Group policies for being COVID+

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siednarb

siednarb

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Wondering what all the groups, especially PP groups, are doing if/when a physician anesthesiologist tests COVID+
Are they staying home 10-14 days? Less?
Coming back to work after X days symptom/fever free?
If missing work, are they docked PTO time? financial hit in some other capacity? work an extra call when recovered? etc...
Or Make it up in some other capacity?


Also - what if a physician's in-house family member (spouse, children etc...) are positive?
Is your group's expectation that the physician also quarantine? If so for how long? Stay working until symptomatic?

With numbers increasing in my midwest state location, we would like to know what others are doing with this scenario, what steps are being taken and what renumeration with regards to such a prolonged quarantine

For those who also have CRNAs in their prevue are the rules the same for them in your group(s).

TIA for any insight you can provide as to what you may be doing with regards to this issue.
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This is academic perspective (and I'm not anesthesia, but to my knowledge same policy institution-wide), but we're following CDC guidelines with exception of quarantining ourselves for exposure to close contacts who become known positive as long as the physician remains asymptomatic. Expectation would be to distance from that individual as best as possible. AFAIK no reimbursement unless you opt to use sick days, just an expectation that you make up missed shifts down the road. Policy has been dynamic. As COVID explodes I wouldn't be surprises if that becomes much more lax

Edit: holy crap 20 year member. I don't think I've seen a message board with anyone who has been a participant nearly as long as that. Also had no idea SDN has been around that long
 
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We were very good at protecting ourselves, luckily during the first wave, no one got sick.

We are mostly hospital based practice. The hospital policy has been, especially in the beginning when there weren’t enough tests, as long as the workers are asymptomatic, they were expected to come to work.

The situation is very dynamic and can shift on a day to day basis. We are thinking about closing or slowing down elective surgeries again. Then your workforce will slim down.

If the positive rates and hospitalization keep going up, some of older workers (physicians, crna, techs) may elect to just stay home or take the early retirement. We were down to 3-5 urgent/emergent cases a day. And maybe 3-5 covid intubation at its height in April. Nothing compare to NJ or NY.

I don’t think there will be an universal one size fit it all solution. But it will be something that either the leadership or all the partners have to agree and can live with. When you’re only doing 1/5 of your usual volume, you can’t really keep paying people to come in and do nothing either.
 
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WheezyBaby said:
Edit: holy crap 20 year member. I don't think I've seen a message board with anyone who has been a participant nearly as long as that. Also had no idea SDN has been around that long
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Thanks for making me feel old as hell (though I'm 'only' in my 40s) - I joined SDN when I started medical school in 2000


IMGASMD said:
We were very good at protecting ourselves, luckily during the first wave, no one got sick.
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We were also good about protecting ourselves and still are - and also during the first wave none of us got sick - but the numbers are just exponential now in our area and we feel it's only a matter of time before someone gets COVID (likely from out of the hospital than in the hospital) and we want to have some semblance of a policy in place for how to deal with it - from both a scheduling perspective and a financial affect perspective
 
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siednarb said:
Thanks for making me feel old as hell (though I'm 'only' in my 40s) - I joined SDN when I started medical school in 2000



We were also good about protecting ourselves and still are - and also during the first wave none of us got sick - but the numbers are just exponential now in our area and we feel it's only a matter of time before someone gets COVID (likely from out of the hospital than in the hospital) and we want to have some semblance of a policy in place for how to deal with it - from both a scheduling perspective and a financial affect perspective
Click to expand...

It’s always good to have plan b,c and d. But I think it’s so dynamic and depending on sooo many other players, hospital administration, surgery center admins.... etc etc.

Probably 14 days mandatory off, which would be the right thing to do. But like you also eluded to in OP, who is going to shoulder the financial fall out?
 
siednarb said:
Wondering what all the groups, especially PP groups, are doing if/when a physician anesthesiologist tests COVID+
Are they staying home 10-14 days? Less?
Coming back to work after X days symptom/fever free?
If missing work, are they docked PTO time? financial hit in some other capacity? work an extra call when recovered? etc...
Or Make it up in some other capacity?


Also - what if a physician's in-house family member (spouse, children etc...) are positive?
Is your group's expectation that the physician also quarantine? If so for how long? Stay working until symptomatic?

With numbers increasing in my midwest state location, we would like to know what others are doing with this scenario, what steps are being taken and what renumeration with regards to such a prolonged quarantine

For those who also have CRNAs in their prevue are the rules the same for them in your group(s).

TIA for any insight you can provide as to what you may be doing with regards to this issue.
Click to expand...

We are fairly strict. Recently had a trauma patient that went to the OR and nobody was wearing PPE. Patient turned out to be covid positive. That anesthesiologist is being quarantined at home for 10-14 days.

Our community was awesome during the first wave, this second wave is hitting us hard. Have 90 some staff members that have tested positive.
 
siednarb said:
Thanks for making me feel old as hell (though I'm 'only' in my 40s) - I joined SDN when I started medical school in 2000



We were also good about protecting ourselves and still are - and also during the first wave none of us got sick - but the numbers are just exponential now in our area and we feel it's only a matter of time before someone gets COVID (likely from out of the hospital than in the hospital) and we want to have some semblance of a policy in place for how to deal with it - from both a scheduling perspective and a financial affect perspective
Click to expand...

Hows the michigan 68
 
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IMGASMD said:
If you don’t have enough personnel, this can be a problem.
But if IIRC, you have a big group that can do this.
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Yea, we have the same issue here. Currently we're short staffed due to several retirements during COVID, went from 44 anesthesia docs, down to 39, also down from 11 AA to 8 for other various reasons. There's no way we could handle any of us quarantining for a full 14 days.

Currently our guidelines are to return to work after being afebrile for 72 hours.
 
OTCAwesome said:
Yea, we have the same issue here. Currently we're short staffed due to several retirements during COVID, went from 44 anesthesia docs, down to 39, also down from 11 AA to 8 for other various reasons. There's no way we could handle any of us quarantining for a full 14 days.

Currently our guidelines are to return to work after being afebrile for 72 hours.
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You can still transmit the virus if you are afebrile. I hear you. Not ideal... and no real good answer besides shutting down elective surgeries again- not popular.
 
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sevoflurane said:
We are fairly strict. Recently had a trauma patient that went to the OR and nobody was wearing PPE. Patient turned out to be covid positive. That anesthesiologist is being quarantined at home for 10-14 days.

Our community was awesome during the first wave, this second wave is hitting us hard. Have 90 some staff members that have tested positive.
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Jesus, no PPE! At my places, covid (+)/(-), or unknown, everyone gears up. Anesthesiologists N95 (sometimes PAPR), faceshield all the time. I have been doing this for almost 8 months!
 
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if you are positive, you are out for 14 days minimum and at least 72 hours with no symptoms

if you have close contact with someone who is positive you have to test negative prior to returning to work

we don't dock pay for people being quarantined but it is expected you will make it up to whoever has to cover one of your calls or weekends in your absence
 
narcotics999 said:
Jesus, no PPE! At my places, covid (+)/(-), or unknown, everyone gears up. Anesthesiologists N95 (sometimes PAPR), faceshield all the time. I have been doing this for almost 8 months!
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Yeah... they f'up in the setting of a trauma patient. Big email went out to our group regarding compliance with PPE. We have the same standards... this particular partner bought himself 2 weeks of unpaid leave.
 
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narcotics999 said:
Jesus, no PPE! At my places, covid (+)/(-), or unknown, everyone gears up. Anesthesiologists N95 (sometimes PAPR), faceshield all the time. I have been doing this for almost 8 months!
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Same. Exactly for this situation because I don’t want to quarantine. We’ve had several patients who are initially negative become positive in the next few days.
 
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I recommend everyone be extra vigilant as the community (and some who work in hospitals) get “COVID fatigue” and cases start to rise
 
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Twiggidy said:
I recommend everyone be extra vigilant as the community (and some who work in hospitals) get “COVID fatigue” and cases start to rise
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It already happened. We are up to 160k cases a day and the numbers continue to rise at a brisk pace. A month ago it was holding steady at 30k a day for quite a while.

Even on this website where you would think that medical professionals would be wise to the situation, we had a bunch of emergency medicine attendings spouting nonsense about freedom from masks and crap like that to the point where the administration stepped in.
 
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About 40 in house and 12 intubated. Did 5 myself. I am getting a little fatigued already. I thought it was suppose to disappear after the election....

I am scared.....
 
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We follow the CDC guidelines if positive, which I think are still 10 days after 1st symptom/positive test and at least 3 days afebrile, with resolving symptoms. Staff primarily taking care of onco/immune compromised patients need a negative test as well.
Lates and calls are compensated, so if someone else did them, they get the extra $$. Our income isn’t determined by days worked, so no change there. You don’t have to make them up if you go out sick less than 8 weeks. I think that’s when you’d go on long term disability.
Known significant exposure quarantines for 7 days post exposure and can come back with negative test provided they are asymptomatic and complete daily symptom checklist for 7 more days. I’m not sure what would happen if you can’t quarantine from a family member. I’d just move into the basement. It has a separate entrance, full bath, pull out couch, liquor, etc.
CRNAs are employed by the hospital and have to follow their rules. They have to take accrued sick leave, paid time off, then unpaid time off, etc. Totally different.
 
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IlDestriero said:
We follow the CDC guidelines if positive, which I think are still 10 days after 1st symptom/positive test and at least 3 days afebrile, with resolving symptoms. Staff primarily taking care of onco/immune compromised patients need a negative test as well.
Lates and calls are compensated, so if someone else did them, they get the extra $$. Our income isn’t determined by days worked, so no change there. You don’t have to make them up if you go out sick less than 8 weeks. I think that’s when you’d go on long term disability.
Known significant exposure quarantines for 7 days post exposure and can come back with negative test provided they are asymptomatic and complete daily symptom checklist for 7 more days. I’m not sure what would happen if you can’t quarantine from a family member. I’d just move into the basement. It has a separate entrance, full bath, pull out couch, liquor, etc.
CRNAs are employed by the hospital and have to follow their rules. They have to take accrued sick leave, paid time off, then unpaid time off, etc. Totally different.
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You have a basement?
 
narcotics999 said:
Jesus, no PPE! At my places, covid (+)/(-), or unknown, everyone gears up. Anesthesiologists N95 (sometimes PAPR), faceshield all the time. I have been doing this for almost 8 months!
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Agree. Why would anyone do any case without PPE? We've got plenty of N95s (no more UVC or other disinfection methods like when this started), plenty of re-usable face shields and lots of disposable goggles and masks with face shields. And we do that in a hospital where every elective surgery patient is tested pre-op and the air cleaners are in every OR running 24/7.
 
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nimbus said:
Same. Exactly for this situation because I don’t want to quarantine. We’ve had several patients who are initially negative become positive in the next few days.
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That sounds exactly like my rotation back in April/May where pt's were required to have 2 negative tests prior to surgery and we STILL have pt's testing positive a day or two later.
 
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MirrorTodd said:
That sounds exactly like my rotation back in April/May where pt's were required to have 2 negative tests prior to surgery and we STILL have pt's testing positive a day or two later.
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We used to tell patients to try to isolate after their test (which has to be within 72 hours) but I don’t think they do that anymore. Perhaps we should start again. Of course there’s still no guarantees. One could get exposed around the time of the test and pass only to be contagious shortly thereafter.
I don’t wear N95s for negative patients, but maybe I’ll start as the second wave is rolling in.
 
IlDestriero said:
We used to tell patients to try to isolate after their test (which has to be within 72 hours) but I don’t think they do that anymore. Perhaps we should start again. Of course there’s still no guarantees. One could get exposed around the time of the test and pass only to be contagious shortly thereafter.
I don’t wear N95s for negative patients, but maybe I’ll start as the second wave is rolling in.
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I am already going back to the same procedure as before. Going to put on n95 before I enter the hospital. It only comes off, when eating, if I decide to eat.

But like what everyone else eluded to, this thing is more likely transmitted outside of hospital than inside....

The only time I don’t really wear some sort of mask now is when I’m at home or in my car.

It really really boggles my mind, when we have ED physicians in the forum that really believe that the mask won’t do anything good.
 
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IlDestriero said:
We used to tell patients to try to isolate after their test (which has to be within 72 hours) but I don’t think they do that anymore. Perhaps we should start again. Of course there’s still no guarantees. One could get exposed around the time of the test and pass only to be contagious shortly thereafter.
I don’t wear N95s for negative patients, but maybe I’ll start as the second wave is rolling in.
Click to expand...

A few months ago our institution recommended (but didn't mandate) eye pro for all patiemt encounters. Didn't do it then but our numbers have gotten to the point where I think I'm going to start
 
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GassYous said:
It already happened. We are up to 160k cases a day and the numbers continue to rise at a brisk pace. A month ago it was holding steady at 30k a day for quite a while.

Even on this website where you would think that medical professionals would be wise to the situation, we had a bunch of emergency medicine attendings spouting nonsense about freedom from masks and crap like that to the point where the administration stepped in.
Click to expand...

So your hospital has thought police?
 
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WheezyBaby said:
A few months ago our institution recommended (but didn't mandate) eye pro for all patiemt encounters. Didn't do it then but our numbers have gotten to the point where I think I'm going to start
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Used to wear a mask over an n95 and a face shield for months. Had like 3 n95s that I reused for weeks. After the situation calmed down I stopped wearing the n95 routinely even when people were leaving the or for intubation and being insane but I think I will start wearing the n95 and mask again. The sheer number of people in this country who seem to have a tenuous grasp of facts is incredible. Look at trump not conceding to his opponent after getting crushed in the election or continuing to claim that the virus will just disappear. It is just mindbogglingly stupid.
 
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GassYous said:
Used to wear a mask over an n95 and a face shield for months. Had like 3 n95s that I reused for weeks. After the situation calmed down I stopped wearing the n95 routinely even when people were leaving the or for intubation and being insane but I think I will start wearing the n95 and mask again. The sheer number of people in this country who seem to have a tenuous grasp of facts is incredible. Look at trump not conceding to his opponent after getting crushed in the election or continuing to claim that the virus will just disappear. It is just mindbogglingly stupid.
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After 2020, my mind can no longer be boggled.
 
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nimbus said:
After 2020, my mind can no longer be boggled.
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Everything is capable of happening in 2020
Em00l5IW8AE3-cS.jpg
 
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abolt18 said:
I don't know what this picture is. I Will Smith and 2 women... Story behind it?
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They are the two Aunt Vivians from Fresh Prince of Bel Air. Will and Aunt Viv #1 had a notorious falling out during the series leading to Aunt Viv #2.
 
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Twiggidy said:
They are the two Aunt Vivians from Fresh Prince of Bel Air. Will and Aunt Viv #1 had a notorious falling out during the series leading to Aunt Viv #2.
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WTF!??!?! I watched that show SO much (never really sequentially though) and I somehow never noticed this??? Oh man, I guess I wasn't really paying attention. Aunt Viv #1 is the one I think of as Aunt Viv, But I definitely recognize Aunt Viv #2.
 
OTCAwesome said:
Yea, we have the same issue here. Currently we're short staffed due to several retirements during COVID, went from 44 anesthesia docs, down to 39, also down from 11 AA to 8 for other various reasons. There's no way we could handle any of us quarantining for a full 14 days.

Currently our guidelines are to return to work after being afebrile for 72 hours.
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Are you located in GA? I ask because of the AA part.
 
abolt18 said:
WTF!??!?! I watched that show SO much (never really sequentially though) and I somehow never noticed this??? Oh man, I guess I wasn't really paying attention. Aunt Viv #1 is the one I think of as Aunt Viv, But I definitely recognize Aunt Viv #2.
Click to expand...
Seriously? Well you clearly missed a bunch of seasons then.
So odd. They look NOTHING alike.
 
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