COVID-19: Leaders get creative in filling physician shortage

With the number of confirmed COVID-19 cases in the United States now exceeding 100,000—making it the first country to reach this grim "milestone"—the severity of the physician shortage has never been more apparent.

In the population-dense Northeast alone—where New York seems to be hardest hit by the pandemic—the physician shortage stands at about 24,000 doctors. With a rising demand for medical supplies, hospital beds, and healthcare professionals to meet the needs of mounting coronavirus cases, healthcare systems, state officials, and even the military are sounding the call for assistance. State leaders and medical boards alike are getting creative in the ways that they are filling the physician gap. But, is it safe?

‘Surge’ healthcare force

In New York, more than 50,000 healthcare workers—from physician retirees to practicing nurses—have answered Governor Andrew Cuomo’s pleas for medical volunteers to help support the staffing shortages in hospitals.

“We have been working on putting together a surge healthcare force,” Governor Cuomo said during his Wednesday briefing on the pandemic. “Go back to the retirees. Go back to the nurses and doctors who may not be in the hospital [or] direct medical care occupation and ask them to sign up for possible reserve duty.”

Specifically, at least 2,265 physicians—including anesthesiologists, ER technicians, ICU physicians, infectious disease specialists, and pulmonologists—have signed up to volunteer in New York's Surge Healthcare Force. Additionally, a growing number of nurse practitioners, physician assistants, nurse anesthetists, respiratory therapists, registered nurses, and licensed practical nurses—over 24,000 in total—have stepped up to the plate.  

But it’s not just COVID-19 patients who are in need of care. 

“We are all concerned about the immediate critical need, the life and death of the immediate situation. But, don’t underestimate the emotional trauma that people are feeling and the emotional health issues,” Governor Cuomo added.

Last year a survey of more than 20,000 people showed that Americans are experiencing severe loneliness, which can take a toll on both mental and physical health. This is only expected to grow in the coming months. To that end, more than 8,000 mental health professionals have volunteered to provide free online mental health services.

Interestingly, governors across the nation—including those in Illinois and Colorado—are following suit, making similar requests for healthcare volunteers among their own denizens, primarily focusing on retirees. While the responses have been largely positive, there still aren’t enough doctors and nurses to go around.

Yet, experts have warned that increased human resources will be critical to containing the outbreak. In addition to addressing the existing lack of manpower and equipment across healthcare systems, enlisting as much auxiliary medical staff as possible will be vital to mitigate burnout and stress.

As Governor Cuomo put it at a press conference on Tuesday, “Workers will get sick and this is going to go on for weeks and you can’t ask a person to work for 14 days consecutive or around the clock shifts.”

Bending the rules

Although many physician retirees are ready and willing to serve in any way they can, that doesn’t mean it’s an easy process. For instance, volunteers can’t just show up and start working at a hospital or another healthcare system. Their credentials first have to be verified—a laborious process that can take weeks.

To help speed things up, the Federation of State Medical Boards is allowing free access to its physician database, so that hospitals can quickly verify physician education, training, licensing, and certifications. Even better: Many states are now loosening their licensing restrictions to give those with clinical skills—like out-of-state physicians—the opportunity to serve the cause right away.   

Sending out an SOS

As of Friday afternoon, there are 227 cases of COVID-19 among US troops and 435 total cases among Defense Department-affiliated personnel, according to a report from the Pentagon. To help combat the deadly respiratory virus—both among troops and across the nation—the US Army sent out an SOS to more than 800,000 retired soldiers who previously served in specific medical specialties, asking them to re-enlist.

Recruitment efforts are focusing on retired army medical personnel in the following healthcare-specific military occupational specialties: critical care office, anesthesiologist, critical care nurse, nurse practitioner, ER nurse, respiratory specialist, and medic. It is unclear, however, whether re-enlisted retirees would be returned to active status.

Of note, the call to retirees does not include those currently working in a civilian capacity in a hospital or other medical facility, where—army officials acknowledge—the need for care may be greater. But, interested retirees from different specialties are encouraged to reach out to Human Resources Command, Reserve Personnel Management Directorate, at usarmy.knox.hrc.mbx.g3-retiree-recall@mail.mil or call 502-613-4911.

So far, over 9,000 retired soldiers have expressed interest in re-enlisting.

“Army Surgeon General Scott Dingle told reporters that these volunteers will ‘fill those holes’ in military medical treatment facilities across the nation where some staff are now deployed to field hospitals, leaving vacancies in their traditional assignments,” wrote Elizabeth McLaughlin in an article for ABC News.

Possible repercussions

Calling on retired doctors and other healthcare workers seems like a rational strategy, and it has been fairly popular among states so far. But, is it safe?

From the start, health experts have warned that elderly individuals are most susceptible to COVID-19. And medical personnel are on the front lines fighting this pandemic, potentially exposing themselves to the virus day in and day out—some without proper personal protective equipment. Recruiting former medical personnel could, therefore, be putting them in extremely high-risk situations.  

“If you start calling in retired doctors, nurses, whatever—these are de facto people at high risk. They're older—that's why they're retired. Many of them will have serious medical risks on top of that. And if we're going to put them anywhere near the front lines of this particular pandemic crisis, we are endangering some very high-risk people,” Dr. Irwin Redlener, director, National Center for Disaster Preparedness, Columbia University, told NPR.

Hope on the horizon

While things may seem bleak, there is some good news. On Friday, the House approved a $2.2 trillion financial aid bill, which the President signed into law. The bill, aimed at stimulating the coronavirus-ravaged US economy, will provide roughly $100 billion to hospitals and community health centers to help ramp up efforts to combat the COVID-19 pandemic. 

In addition, $16 billion will be given to the Strategic National Stockpile to increase the availability of medical equipment—including ventilators and masks—increase the hiring of essential healthcare workers during the pandemic, and speed up the development of vaccines, treatments, and diagnostics. The coronavirus relief bill will also allocate $80 million to the FDA to prioritize and expedite the approval of new drugs.