Do you eat in the Doctor's Lounge?

[XRT_doc]

Do you guys eat in the doctor's lounge during this Covid-19 pandemic? I kind of want to stay away from the pulmonologists and hospitalists so I've stopped eating there. Any of you taking the same precautions?

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[BobbyHeenan]

I did a couple of times a week, but no way in hell I'm going there now. If I get an inpatient consult unless they really need treatment, I'm likely going to avoid seeing patient unless absolutely necessary and wait until they're discharged to see them in clinic in a more controlled environment.

 

[medgator]

Our doctors lounge basically is switching the hot food line from self service to being run at the cafeteria and stocking more grab n go items

 

[KHE88]

A lot of doctors here are still in denial, especially those mainly reimbursed on procedure volume such as surgeons. They are upset at the prospect of losing their income. Of course, they all congregate in large groups in the doctors' lounge. Bringing up the whole situation to admin, I am again made to be a stupid conspiracy theorist who is gullible and tricked by CNN and told that all of the other doctors think it's way overblown.

I'm so done with this.

 

[Palex80]

Our cafeteria has undertaken some measures:

1. Switched from max. 4 people per table to 2 people per table, seated in a diagonal manner (two chairs removed).
2. We need to keep 2 meters apart in line.
3. You get spoons, fork, knife placed on your plate (you are not supposed to take them out of any box)
4. No self-service buffet. You say what you want and someone else places it on your plate.
5. Salad bar closed. Salad can be purchased in pre-packed containers.
6. Payment only with cards / badge, no notes/coins
7. A maximum of XXX persons at the cafeteria at the same time. There is someone checking all the time and stopping additional people from coming in.
8. Tables cleaned with desinfectant wipes the moment you stand up and leave.
9. Longer opening times in order to avoid lines.

It's alot more quiet... Food is getting better, I think they are trying their best in keeping us happy... I fear next week is going to hit us hard...

 

[deleted1002574]

All Grab and Go, now. I hear the soft serve machine is going to be out of service. What a time to be a doc ..

 

[deleted1002574]

A lot of doctors here are still in denial, especially those mainly reimbursed on procedure volume such as surgeons. They are upset at the prospect of losing their income. Of course, they all congregate in large groups in the doctors' lounge. Bringing up the whole situation to admin, I am again made to be a stupid conspiracy theorist who is gullible and tricked by CNN and told that all of the other doctors think it's way overblown.

I'm so done with this.

Garbage people. Keep sending friendly emails to admin, keep the evidence.

 

[Tigerstang]

A lot of doctors here are still in denial, especially those mainly reimbursed on procedure volume such as surgeons. They are upset at the prospect of losing their income. Of course, they all congregate in large groups in the doctors' lounge. Bringing up the whole situation to admin, I am again made to be a stupid conspiracy theorist who is gullible and tricked by CNN and told that all of the other doctors think it's way overblown.

I'm so done with this.

Seriously are you me? This is getting creepy.

 

[XRT_doc]

Well we still want our surgeons to do the lumpectomies

 

[BobbyHeenan]

Well we still want our surgeons to do the lumpectomies

Better than a mastectomy with a hospital stay.

 

[evilbooyaa]

Well we still want our surgeons to do the lumpectomies

Lumpectomies for early stage breast or DCIS can wait up to 3 months for their lumpectomy, dependent on age of patient.

 

[Gfunk6]

I would avoid doctor's lounges like the plague (pun intended).

With regard to surgeries, it is nuts around here. All hospitals and surgical centers have cancelled "elective" surgeries though there is wild variance on how precisely to define that. Fortunately, anything cancer-related seems to get a pass although operative time has been dramatically slashed by as much as 50% - so getting patients what they need is harder.

Nationwide there are myriad tragic situations of patients getting caught in the middle. One of my patient was scheduled for a nerve block for crippling pain in his lower extremity due to metastatic cancer - this has been delayed by at least two weeks.

 

[taserlaser]

They are limiting ICU stay needed type heroic type surgeries I think here. Not saying no, but weighing it against resources used.

 

[BobbyHeenan]

I would avoid doctor's lounges like the plague (pun intended).

With regard to surgeries, it is nuts around here. All hospitals and surgical centers have cancelled "elective" surgeries though there is wild variance on how precisely to define that. Fortunately, anything cancer-related seems to get a pass although operative time has been dramatically slashed by as much as 50% - so getting patients what they need is harder.

Nationwide there are myriad tragic situations of patients getting caught in the middle. One of my patient was scheduled for a nerve block for crippling pain in his lower extremity due to metastatic cancer - this has been delayed by at least two weeks.

Our hospital and neighboring "competitors" banded together to come up with an OR triage list of what is still going on and what isn't. It goes something like this...

Tier 1 - the obvious - carpal tunnels, cosmetics, cataracts, knees and hips - not allowed to be done right now
Tier 2 - low risk cancer (like early stage breast); surgeons are to "strongly consider" delaying
Tier 3 - emergency or high risk cancer are allowed to continue

 

[Palex80]

Our hospital and neighboring "competitors" banded together to come up with an OR triage list of what is still going on and what isn't. It goes something like this...

Tier 1 - the obvious - carpal tunnels, cosmetics, cataracts, knees and hips - not allowed to be done right now
Tier 2 - low risk cancer (like early stage breast); surgeons are to "strongly consider" delaying
Tier 3 - emergency or high risk cancer are allowed to continue

There are also a ton of other diagnostic & therapeutic procedures in other disciplines.

All the vertigo / hearing tests the ENT-people do.
All the minimal invasive (often simply cosmetic) procedures the angiologists do for varicosis.
All the colonoscopies performed for early detection of polyps/cancer in high-risk patients as well as all follow-up colonoscopies, gastroscopies after polyps/cancer treatment
All the dementia screening / workup done by neurologists
All the sleeping disorders stuff the neurologists/pneumologists do (sleep lab)

The list goes on and on.

 

[BobbyHeenan]

There are also a ton of other diagnostic & therapeutic procedures in other disciplines.

All the vertigo / hearing tests the ENT-people do.
All the minimal invasive (often simply cosmetic) procedures the angiologists do for varicosis.
All the colonoscopies performed for early detection of polyps/cancer in high-risk patients as well as all follow-up colonoscopies, gastroscopies after polyps/cancer treatment
All the dementia screening / workup done by neurologists
All the sleeping disorders stuff the neurologists/pneumologists do (sleep lab)

The list goes on and on.

Yes - all that stuff is on the list, I just mentioned examples.

Mammograms, screening CTs , etc have been stopped as well.

 

[metallica81788]

Radiology is calling me trying to postpone any scan that isn't "medically necessary" for a few weeks maybe up to a month. Then the patient has to find out. Cue the angry grade 1 meningioma patient whose MRI has been stable for 3 years...

 

[radoncgrad2019]

I haven’t any patients upset about cancellations for things that can be delayed. They don’t want to be around hospitals either

 

[metallica81788]

That's been my only one so far. Most others are reasonable like you mentioned. Trying to do more telemedicine, but just started that the other day.

Wondering when the fountain drink machine in the lounge will get shut down - it's already a trek to get there with all of the screenings.

 

[deleted605854]

Never have because I don't like the food there. I always bring my own food, I would sometimes get coffee from there. But I'll probably never ever go there again.

 

[Carotenoid]

Lumpectomies for early stage breast or DCIS can wait up to 3 months for their lumpectomy, dependent on age of patient.

is it going to be 3 months though?

 

[Carotenoid]

Yes - all that stuff is on the list, I just mentioned examples.

Mammograms, screening CTs , etc have been stopped as well.

yup, colonoscopies. A rectal pt of mine who did a TNT - his/hers colo was cancelled as well.
I guess in a year or so we will have a whole bunch of advanced cancers + palliative cases.

 

[BobbyHeenan]

yup, colonoscopies. A rectal pt of mine who did a TNT - his/hers colo was cancelled as well.
I guess in a year or so we will have a whole bunch of advanced cancers + palliative cases.

Right now that kind of colonoscopy still allowed but baseline screening not. We’re not a in a “hot spot” of C19 cases yet, but will be like the rest of the world in a week or so.

 

[Palex80]

is it going to be 3 months though?

You can also put them on antihormonal treatment if you feels it's too risky to wait without any treatment. Make sure you clip the tumor first, though...

 

[Carotenoid]

You can also put them on antihormonal treatment if you feels it's too risky to wait without any treatment. Make sure you clip the tumor first, though...

antihormonal for rectal cancer??? hmmmm... here is an idea

 

[Palex80]

antihormonal for rectal cancer??? hmmmm... here is an idea

LOL, sorry, I was referring to the post on breast cancer...

 

[Mandelin Rain]

I’m going to be honest, I don’t think deferring patients is going to work out all too well for departments.

This virus will (likely) diminish over the summer, but there will be a backlog of patients. The lowest risk will be deferred again. And then... when the virus reactivates in autumn, they’ll be deferred again. Or will they?

I’ve changed my approach on this to hypofractionating heavily those I believe need treatment and telling those that don’t (really) need treatment to stay away. No deferrals.

 

[xrthopeful]

I’m going to be honest, I don’t think deferring patients is going to work out all too well for departments.

This virus will (likely) diminish over the summer, but there will be a backlog of patients. The lowest risk will be deferred again. And then... when the virus reactivates in autumn, they’ll be deferred again. Or will they?

I’ve changed my approach on this to hypofractionating heavily those I believe need treatment and telling those that don’t (really) need treatment to stay away. No deferrals.

not wrong. I don't think deferring right now is wrong either though. if i was treating a breast now though I would be doing 5 fractions probably.

 

[Mandelin Rain]

I don’t think it’s wrong. It’s just that there’s no end in sight. And we don’t know where we’ll be in 3 months. Might be worse.

Just trying my best, as I assume everyone is.

 

[evilbooyaa]

is it going to be 3 months though?

Can re-assess after sometime but minimum of 8 weeks I believe? It'll honestly dependent on new infection kinetics.

 

[evilbooyaa]

yup, colonoscopies. A rectal pt of mine who did a TNT - his/hers colo was cancelled as well.
I guess in a year or so we will have a whole bunch of advanced cancers + palliative cases.

Yeah, wouldn't be cool with that as a physician or a patient. Delayed a month, maybe, but not fully cancelled.