The Self-Harm Continues

Things are starting to pick back up at our small-town hospitals down south, but we aren’t back to normal numbers yet.  If you saw the sudden evaporation of demand for non-Covid-19 emergency and urgent care, then have a cookie, but it surprised the rest of us.  We have had patients with acute coronary syndromes and intra-cerebral hemorrhages leave the ER for fear of “the coronavirus” despite all pleadings.  What has happened is stunted, nonsensical, panicky, idiotic.  None of our staffs have been laid off, but hours are being looked at for trimming at small county hospitals with razor thin margins even in a good year.  Force a lot of the local population to stay home from work well past the point of common sense, and the economies will continue to roll downhill for the rest of the year and well into the future.  

And many of us in the ER have been relatively isolated from the immediate effects of the Great Viral Clench.  Merritt Hawkins surveyed 842 physicians, and found that 21% have “experienced pay cuts or have been furloughed as a result of the crisis.” 

With a “crisis” comes lots of thrashing and expenditure.  “Congress passed a $2 trillion coronavirus relief package in March called the CARES Act, and while it provides $100 billion for hospitals, the promise of the funding hasn’t been able to stop the drastic job changes healthcare workers are facing.”  Of course, it hasn’t.  In much the same way that the massive Affordable Care Act boondoggling didn’t fix health care, so I am more than a little skeptical that this latest Congressional movement will do more than further line the pockets of Big Hospital.  “Medical University of South Carolina in Charleston started temporarily laying off 900 workers this week, a move it expects will last through June.” 

“The hospital confirmed that workers won’t face cuts if they are treating patients with COVID-19…”  And if they’re treating non-Covid conditions?  “The cuts at MUSC came as the hospital saw a 75% drop in surgeries, 30% fewer patients arriving at the hospital, and 70% fewer patients arriving there by ambulance. Without staffing changes, it projected a $100 million loss through June 30.”

Almost two years ago, after its roof was torn off by Hurricane Michael, a local regional medical center in Panama City, Florida laid off 800 people in a move adding to the local devastation, and severely limiting ready access to care in our region.  That hospital was just starting to get back on its feet when the Age of Covid was declared.  What happened to them two years ago was tragic; what’s happening now in Charleston and across the nation is worse for its needless stupidity. 

“As a result of the pandemic, 14% of physicians said they plan to seek a different practice, and 6% said they planned to exit patient care entirely.”  I have personally not been able to get patients in a timely manner in to see cardiologists or general surgeons, resulting in repeat ER visits, and conditions that, if not worsening, are certainly no better.  A family member, a specialist, is retiring six months ahead of schedule, because his previously full waiting room became empty literally overnight and the overhead has become unbearable.  There is no evidence that any of these closures or sudden fear of accessing care has in any way slowed the spread of a virus already regarded as a pandemic.  That will not be a convincing argument for those that claim this would have been far worse without these reactions.  That may be so, but it’s also a very convenient bunker to occupy, unassailable because it can’t be disproven. 

What is certain is that this mass reaction is leading to delayed diagnoses, and absent intervention.  While another opportunistic infection – the LELT movement – is waiting in the wings to fill the vacuum, leading media figures, benighted politicians, and a permanently cowed public are eliminating the very professionals they claim to need most. 

Here’s your mask.

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at AuthenticMedicine.com . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption.