The Tribune

By YOURI KEMP

Tribune Business Reporter

ykemp@tribunemedia.net

The Medical Association of The Bahamas (MAB) president yesterday hailed the government's "wise decision" to prevent doctors seeing patients face-to-face for non-emergency care.

Dr Marcus Cooper, responding to the government's latest Emergency Powers Order, told Tribune Business: "What the order is saying is that physicians should not be practicing as usual, and face consultations should be reserved for emergencies and not non-urgent and routine visits, with the exception of antenatal care and pediatrics where they are giving vaccines."

The order, which effectively pushes doctors to tele-medicine and online contacts with non-emergency patients, requiresthat all private medical and dental practices "shall eliminate all routine and non-emergency physical encounters with patients, and shall provide as best as possible all routine and non-emergency services via remote or virtual means excluding private renal dialysis facilities.

"Where physical interaction is a necessity due to a medical emergency there must be strict adherence to social distancing and hygienic requirements."

Dr Cooper added of the Order: "This is to make sure physicians are aware of how serious this is, and to try to contain the [COVID-19] spread by having too many people in our offices and things like that. Non-urgent visits may turn into non-urgent procedures or non-urgent surgeries, and you want to limit that exposure to other healthcare professionals so it makes a lot of sense."

"Non-urgent is if somebody comes to your office because they are having headaches, not severe headaches or the worst headache in their life that you sometimes would get with a stroke, but just a headache, or somebody who is having acid reflux or somebody who has stubbed their toe or they have various minor issues.

"These are things that need not be dealt with immediately. Another problem is that you may have had constipation for two years and you decide that now I'm not working, let me go to the doctor since I have free time on my hand. Those types of things you want to avoid people coming to your office for."

Dr Cooper said he thinks this "could work", and added: "There are some disciplines where they are going to have to continue, but still not with business as usual. At least they are going to think about it, and try to have telephone conversations and use alternative means of triaging the patient.

"For example, you call them and you see if this is an emergency or not. If it is not then you need to reschedule them for a later date, and if it is then you bring them in to the office and you make sure that you practice social distancing and the other things.

"I think this is feasible. I think it's a wise decision. You have some physicians like the oncologists who are asking to be exempted from that list as well so that they can continue to give people chemotherapy and radiation therapy, and that's important, too."

While doctors can still make home visits, Dr Cooper said: "I think that physicians will have to use their discretion as to whether a home visit is required, because sometimes some of these situations are emergencies, and this is not a time where we want patients who are not ambulatory or patients who are bed-bound to end up in the hospital because of an infection or because their blood sugar is high or they have kidney problems. Physicians will have to make a decision whether they need to go and do a home visit to prevent a patient having to go into the hospital.

"I think it is important that physicians also provide a number that patients can reach them at in case they are having an emergency, or something they think is an emergency. What I have done at my office is I have my calls transferred to an office mobile number so the nurse can triage the patient.

"So even though you don't want people turning up to the office for non-urgent issues we do want the opportunity to triage them in some sort of way so we can find out what the issue is."