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Dear Dr <<Last Name>>,
Family doctors like you will be the backbone of our health system’s collective efforts to manage COVID-19 as it makes its way through Ontario. Some of you are already running the COVID Assessment Centres in your community. Many more will need to work outside your usual practice and scope to back-fill urgent medical demand in the coming weeks.
Your work is essential. Your health and well-being are critical. The prospect of facing this pandemic is unnerving to all of us at the front lines in the community, and you are not alone in your concerns. We are working together to prepare, and will continue united in our efforts to deliver safe care over the upcoming months.
Family doctors have succeeded in obtaining funding changes to allow for virtual care, and continue to vocally advocate for resources to make your practices safer, including personal protective equipment (PPE) like masks and gowns.
You have received regular updates on COVID-19 preparation, and the SGFP has been working closely with the OMA and our primary partners including the Ontario College of Family Physicians (OCFP) and the Association of Family Health Teams of Ontario (AFHTO) to bring you information and resources to provide care safely during this crisis. These suggested practices may need to be tailored to your specific patients', clinic’s and community’s needs.
How to change your usual clinic processes to improve safety for you, your staff and your patients:
Reducing all avoidable in-clinic visits:
- Non-essential care appointments should be rescheduled for 3 months.
- Telephone visits can be used for minor (K080) and intermediate (K081) assessments, and counselling / psychotherapy / primary mental health care (K082) sessions (click here for more details).
- Video visits are possible using OTNinvite (requires registration). If you plan to use non-regulated products like FaceTime or Skype, getting informed verbal consent from patients is recommended. Click here for details on implementing video visits in your practice.
- Online screening questions for COVID-19 are available here for patients to use to self-screen for the infection, in order to reduce avoidable clinic visits and directed to designated COVID assessment or self-isolation as appropriate.
- Share the OCFP’s guide for patients to orient them to new clinical care practices during this pandemic.
Reducing transmission of COVID-19 in your clinic:
- Post this sign outside your clinic front door, directing patients not to enter if they have any of the possible COVID-19 symptoms, and to instead call your clinic by phone first for triage and direction for next steps.
- ‘No waiting’ waiting rooms help implement social distancing and reduce transmission of COVID-19 between patients and others within your clinic. Some options to accomplish this include asking patients to wait outside the facility, and calling them on their mobile phone when their examination room is available. Clinic set-ups and environmental conditions may place special constraints.
- More frequent cleaning of exposed surfaces, door handles, countertops, keyboards and pens with bleach, alcohol-based or soap products.
- The use of PPE based on risk assessment (click here for guidelines), as access to sufficient supplies of masks, gowns and even gloves is an issue for many clinics. The SGFP and OMA are strongly advocating for sufficient access to protective equipment for family doctors for instances where face-to-face contact or examination is required.
- Asking all clinic staff to regularly self-assess for COVID-19 symptoms (using the MOHLTC questionnaire) before the start of each shift.
Considering psychological safety for you, your staff and your patients:
The workload, risks to personal and family safety, and ethically challenging circumstances you may be asked to face over the next few weeks will take a toll of all of us. Some of you may be in higher risk and demand situations, and may feel isolated or overwhelmed. Please know that you are not alone.
- OMA’s Physician Health Program is here for you.
- Your colleagues are here for you. Informal social media, and connections and conversations on OMA Exchange can help you reduce isolation and find support when you need it.
- Patient resources from the OCFP and other system partners are in development to address anxiety related to the pandemic, or in the context of concurrent mental health conditions.
Click here to review the OCFP’s COVID-19 page, which will be kept up to date to provide family doctors with details and tips for safer care during this pandemic.
The work you do every day as family doctors is remarkable. During this pandemic, your contributions to our society will become even more essential and apparent. Give your best, consider safety and sustainability, and we will continue to support each other, our neighbours and our health system.
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