Why Dermatologists and Plastic Surgeons Are Getting Ready to Join Other Health Care Workers Fighting COVID-19
“I have entered my name as a volunteer to go into the hospitals if needed.”
General care doctors and nurses staffing hospitals are among those on the front-lines in the fight against the coronavirus. But with a medical crisis that has so far exceeded 59,000 positive cases of COVID-19 nationwide, specialized physicians like dermatologists and plastic surgeons may also be called to help.
The Federation of State Medical Boards is keeping a running list of states that are waiving licensing requirements in response to COVID-19. The state of Washington, for example, is calling for emergency volunteer health practitioners. To help expand reserves, an emergency declaration allows health care workers licensed in another state to practice in Washington without a Washington-specific license. New York, California, Colorado, Florida, and many more states have similar provisions.
“This is a scary, scary time,” says Shari Marchbein, a board-certified dermatologist and clinical assistant professor of dermatology at NYU Grossman School of Medicine in New York City. “There is a desperate lack of personal protective equipment putting all health care workers at risk, and we also risk bringing [COVID-19] home to our families and children and potentially getting them sick.” She is prepared to assist “in a worst-case scenario.”
Doctors in California are facing the same reality. “As a dermatologist, I am not a specialist in virology or epidemiology, but we [dermatologists] certainly know and understand intimately the transfer of bacterial, viral, fungal, and parasitic infections to and through the dermis,” says Ava Shamban, a board-certified dermatologist in California. Shamban has closed her offices and is currently holding all non-emergency appointments via telemedicine.
On Wednesday, New York governor Andrew Cuomo called on health professionals to join a “reserve workforce” via Twitter. His tweet included a link to a survey for medical professionals to volunteer to serve, if needed.
“With your help, New York State is working to protect our residents and strengthen our public health system. We are looking for qualified health, mental health, and related professionals who are interested in supporting the state’s response,” the survey reads, before requesting credentials, contact information, and experience related to treating infectious diseases, respiratory conditions, critical care, and emergency medical services.
Private practice doctors who may not have worked in a hospital since residency are facing the reality that they may soon be treating coronavirus patients. “I have entered my name as a volunteer to go into the hospitals if needed,” Dhaval Bhanusali, a New York City board-certified dermatologist at Hudson Dermatology and Laser Surgery, tells us. “Outside of some time during medical school and intern year, we do not have formal training in ICUs or ventilator management. I’ve spent the last few days refamiliarizing myself in case I’m called on to help. These are unprecedented times, and while I never thought I’d have to relearn any of this, thankfully, I will have the foundation to do so if needed.”
Even if a doctor isn’t called on as an individual, private practice offices may have medical supplies that can be donated to hospitals in need. “I have spent the last two days inventorying my medical supplies at my office and sent a list to the state in case any are needed or in short supply,” says New York City board-certified plastic surgeon David Shafer. “I have offered my office facilities if needed, and also my own skills to offset other doctors who are providing direct care.”
The American Academy of Dermatology (AAD) has shared with us its recommendations for actions dermatologists can take to help: “Prepare your offices to accept telemedicine appointments, preserve medical supplies, donate to the front-lines, and look into ways to donate testing material to labs looking to develop more coronavirus testing kits.”
The AAD acknowledges that dermatologists aren’t inherently on the front lines against the virus, but that may change at the situation worsens. “There are no specific dermatologic manifestations of COVID-19 disease. However, dermatologists, as physicians, may be deployed to meet other medical needs in high-density COVID-19 areas,” says Bruce H. Thiers, a board-certified dermatologist and the president of the AAD. “In the meantime, dermatologists are employing tactics to keep patients out of crowded emergency rooms.”
Those tactics, says Thiers, include treating urgent skin problems in their own clinics or offices that may otherwise have been directed to a hospital emergency room, rescheduling all non-urgent appointments to telemedicine care, and preserving personal protective equipment (PPE) to be donated to emergency front-line care providers.
As the pandemic develops and intensifies, the mandate for health care professionals of all specialties and levels of expertise may change. For example, NYU Grossman School of Medicine has announced that it will allow senior medical students to graduate three months early to begin working immediately as paid hospital interns. For medical professionals, as much or even more than the rest of us, the future is uncertain.
“While dermatology may define my field of expertise, my real duty is to be a healer above everything else,” says Bhanusali. “Speaking to patients, calming fears, educating, and anything else needed comes with the territory. If we can help, we try our best to do so.”