AMA urges Trump, FEMA to provide PPEs for physicians

After urging the Trump administration to provide more personal protective equipment (PPE) for physicians and other healthcare workers in the coronavirus battle, the American Medical Association is calling on the Federal Emergency Management Agency (FEMA) to act as the single national source for procurement of the supplies. 

Even though AMA has been urging President Trump and his Administration to take a stronger role in PPE acquisition and distribution, the organization is still seeing “states and facilities in direct competition with the federal government and each other for limited amounts of PPE,” the group said in a press release.

“We have not seen any movement towards centralizing the current flawed, state-based system and we continue to let our dedicated physicians, nurses, and other health care workers treat highly infectious patients at significant risk to their own health and wellbeing due to lack of appropriate PPE,” James L. Madara, MD, CEO and executive vice president of AMA wrote in a letter to FEMA. “This is an urgent matter to protect these brave men and women fighting on the frontlines to save American lives.”

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Physicians are understandably frustrated by a lack of personal protection against COVID-19, noted Madara and AMA President Patrice Harris, MD, at the recent AMA National Physician Town Hall, which aired on YouTube.

“You have already paid a terrible price for our nation’s unpreparedness and its inability to get you the basic supplies and protective equipment you’ve been pleading for. Many in our medical community have fallen severely ill; some have died,” Harris said.

PPE shortages have been rampant across the U.S., Madara noted. “We are hearing that many facilities treating COVID-19 patients are days away from running out of PPE. In others, there are reports of health care workers being forced to reuse single-use N95 respirators and surgical masks for days, if not weeks, due to extreme shortages.”

AMA is also concerned about PPE shortages in the laboratory community. 

“Laboratory workers handling SARS-CoV-2 specimens and test kits are at significantly heightened risks for contracting COVID-19. As the U.S. continues to struggle with providing widespread testing services, it is critical that we have a robust, healthy laboratory workforce to process these tests,” Madara wrote.

To help ease these burdens, it is critical that FEMA move towards a national system of PPE acquisition, acting as the single source of procurement for critical supplies and alleviating pressure on states and health care facilities to source the equipment themselves, according to Madara. “This would not only provide critical clarity and reduction in administrative burden, but would also allow states and hospitals to benefit from the tremendous bargaining power of the federal government.”

Harris said that, during a March phone call with President Trump and the Administration’s Coronavirus Task Froce, she pressured them to alleviate PPE shortages and to “invoke the full powers of the Defense Production Act to accelerate production and resolve supply chain issues. The AMA will continue to apply pressure until this happens.”

The AMA also asked for a unified federal tracking system could identify areas of high demand and high priority for PPEs, Harris noted.

The AMA also believes that healthcare workers should “not be disciplined in any manner” for raising the issue of inadequate PPEs at their facilities, Harris said. AMA has heard about cases of physicians receiving disciplinary action or being fired for talking publicly about the lack of PPEs.

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Other important issues covered during AMA’s National Physician Town Hall included:

Financial relief for physician practices is included in the $100 billion healthcare funding provision in the CARES Act. While that portion of the CARES Act is often portrayed as only for hospitals, it includes support for physicians caring for COVID-19 patients and for recouping financial losses, Harris said.

The CARES Act funding will help alleviate the loss in revenue due to the “sharp decline in office visits and cancelling of elective procedures,” said Todd Askew, senior vice president of advocacy for AMA. Large portions of the Paycheck Protection Program loans via the CARES Act will be forgivable, so it acts as a grant, Askew added.

In response to one questioner’s concern that some physicians practices have had to close doorsor reduce hours due to COVID, Harris noted that “a lot of people don’t realize that the “onesies-twosies” doctor practices are small businesses. “They have employees and pay rent.”

“At our early meeting with the President - and other medical leaders were on the call - we all raised the issue around the importance of practices no matter the practice size. We also advocated strongly to make sure practices can [receive] financial support through business loans,” Harris said.

AMA has been working with CMS to significantly expand telehealth coverage and fast track new CPT codes, “so you can get paid for COVID-19 testing,” Harris said.