April 8, 2020 – Twin Cities Pioneer Press —
As Minnesota hospitals prepare for a surge in coronavirus patients, it is almost certain that they will need more doctors and nurses.
In addition to seeing higher numbers of patients, many front-line health-care workers will likely become sick and require replacements. As hospital beds are added, staffing needs will increase. These needs may be especially acute in rural areas which suffer from well-documented chronic shortages of doctors and nurses. Rural Minnesota also has an older population which is at higher risk from COVID-19 and more likely to require hospitalization.
Despite these foreseeable problems, it is still unclear what, if any, plans our state has to deploy doctors to these areas, train them for the unique working conditions of the crisis, and enable them to start working quickly should an urgent need arise.
Fortunately, Minnesota does have an established program for such a calamity, called the Medical Reserve Corp (MN Responds MRC) program. I, like many other doctors, am registered with MN Responds MRC and prepared to provide emergency assistance in the case of pandemic disasters. Other doctors I have spoken with are signing up right now, and the Minnesota Medical Association is directing physicians to this program. But surprisingly, the Department of Health does not appear to have prioritized MRC or any other pathway for involving emergency-response physicians in any comprehensive way. Nor is it clear it has plans to protect their safety with adequate PPE.
Over the past month I’ve contacted hospitals, the Department of Health, professional societies, state legislators, emergency room physicians and the governor’s office, asking how I and other doctors can help. What I’ve learned is discouraging but not surprising. Administrative and bureaucratic barriers to rapid recruitment and deployment seem to be slowing things down, not unlike the way such barriers chronically impede health-care decisions and increase costs even when we are not in crisis mode. Also, the fragmentation of our health-care system and poor communication among its entities is only exacerbating the problem, and I fear this will unnecessarily cost the lives of Minnesotans as this crisis unfolds.
Because we can expect that all emergency and intensive care physicians in Minnesota will be working at or beyond capacity, doctors who are called in to assist or replace them will likely be specialists in other areas of medicine. These replacements will need to be oriented and provided with brief training, something that requires preparation and planning ahead of time, not spur-of-the-moment. Such organization also requires cooperation and respect among physicians from all specialties.
There are also credentialing and licensing obstacles that must be dealt with before MRC members can be called up effectively. Background checks of medical licenses, credentials, and work histories are required of all medical doctors, even state employees, for each and every hospital they work in, and such investigations can take weeks or months normally. Minnesota will need to temporarily reduce such administrative and liability requirements so as to allow doctors to move quickly among hospital facilities in urgent need of medical personnel, as has been done in New York and other states. But no one at the Department of Health seems to have made these issues, or even use of the already existing Medical Reserve Corp, part of the state strategy for dealing with COVID-19.
I urge Gov. Walz and the Minnesota Legislature to make immediate decisions related to the possibility of urgent additional staffing of hospitals, and to issue a clear message to physicians, hospitals and the public about the role of the Medical Reserve Corps and whether and how they intend to use it. I urge them to pass laws or provide executive orders waiving onerous credentialing requirements and enabling licensed doctors to be quickly deployed around the state to respond to COVID-19.
I also urge them to take steps to encourage effective teamwork and communication among the numerous entities, private as well as public, that make up Minnesota’s complicated health care system, because to date this does not appear to be happening to the degree that may soon be needed if lives are to be saved.
Andrea Nelsen, M.D., Prior Lake, is a psychiatrist and also has a master’s degree in public health. She is a DFL candidate for the Minnesota House of Representatives from District 55B.