Covid-19: working in healthcare

So, should healthcare workers be required to have Covid-19 vaccines?

Yes.

What is the precedent?

Take tuberculosis, for example. Airborne, very contagious. I was born in a Knoxville, Tennessee tuberculosis sanatorium, because my mother coughed blood a month before she was due and got quarantined for active tuberculosis. Yes, the state could quarantine my mother. I was removed immediately at birth because tuberculosis doesn’t cross the placenta. The antibodies do, but the infection doesn’t. However, newborns usually catch it and die very quickly. I was lucky. My father and grandparents took care of me for 5 months. Then my mother was allowed out (after 6 months total) but was not strong enough to take care of me. So I was taken to my maternal grandparents for the next four months, and did not touch my mother until I was 9 months old.

My mother was taking 36 pills a day at home, because you have to use multiple drugs to kill tuberculosis. It develops drug resistance very very quickly.

Well, so what, you say?

Healthcare workers in the United States are routinely checked with a ppd for tuberculosis. If it is positive, you cannot work until further testing. If you have latent tuberculosis, you are treated. If you have active tuberculosis, the treatment is longer and more complicated, here: https://www.cdc.gov/tb/topic/infectioncontrol/default.htm

My cousin then said, “Well, you don’t have to show the tuberculosis test to go in a restaurant!”

Well, not right NOW, because currently tuberculosis is under more or less reasonable control in the US. Remember that guy who came in to the US with active multi drug resistant tuberculosis and knowingly exposed everyone on that airplane? Great. I remember reading about that and thinking what a selfish jerk he was. And then the group of unimmunized people who went to India and all got measles. The US at that time did not bar anyone from returning, but asked them to finish a 3 week quarentine before returning to the US. One person did not do that. There was a measles outbreak in the midwest which cost the CDC (and therefore you and me because those is tax dollars) millions to trace, quarantine and clean up. So there was discussion at that time about whether the policy should be changed and we should not allow US citizens with known infectious diseases to come in on airplanes. We DON’T allow immigrants in with infectious diseases: they are tested for tuberculosis if coming from countries where it is endemic.

So, if we had a huge outbreak of tuberculosis, we WOULD have quarantines and shut downs.

I have tested a patient for tuberculosis, about two years ago. Her son had been diagnosed with active tuberculosis. We tested her with a blood test and then repeated it in three months. Negative, hooray. In residency I also saw a case of miliary tuberculosis. That is where the tuberculosis is growing so well in the lungs that it looks like little grains of rice in the lungs on imaging. Not a good thing.

My cousin: “You shouldn’t have to put something in your body to work.”

If you have tuberculosis, you do not get to work in healthcare, because you can kill your patients. I think that this is a good thing, to not kill our patients.

I am submitting this to the Ragtag Daily Prompt: starspangled. Keep America Healthy, how about that?

I voted

…after I spent about three hours going through paper and throwing it out… ok, like a total numbskull I mislaid my ballot. Have you mislaid your ballot? FIND IT! VOTE!

” …that government of the people, by the people, for the people, shall not perish from the earth.

When I went across the country as a Mad as Hell Doctor in 2009, we talked to people everywhere. I joined the group in Seattle. I had never met any of them and had only heard about them two weeks before. But we were on the road, talking about health care, talking about single payer healthcare, talking about Medicare for All.

Some people said, “I don’t want the government in healthcare.”

We would ask, “Are you against medicare?” “No!” “Medicaid?” “No!” “Active duty military health care?” “No! We must take care of our active duty!” “Veterans?”  “No! They have earned it!”

…but those are all administered by the government. More than half of health care in the US. So let’s go forward: let’s all join together and have Medicare for ALL! And if you don’t agree… so you don’t think you should vote? Hmmm, I am wrestling my conscience here….

We need one system, without 20 cents of every insurance paid dollar going to health insurance profit and advertising and refusing care and building 500++ websites that really, I do not have time to learn and that change all the time anyhow. How about ONE website? How about ONE set of rules? We are losing doctors. It’s not just me worrying: it’s in the latest issue of the American Academy of Family Practice.

Vote. For your health and for your neighbor’s health.

____________________________________________

Physicians for a National Healthcare Progam: http://pnhp.org/

Healthcare Now: https://www.healthcare-now.org/

I can’t credit the photograph, because I don’t remember who took it…. or if it was with my camera or phone or someone else’s! But thank you, whoever you are!

Great Falls

What does this have to do with the Daily Prompt: grit? And with Great Falls, for that matter.

I took this at Great Falls, Virginia, on a hike. And even something as delicate as a butterfly wants to survive in our world.

I will be calling Congress again today, do not pass a bill to take away more health care form US citizens. Wake up, US citizens, our health care system is currently built on greed and profit. Let’s join the rest of humanity with medicare for all, single payer, instead of continuing to enrich insurance companies and healthcare corporations….

 

The pending healthcare bill

I’ve just seen an article from the American Academy of Family Physicians that more and more solo and small practices are closing.

Call your Congressperson, because the thing that is most likely to close my small clinic and clinics near you is the latest healthcare bill passing.

That is, to be even more specific, the thing that will most likely close MY one doctor clinic is THAT I WON’T BE ABLE TO AFFORD HEALTH INSURANCE.

Really? Oh, yes.

I was sick for ten months, June of 2014 until April of 2015. I managed to hire a physician’s assistant by November of 2014 and I returned to work April of 2015. I was only allowed to work half time initially, for a year. Actually, quarter time. Because the latest article on primary care has average salaries. What interests me is that every doctor they interviewed who is earning the “average” is working 60-70 hours a week.

So when I returned to work I was allowed to work half days. That is, four hours a day. So, 20 hours a week. One third to one quarter time.

Also I was paying for my own insurance and I had a $5000.00 deductible. Which I had to pay in both 2014 and 2015. I also had to spend retirement money and savings to keep the clinic open. Negative earnings and using up savings in 2014 and 2015. I worked 20 hours a week for a year. And guess what? My income for 2015 qualified me for Obamacare in 2016.

No deductible. By April of 2016 I am released to “full time”. But I have learned my lesson. My sister died in 2012 and my father in 2013 and these deaths were the trigger for me getting sick. I can’t retire yet. I have burned through savings for three years. I choose to work 40 hours a week.

This means that I stop seeing patients by 2:00 pm. I still do an eight hour day because there is at least three hours of phone calls, insurance prior authorizations, lab results, x-ray results, specialist letters — like yesterday. The specialist says the patient should have an MRI. But the patient is a veteran. So the specialist says I should order it. That means filling out the paperwork for the VA authorization, mailing the order to the patient, calling the patient to remind them that triwest will throw my order away unless the patient calls to get the test authorized. Yep. And the specialist gets paid 3-4 times what I make. How nice.

I also choose longer visits. The local hospital kicked me out of their clinics because I protested about a daily patient quota. I was not diplomatic. And I don’t care, because two years later they decided I was right and lowered it. And I like my private clinic better.

BUT if Congress passes this healthcare bill and I return to over $1000.00 per month health insurance for me and a 19 year old daughter, and with a $5000.00 deductible…. I don’t know. I think I will run a Go Fund Me and ask President Trump and my Congresspeople to donate to pay my health insurance and keep me open.

And by the way: I think Congress should have the same health care as their constituents. Give the ones over 65 medicare and the ones under 65 medicaid. Let them experience what older Americans and disabled and poor experience. And don’t let them bypass it with cash, either.

Call Congress. Stop the bill. Thank you.

 

I am a board certified board eligible family doctor for over 30 years, who has chosen to do rural medicine the entire time. I am small and ordinary…. like this song sparrow.

For the Daily Prompt: meddle.