses and many of us are testing and triaging our own patients and others to keep the public safe and the emergency rooms from being flooded. If we stop testing, it will cause more of a backup and delay to care. Many of my colleagues will stop testing now that others are vaccinated. Taking that risk doesn’t make sense seeing that if we get sick, we will have to shut down for 2 weeks. Luckily, we can transition to telehealth and I have a colleague that is prepared to see my patients if I get sick.

These vaccines have 95% efficacy after 2 weeks. Independent physicians are hoping to be vaccinated early so we can help in the effort to vaccinate the public. I signed up to receive and administer COVID19 vaccines for the public either through my office or another site. I have refrigeration and freezing capabilities for the Moderna vaccine. This is why our physicians must be vaccinated now. We must protect our clinicians so they can safely administer to the public which will expose them to so many asymptomatic carriers.

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