Over the past five months, physicians around the world have been working as part of healthcare teams to treat patients with COVID-19. The work has been both the most exhausting and the most gratifying of our careers, and I know that my (and my colleagues’) emotions can jump from one extreme to the other multiple times a day.
However, in addition to the stress of direct patient care, this pandemic has served to highlight other stressors in our healthcare system—and a number of us have taken the opportunity to attempt to address these, as well. These efforts serve dual purposes: to work toward solutions to the problems at hand and to allow physicians to feel as though they are making significant contributions to the deeper issues impacting our patients’ health. Here, I highlight two such examples, but there are countless more as physicians discover new ways to improve our healthcare system daily beyond direct clinical care.
GetUsPPE.org
The lack of an organized system for the manufacture, procurement and distribution of personal protective equipment in the United States was apparent since the beginning of the pandemic. In late March, a number of emergency physicians around the country began discussing the issue via social media, quickly realizing that the situations we faced were similar—the same issues I was experiencing in Boston were being mirrored by physicians in New York City, Chicago and Los Angeles.
Though those of us who were fortunate enough to work within strong healthcare organizations had enough PPE, we knew that many healthcare professionals in smaller hospitals, clinics, nursing homes and other facilities were dealing with truly unsafe conditions. It was also clear that many well-meaning PPE donors simply didn’t know how to connect to the frontline workers in need of the supplies. To help, a group of physicians took the lead and created GetUsPPE.org with the goal of connecting the two groups. We quickly formed a nonprofit, building a team of volunteers and developing partnerships with national organizations like the American Medical Association and American Hospital Association.
The key to the organization’s rapid growth and success has been the incorporation of volunteer physicians and computer programmers with expertise in website development, database construction and matching algorithms (designed to connect donors to those in need close by). Since its inception, GetUsPPE.org has delivered 2.1 million units of PPE and built a team of 200 national volunteers (in addition to 50 regional affiliate teams). There are over 13,000 active requests in our database, and they shift as COVID-19 waxes and wanes across the country. In the past month alone, requests from Texas, Arizona, Florida and Georgia have increased over 200% and have shifted from acute care hospitals to nursing homes, visiting nurse teams and rural healthcare clinics. As donations have come in, GetUsPPE.org has partnered with trusted PPE manufacturers to provide supplies to those who need it the most—all free of charge to recipients.
With the recent hire of full-time staff members, GetUsPPE.org shows no signs of slowing down, and it serves as an example of the national impact a team of physician leaders can have on the safety and well-being of not only their patients but also their colleagues. Physicians are ideally suited to volunteer leadership roles such as these, given both their medical expertise and in-depth understanding of our healthcare system. However, initiatives such as GetUsPPE.org are not likely to succeed without assistance and guidance from nonclinical leaders, too, as most physicians have neither the time nor the expertise to form and grow a nonprofit organization. Nonclinical leaders who are willing to help physicians with game-changing ideas navigate the waters of organizational development are key to any new initiative.
CivicHealthMonth.org
As the COVID-19 pandemic has worsened during the past few months, our existing and growing concern about the inequities in our healthcare system has only deepened. Patients of color already face disparities in many aspects of their healthcare, with well-published evidence of this spanning specialties from cardiology to emergency medicine. Unfortunately, communities of color and those with disproportionately fewer resources have also been hit hardest by the pandemic, and would benefit from policy
solutions that specifically target their needs.
Just as importantly, the pandemic has shed light on how precarious many of our nation’s hospitals are—especially those serving patients who have the greatest needs. The AHA estimates that the first four months of the pandemic resulted in $202.6 billion in losses for our hospitals and health systems, highlighting the need for policy in support of healthcare funding. All of these critical and timely needs led to our decision to create a Civic Health Month.
It was initially developed by Alister Martin, MD, an emergency medical specialist at Massachusetts General Hospital, and his team, but it grew quickly as other healthcare organizations realized its potential impact. A nonpartisan effort with advisers from both sides of the aisle, its goal is simple: to increase voter engagement and empower both patients and their healthcare providers to fix the healthcare system by exercising their voices in the democratic process. Organizational members display QR-coded voter registration links, provide nonpartisan patient voting materials to patients who may be inpatients on election days, and use their social media posts and email blasts to increase engagement.
We’ve heard from a number of organizations that their physicians and other healthcare providers have felt exceptionally empowered by this organizational involvement, providing an avenue for positive patient engagement during this pandemic. At a time of physician burnout and patient uncertainty and fear, promoting programs like this one allows nonclinical leaders the opportunity to find wins that benefit all members of their teams.
In addition to Civic Health Month, Martin is also responsible for spearheading another voter registration effort. Given that the demographics of patients who visit EDs align well with those of unregistered voters, he developed the idea of using EDs as voter registration sites, and thus Vot-ER.org was born. Since that time, the program has spread from our ED at Massachusetts General Hospital to sites across the country, providing supplies and equipment promoting ED patient voter registration to over 12,000 healthcare providers at more than 70 hospitals and community health centers across the U.S.
These examples—GetUsPPE.org and Civic Health Month—are only two of the many nonprofits, volunteer organizations and informal teams being formed by physicians in response to the cracks we see in our healthcare system. The COVID-19 pandemic has served to highlight the inequities in healthcare and holes in the supply chain that have always been present, and physician leaders who have developed specific skills by training in research, public health, business and public policy will continue to tackle them in new and unique ways.
Ali S. Raja, MD, FACHE, is executive vice chairman, Department of Emergency Medicine, Massachusetts General Hospital, Boston (ARaja@mgh.harvard.edu).