Knowledge Library

Treating Unvaccinated Patients

MIEC has been receiving increasing calls from members who are concerned about patients who have not received a COVID vaccine. Members have expressed concerns regarding the safety of unvaccinated patients, other patients in the practice, and their staff. Some members have expressed an unwillingness to continue treating patients who are either vaccine-hesitant or who have refused to get vaccinated, or they are unwilling to see these patients in their offices. To address this question more broadly, MIEC turned to ECRI, which provided the following recommendations based on a review of clinical and gray literature and ECRI resources. ECRI answers questions...

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Crisis Standards of Care

Over the past few weeks, increasing COVID-19 hospitalizations finally overwhelmed hospitals, driving health officials to cross a threshold that had been avoided successfully since the beginning of the pandemic. Last week, two hard-hit areas of the United States declared “crisis standards of care” due to lack of available healthcare resources in the setting of COVID-19. On 9/7/21 the Idaho Department of Health and Welfare announced that two districts in Northern Idaho would activate crisis standards of care; the rest of the state followed suit on 9/16/21 due to a lack of critical care resources at the state’s largest health system....

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Post-COVID Patients: Timing of Elective Surgery

As the U.S. slowly recovers from the pandemic and COVID hospitalizations decline, a backlog of surgeries is beginning to clear as facilities resume elective surgical procedures. Over the past year, guidelines for performing elective surgery in the setting of COVID have been available from the American College of Surgeons, American Academy of Orthopaedic Surgeons, American Society of Anesthesiologists, and other national authorities. These recommendations have focused on issues such as: ensuring adequate availability of critical care resources, hospital beds, and personal protective equipment in the setting of the pandemic; minimizing the risk of COVID transmission between patients and healthcare personnel;...

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Current Status of COVID-19 Testing

As the nation continues to struggle to manage the COVID-19 (COVID) pandemic, one crucial element to mitigating the crisis- testing- has continued to present a variety of challenges to health care providers.  Barriers to effective COVID testing include shortages of testing supplies, doubts about accuracy, and evolving recommendations around who should be tested.    Types of Tests  Currently, available COVID tests analyze tissue or fluid samples to assess the current or past presence of the SARS-CoV-2 virus.  The types of tests include molecular, antigen, and antibody testing. Most of the COVID-19 testing currently being conducted in the U.S. uses polymerase chain reaction (PCR) technology to amplify and detect the presence of viral DNA.   Each type of test has its advantages and drawbacks.  The FDA published the table below to help inform both providers and the public about the various types of testing being completed in response...

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Masks in the Medical Practice: Can Patients Refuse?

Public health officials and regulatory bodies have been clear that those working, visiting or being treated in a healthcare setting should wear face masks to reduce the spread of COVID-19. While face masks and their overall effectiveness have been questioned by some, wearing a cloth face covering has been shown to reduce the rates of COVID transmission in the population and may even reduce the severity of illness for those who are infected. For this reason, it is recommended that all healthcare providers require patients to wear face masks when they are receiving medical care. Unfortunately, some patients are unable...

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