Rollout sidelines family doctors
Many say they’re all set to start giving vaccines
LEVITTOWN, Pa. – Call your primary care doctor first.
That’s the direction patients are typically given when they’re facing a nonemergency medical situation.
But in the case of securing the COVID-19 vaccine, many primary care physicians and their patients have been left in the dark.
Thousands of calls have flooded private doctors’ offices across Pennsylvania since the rollout of the COVID-19 vaccine.
Yet primary care physicians who aren’t affiliated with hospitals are among the last in line to receive and distribute the vaccine to patients, medical leaders say.
Dr. Keith Sadel, who owns and operates a private family practice in Upper Southampton, Pennsylvania, filed his paperwork to get the vaccine for his patients and submitted the required forms two months ago.
Still, no vaccine.
“When I see that some of my patients who are young and healthy and are not health care workers getting the vaccine at Rite Aids, while my patients 65 years and older can’t get the vaccine and they look toward me, this is frustrating as you can imagine,” said Sadel, who cares for about 4,000 patients, most of whom are elderly and have medical problems. “I do not understand why pharmacies are placed over physicians to deliver the vaccine.”
He is not alone. The federal government has largely left vaccine rollout to the states and public health departments, and Pennsylvania, like many states, is relying on hospitals to be the main distribution points.
Pennsylvania last week opened up vaccine eligibility to anyone 65 and older and adults with pre-existing medical conditions, spiking demand despite dwindling supply. On Tuesday, Gov. Tom Wolf expressed frustration with
the federal coronavirus vaccine rollout, saying Pennsylvania needs 6.5 million more individual doses just to complete full vaccination of everyone in the current 1A phase of the state’s plan.
Yet there are questions about whether the state and its counties are making use of all the vaccines delivered so far.
A report from Becker’s Hospital Review ranked Pennsylvania 42nd out of the 50 states in percentage of vaccine doses received that have been administered. Of the approximately 1.6 million vaccines delivered to the state, about 800,000 have not yet been given, according to data from the state and Centers for Disease Control and Prevention.
“If they gave us a thousand vaccines tonight, I’d have it in a thousand arms this week,” said Hatboro family doctor Harris Cohen, who has the refrigeration and staff in place to give the Moderna vaccine, one of two that has received emergency use approval from the Food and Drug Administration.
Only a fraction of the vaccines distributed so far have gone to primary care physicians, according to the state’s list of approved providers. At the same time, confusion about how to sign up for a shot has left many Pennsylvanians frustrated, and those at high risk of serious
complications from COVID-19 continue to wait, with little news on when they’ll be inoculated.
That confusion has translated into about a hundred calls a day flooding Cohen’s family practice, Hatboro Medical Associates.
“This is the most important health issue we have right now, yet there are so many roadblocks,” he said. “Every patient I see asks about it and I don’t have an answer. It reminds me of the testing shortage in early March. Again, I feel paralyzed that I don’t have the answer.”
Pennsylvania Department of Health officials don’t have the answers either. When asked, they lacked a detailed explanation for how the distribution of vaccines is being prioritized for nonhospital providers.
April Hutcheson, the Pennsylvania Department of Health’s director of communications, said, “In terms of who becomes a provider to administer vaccine – first, it has to be within the scope of practice of the doctor to be able to provide injections. Then they enroll as a provider.”
Hutcheson then provided the state’s link for providers, outlining the application process and requirements.
Both Sadel and Cohen have
met those requirements. Yet when they see who is receiving the vaccine in their region – such as a Bucks County dermatology office – more questions surface.
On the national front, medical leaders are calling on President Joe Biden to direct states to get vaccines to physician practices. In a Jan. 26 letter, Halee Fischer-Wright, CEO of Medical Group Management, cited a survey that showed 85% of independent practices and 45% of hospital or health systemowned practices actively seeking the COVID-19 vaccine for their patients reported having obtained none to date.
“Despite possessing the ability to identify and inoculate vulnerable patients, states have largely not leveraged physician practices in vaccine rollout efforts,” she wrote.
“We strongly believe that medical groups have a critical role to play in COVID-19 vaccination efforts due to their trusted role as providers within the community and ability to identify vulnerable patients,” she said.
Not only are doctors having trouble getting vaccines for patients, many physicians and medical staff not employed by hospitals or health systems reported problems getting inoculated themselves, even though they are caring for patients in the top-priority group.
Cohen said he was able to get his vaccine through Doylestown Hospital, which under a state order is required to set aside 10% of vaccines for community front-line workers. But for doctors working to secure the vaccine for patients, it’s been “a mad scramble.”
Sadel, who applied as early as he could, has been calling the state health department to check on the status of his application. One woman, he said, inquired about his freezers and wanted the make and model numbers.
Two weeks later, he learned his application was “under consideration.”
Many of his patients, he said, fear going to a pharmacy for the vaccine.
“I know my patients, and I’m much more equipped to give vaccine than a pharmacy,” said Sadel, who has a defibrillator, IV fluid and other medications on hand in case someone has a reaction. “I’m capable of handling emergencies in ways pharmacies are not.”