Tuesday, March 16, 2021

Allow physicians to administer Covid vaccines

New York has done a fair job of getting the state’s residents vaccinated. To date, 22% of New Yorkers have received a last one dose of a vaccine and 11% have completed their vaccine series.


Despite that, things could be better.


We’ve heard far too many reports of navigation, access, equity, and trust issues that have prevented people from getting vaccinated without struggle or at all.   


Consider technologically-disadvantaged seniors who’ve had difficulty navigating the online registration process. It’s so bad of experience that groups of volunteers have popped up across the state who go to seniors’ homes or hold registration clinics at town halls to help walk them through the process.


Or, what of those souls with preexisting conditions that are deadly when combined with Covid? Many of them have had to obsess about standing in line at a public clinic with dozens of complete strangers who could get them sick, a concern also shared by seniors.


Then, there are the rural residents. The local press has covered extensively the low vaccination rate in Allegany County and similar numbers in the GLOW counties. So, the state ramped up efforts to bring more shots to those people and, by not mandating residency, permitted those clinics to be overrun by shot-seekers from cities and suburbs, negating the very purpose of those clinics.


That takeover also speaks to the desperation had by many. Consider how many of your family and friends have traveled hours across the state to get a shot at the state fairgrounds or wherever else they might be available -- some Western New Yorkers have traveled as far as Potsdam.


Then, there’s the inability to get minorities vaccinated at an acceptable rate. Blacks, Hispanics, Asians, and Native Americans have all received shots at a clip far below that of Whites. Chalk that up to specific communities being underserved and also the hesitancy some populations are said to have in the shot and any government-run process. 


All of the above are significant obstacles.


How do we overcome them?


Two words: Access and trust.


New Yorkers of all ages, races, and socioeconomic backgrounds deserve access to a vaccine and to have trust in it and the system. That can be furthered by more access and trust: New York government has to grant vaccine access to primary care and family physicians and trust them to get the job done.


Maybe it’s a sense of control in time of crisis, perhaps it’s a hunger for glory in the same, the state has been stingy when it comes who gets to the vaccine inventory. New York’s state-run and county-run clinics, hospitals, and select pharmacies have gotten almost all of the shots. As it stands, hardly any vaccines have made it to doctors’ offices.


In this case, the success of vaccination deployment could improve dramatically if government realized it’s not the solution…it’s just part of it. Many hands make light work, especially when they are experienced hands. We’d all be better served if primary care was allowed to do its thing.


I reached out to my friend Dr. Jason Matuszak, a primary care and sports medicine physician who is also President of the 7,000-member New York State Academy of Family Physicians (NYSAFP) to verify that I wasn’t thinking wrongly about this.


Dr. Matuszak affirmed that physicians are committed to partnering with the State and administering vaccines. The NYSAFP has been in contact with the Governor’s office and the Department of Health to offer their services as a supplement to the state’s and counties’ efforts.


He assured me that receiving, storing, and administering vaccines is old hat to physicians. In a normal year, they are the largest reporters of vaccinations given to either the New York State or New York City vaccine registries. Most primary care offices already run flu vaccine clinics, efficiently administering thousands of doses in short order. They also have the advantage of being able to administer vaccines during every routine office visit.


By being that traditional outlet for vaccines, they can help calm fears and overcome struggles had by their patients.


Take seniors, for example. Dr. Matuszak referenced a Kaiser Foundation study that indicated 96% of Medicare beneficiaries (seniors) say they have a usual and preferred source of care (their “own” doctor). It is so much safer and convenient and far less stressful for a senior just to call up Jason, say they’d like a shot, and visit his office.


Or, what of people of color, whom Governor Cuomo rightfully notes die from Covid at higher rates than their white counterparts? The NYSAFP believes distribution of vaccines through community based primary care practices is the best way to equalize access. Those medical practices have established relationships and trust with their patients and, in most cases, those physicians and other providers live in and look like their communities (this columnist would say that the same can’t be said for government-run clinics that pop-up in those places, which is detrimental to public health goals).


As for rural residents, family physicians are their health network. They don’t live near hospitals or sprawling multi-faceted clinics. They don’t have large community centers where the state could one day appear. What they do have is their country doctor. In many locales – like the Southern Tier or the Adirondacks -- this is the only way to administer vaccines. It doesn’t make sense to drive hours for the shot when it can be given in their community.   


I encourage state officials to take up the NYSAFP on their offer to be a trusted partner in this process. They can remove barriers, improve access, add efficiencies, and bring trust to the termination of this pandemic. They’ve been wanted, they’ve been needed by their patients. And, with President Biden’s recent announcement that there will be sufficient vaccine supply for all adult Americans to have access by the end of May, the state, too, will want and need their services. Empower that network of care…now.


From the 15 March 2021 Greater Niagara Newspapers and Batavia Daily News


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