News

  • Monday, April 13, 2020 3:52 PM | Anonymous

    Updated 4/25/2020; for more recent updates visit our Resource Page

    The Iowa Department of Public Health (IDPH) has issues a Personal Protective Equipment (PPE) Shortage Order in response to the ongoing shortage of PPE among clinics responding to the COVID-19 pandemic. This order applies to all healthcare providers, clinics, and facilities providing care or medical treatment of a patient in the state. Providers must do the following:

    • Decrease PPE Demand
    • Implement Contingency Capacity Strategies
    • Implement Crisis Capacity Strategies

    Intentional violation of this order may be considered a misdemeanor. Individual licensees may also be subject to disciplinary measures by their professional licensing boards.


    In response to IMS advocacy, the order also extends blanket liability protections for any actions a physician or other provider takes in good faith to comply with the order. This includes delaying non-emergent medical services or surgical procedures deemed non-essential. Practices are encouraged to consult their legal counsel and medical liability carrier who may recommend documentation in a patient's medical records when a treatment decision was based on the belief that it complies with the order to preserve PPE.

     

    The full PPE Shortage Order is available here .For more information on this order or assistance with any other needs related to the COVID-19 pandemic, please contact Kady Reese or Dennis Tibben on staff at IMS.

  • Friday, April 03, 2020 3:50 PM | Anonymous

    April 1, 2020

    The Honorable Kim Reynolds
    Office of the Governor
    1007 East Grand Avenue
    Des Moines, Iowa 50319

    Re: State Response to the COVID-19 Pandemic


    Dear Governor Reynolds:

    On behalf of the more than 6,300 physician, resident, and medical student members of the Iowa Medical Society (IMS) and Board of Directors, thank you for your leadership over the past several weeks as our state has worked to respond to the novel coronavirus (SARS-CoV-2) and the disease it causes (COVID-19). As scientists, we appreciate the data-driven approach you have taken, in close coordination with Caitlin Pedati, MD, and the experts at the Iowa Department of Public Health, to implement measures to help slow the spread of COVID-19 across our state.


    IMS also greatly appreciates the extensive efforts you and your staff have made to ensure that healthcare leaders have regular contact with your office and necessary state agencies to identify issues and collectively work to design solutions to this unprecedented strain on our healthcare delivery system. The speed with which you and your team are working to address problems identified by IMS and others should be commended. Iowa will emerge stronger from this challenging time because we worked together to respond.


    The Iowa Medical Society recognizes the difficult position in which you find yourself – needing to balance the health and safety of all Iowans, the well-being of Iowa’s economy, and ongoing operations of essential industries like our agricultural and food production sectors that help to feed the world. The measures you have implemented to order closures of retail facilities, bars and restaurants, houses of worship, and other sites of mass gatherings, will certainly have a significant impact on thousands of Iowa families. Given the current absence of an effective vaccination or treatment protocol for COVID-19, we believe these closures are absolutely critical as we look to flatten the curve and prevent overloading our already strained healthcare system.


    The physicians of Iowa are on the very front lines of the fight against COVID-19. Over the past several weeks, we have worked to overcome a wholesale breakdown of the medical supply chain that has resulted in too few testing kits to determine the true spread of the disease in our state and a dangerously short supply of personal protective equipment (PPE) to ensure that clinical staff are not putting their personal safety in danger as they test and treat patients. Our colleagues in industries like dental, biotechnology, and manufacturing have helped to overcome these shortages, donating thousands of pieces of PPE to help fill this gap. Meanwhile, everyday Iowans have turned on their sewing machines and begun to produce fabric masks to help stretch our resources until additional medical-grade supplies can arrive. Iowa’s medical community will be forever grateful for these efforts to provide short-term relief to these dangerous shortages. Unfortunately, as you know, additional supplies from commercial vendors and the federal stockpile have been slow to arrive and not in sufficient quantity.


    This limited supply of PPE and other critical equipment has resulted in potentially dangerous efforts to reuse or otherwise conserve medical resources. Some practices report less than a two-day supply of PPE at current optimized use rates, and Iowa physicians live each day in fear that we are unnecessarily exposing ourselves and our families to illness as a result. We know that additional resources are on the way and we commend the State for its efforts to speed supplies to practices with the greatest need as quickly as it can, but greater efforts are needed.


    Iowa is now experiencing extensive community spread of COVID-19. We see the daily number of positive diagnoses growing exponentially and sadly, we see the number of Iowans in need of hospitalization or who have died as a result of the disease growing as well. Despite these concerning developments, we continue to witness individuals disregarding our collective calls for voluntary social distancing and several businesses continuing operations. Several industries, such as construction, are utilizing protective equipment that could be repurposed to fill the urgent need in healthcare, unnecessarily placing workers in close working conditions at a time when community spread of COVID-19 is on the rise, or risking workplace injuries that will further stain our emergency departments.


    You and Dr. Pedati have often referred to the State’s response to COVID-19 as a dial – when circumstances warrant, we must dial up our efforts to further restrict potential exposure and when we see signs that our social distancing efforts are working, hopefully very soon, we can dial these restrictions back down. Given the severe lack of PPE and ongoing issues with segments of our population not voluntarily social distancing, IMS believes the time has come to temporarily dial up our state’s response efforts. The physicians of Iowa request that you implement a more stringent shelter-in-place order for a period of at least two weeks.


    We recognize that placing additional restrictions on industries will negatively impact Iowa’s economy and enforcing more stringent social distancing requirements will place an additional burden on first responders. We also know, based upon the experiences of other jurisdictions around the world, that these more stringent efforts will make a difference. By placing short-term, enforceable restrictions on greater segments of the economy, we can further slow the progression of the disease until resupply shipments of PPE and other critical medical equipment can arrive. This temporary measure will also allow Iowa businesses that are stepping up to retool and begin in-state production of critical medical supplies, to come online. Finally, this measure will further protect front-line medical workers.


    Iowa’s healthcare providers are dedicated public servants. Regardless of supply shortages and dangers to our personal safety, we will continue to respond to the needs of our communities. We will continue to test and treat our patients, regardless of the circumstances because the practice of medicine is a calling, not a job. We understand that intentionally causing greater harm to an already stressed economy and further restricting the liberties of everyday Iowans is not a decision to take lightly, however, we believe that in the immediate future it is one that must be made to protect those of us on the front lines in this fight against COVID-19.


    We appreciate your thoughtful consideration of this request and thank you again for your tireless leadership during this difficult chapter in our state’s history. The physicians of Iowa continue to stand ready to help you and every Iowa patient in any way that we can.


    On behalf of the IMS Board of Directors,

    Marygrace Elson, MD, MME, FACOG
    IMS President

  • Wednesday, April 01, 2020 11:56 AM | Anonymous

    Colleagues,

    Many of us are concerned about carrying the coronavirus home with us to our loved ones, which could occur even after outpatient care of asymptomatic patients. In addition to following the infection control recommendations of your organization and wearing personal protection equipment (PPE), here are some other practices to consider. 

    Stanford University infection control experts have recommended four easy ways to decrease your risk of transmission to individuals in your home:

    • Wash your hands before you leave work
    • Wash your hands when you get home
    • Wear different shoes at home and at work, or wash your hands as soon as you take off your shoes.
    • Disinfect the common touch surfaces in your home and in your car once each day. (Don't disinfect cutting boards or any item that comes into contact with food.)

    University of Iowa infectious disease specialist Mike Edmonds, MD, recommends wearing nothing below your elbows at work (e.g., rings or wristwatches) to allow for more thorough hand washing. He also recommends against wearing neckties. 

     The following list is gathered from a number of sources, and more for you to consider, depending on where and how you work.

    • Wear washable clothes at work. As soon as you are home, place your clothes in the laundry, and change into clean clothes. Many are showering before getting into clean clothes. Some are showering and changing into clean clothes immediately before leaving the hospital. 
    • At a minimum, thoroughly wash forearms and hands before joining your family.
    • Only take into the workplace the essentials – badge, pager, keys, and cell phone. Avoid taking bags (e.g., purses or backpacks) into patient care areas and then home again. Stow these items away from patient care areas. 
    • Wipe down your personal work areas before and after use (keyboard, telephone, and desk surface) whenever possible. 
    • Put your cell phone in a sandwich bag on entering work and discard the bag before you leave the building.  It will work in a sandwich bag!
    • Wipe down your phone, pager, keys, and badge with disinfectant wipes before entering your home or upon entering your vehicle.  If you haven’t been able to locate disinfectant wipes, use paper towels and household cleaner to make your own.
    • Wipe down your steering wheel and other frequently touched controls when you enter your vehicle.
    • Remember to practice social distancing while at work in team work stations and the break room. This can be harder than it seems! Most of our team work areas were not designed to maintain six-foot distance between team members, and we may not be used to cleaning the table surface before and after we eat in the break room. 
    • Lastly, don’t consider work your only potential exposure. Carriage rates in the asymptomatic population mean we need to be vigilant whenever encountering other people – such as grocery shopping. 

    Thank you for all you are doing for our communities.

    Stay safe!

    Marygrace Elson, MD

    President, Iowa Medical Society

    Additional Donning & Doffing Resources:

    American College of Emergency Physicians COVID-19 Personal Checklist

    CDC: Strategies to Optimize the Supply of PPA Equipment

    NETEC: Personal Protective Equipment for COVID-19

  • Wednesday, March 25, 2020 3:46 PM | Anonymous

    New PPE Requests Guidance

    In an effort to improve response for immediate needs for Personal Protective Equipment (PPE) from healthcare providers across the state, the Iowa Department of Public Health (IDPH) has revised the guidance for reporting PPE shortage and requesting stockpile supplies. IDPH requests that any practice or facility whose PPE supplies are within seven days of running out (at current, optimized usage rates), contact their county emergency preparedness and response agencies.

    Supplies will be distributed based on immediacy of need and those who are providing immediate direct care. Currently stockpile supplies available via area response agencies and the State Emergency Operations Center (SEOC) are:

    • N-95 masks

    • Procedure/surgical masks

    • Face shields

    • Gowns/coveralls

    • Gloves

    Urgent requests, as defined above, are able to be filled within 2-4 days of request, subject to availability of supplies. Revised and all subsequent requests should include quantities needed to sustain 7-10 days of supplies at current usage rates (optimized). For guidance on how to optimize usage of existing PPE, please review Strategies for Optimizing the Supply of PPE from the CDC.

    Counterfeit PPE Guidance

    Counterfeit respirators are products that are falsely marketed and sold as being NIOSH-approved and my not be capable of providing appropriate respiratory protection for workers. Click here to see the NIOSH list of counterfeit respirators, and learn how to identify NIOSH-approved PPE.

    Volunteers Needed

    During this period of clinic shutdowns for some specialties, physicians and clinical staff are encouraged to consider volunteering to help with triage to expand capacity for those clinics screening and treating patients for COVID-19. Volunteering for this disaster response will not impact unemployment benefits for those who are receiving them as a result of their clinic temporarily shutting down.

    The governor’s emergency declaration also allows physicians, physician assistants, nurses, and respiratory therapists whose Iowa licenses have expired or lapsed within the past five years to provide assistance and treatment of COVID-19 patients without having to obtain an active professional license.

    Interested individuals are encouraged to register as a willing and able volunteer through the Iowa Statewide Registry of Emergency Volunteers (i-SERV) – the Iowa Department of Public Health's secure online registry for individuals wishing to volunteer in the event of a large-scale disaster or public health emergency. Volunteers maintain the option to accept or decline any opportunity. Volunteers may also reach out to their local public health department or county emergency management agency to offer their services and seek opportunities. Due to the Governor’s Public Health Disaster Emergency Declaration, individuals who volunteer to respond to the COVID-19 pandemic are granted liability immunity for their service.

  • Tuesday, March 24, 2020 3:45 PM | Anonymous

    Tiffany Milless, MD selected as next IMS President-Elect

    The IMS Board of Directors has named Tiffani Milless, MD, Pathology, Des Moines, as their selection for the IMS President-Elect in 2020-2021. Dr. Milless currently serves as the chair of the IMS Board of Directors. If formally elected by the Board following the IMS Board of Directors meeting on Friday, April 17, 2020, Dr. Milless will serve as the President-Elect until April 2021, then be elevated to IMS President.

    Opportunity for Member Feedback Pursuant to Chapter VI, Section 8 of the IMS Bylaws, “The Board of Directors will communicate its intended selection of the President-Elect to the membership, which shall have 14 days to provide feedback to the Board of Directors.” If you wish to provide feedback on the selection of Tiffani Milless, MD, as IMS President-Elect, please reply here. Your comments will be evaluated and presented to the Board of Directors. All comments must be received by April 11.


  • Tuesday, March 24, 2020 3:43 PM | Anonymous

    The full slate of candidates for the 2020 Iowa Medical Society Election is listed below. The election will open this Thursday, March 26 and close April, 14 at midnight. All member physicians will receive a ballot through Balloteer on Thursday, March 26 to vote.

    If you have any questions, please email Michelle Dekker


     At – Large Directors

    Sharmini Suriar, MD – UnityPoint Clinic, Internal Medicine, Pediatrics

    Lillian Erdahl, MD – University of Iowa, Surgery

    Mony Fraer, MD – University of Iowa, Nephrology

    Cynthia Hoque, DO – Knoxville Hospital and Clinics, Family Medicine

    Lenard Kerr, DO – Acute Care, Emergency Medicine

    Noreen O’Shea, DO – Des Moines University, Family Medicine

    Christina Taylor, MD – The Iowa Clinic, Internal Medicine

    Humphrey Wong, MD – Genesis Pulmonary Associates, Pulmonology

     

    Resident Director

    Alexis Warren, MD – University of Iowa

    Dakota Thompson, MD - University of Iowa

     

    Student Director

    Gabriel Conley – University of Iowa

    Katherine Marciniec – Des Moines University

     

    Candidate for Speaker, Policy Forum

    Joyce Vista-Wayne, MD, DFAPA – MercyOne, Psychiatry

    AMA Delegate Candidates:

    Michael Kitchell, MD – McFarland Clinic, Neurology

    Robert Lee, MD – Iowa Clinic Family Medicine, Family Medicine

    Doug Martin, MD, FACOEM, FAAFP, FIAIME- UnityPoint Health – St. Luke’s Occupational Medicine, Medical Director

    Doug Peters, MD – Burlington Area Family Practice, Family Medicine

    Anne Langguth, MD -  Wolfe Eye Clinic, Ophthalmology


  • Monday, March 23, 2020 3:41 PM | Anonymous

    IMS and the AMA continue to work closely with our state and federal partners to push for additional resources and regulatory flexibility for clinics responding to COVID-19. This includes immediate action to meet urgent clinical needs and action to help address the long-term implications this pandemic will have on Iowa practices.

    Medical Supplies

    Many Iowa practices are reporting low or exhausted medical supplies, especially personal protective equipment (PPE) and basic testing supplies. IMS has been working with our partner associations on a state level to push for local donations to serve as a stop-gap until new shipments of supplies arrive. We have also been pushing the Iowa Congressional Delegation to fight for federal measures to help. The Families First Coronavirus Response Act, signed into law on Tuesday, includes a provision to waive federal limitation on the sale and use of commercial PPE for healthcare providers. IMS and the AMA are urging Congress and the Trump Administration to speed resources and production of additional PPE and necessary testing supplies to clinics responding to the pandemic.

    Workforce Support

    Iowa’s State of Public Health Disaster Emergency Declaration has put in motion steps for the Department of Human Services to begin offering additional child care assistance for front-line health care workers. IMS and the AMA are pushing for additional federal action to help with this unmet need. Clinics and ambulatory surgical centers that are temporarily closing or reducing non-urgent services are being forced to temporarily layoff staff or reduce staff hours. Staff on temporary layoffs may qualify for unemployment benefits. The federal government is allowing states to amend their laws to provide unemployment insurance benefits related to the virus. Information about the changes to Iowa’s laws, such as waiving employer charges for unemployment claims made by employees affected by COVID 19, is available here. IMS is assembling details as they become available. IMS and the AMA are pushing for additional federal action to expand paid family, medical, and sick leave, and to ensure that practices have immediate access to federal grants, interest-free loans, or tax relief to offset these costs.

    Electronic Prescribing Mandate

    As state and federal officials rush to expand telehealth capabilities, clinics add additional screening options, and federal HIPAA enforcement is being relaxed to allow the utilization of otherwise non-compliant platforms, IMS has received inquiries about how practices are supposed to work within the context of Iowa’s electronic prescribing mandate. Especially for those physicians utilizing non-traditional telehealth platforms that lack eRX capabilities, this mandate has the potential to disrupt patient care. IMS has worked with Iowa Board of Medicine and the Iowa Board of Pharmacy to ensure that they will not be penalizing prescribers who issue a written or verbal prescription during Iowa’s public health emergency declaration, so long as that prescription follows all other laws and regulations.

    Surge Capacity Support

    As practices experience a surge in demand for COVID-19 testing and treatment, our state continues to lack a sufficient supply of testing equipment and lacks sufficient bed capacity for the projected increase in need once more Iowans become ill. The state’s emergency declaration includes a suspension of the Certificate of Need law to allow facilities to add beds for the treatment of COVID-19 patients, however, many facilities lack the resources and staffing capacity to be able to do so. IMS and the AMA are urging our state and federal partners to devote additional resources to help expand capacity. This includes urging Congress to appropriate $100 billion for front-line providers and facilities.

    IMG Physician Waiver

    Federal orders to remove barriers for cross-state medical practice and allow for expanded telehealth service failed to address the limitations placed upon international medical graduate physicians whose VISAs limit the practice locations at which they may practice. IMS and the AMA are pushing federal officials to relax these limitations to allow these physicians to provide additional services during the pandemic.

    RHC Telehealth Waiver

    Federal telehealth expansion efforts similarly failed to address existing limitations on rural health centers (RHCs) initiating telehealth visits or billing as the provider of those services. IMS has escalated this issue to our federal partners and is pushing for flexibility to allow these practices to also provide expanded telehealth services to patients. We are also working with our Congressional Delegation to push for a fix to this issue as part of the next wave of COVID-19 federal legislation.

    CME & Professional Licensure Waivers

    Iowa’s original emergency declaration failed to address pending professional license renewals and the associated continuing medical education (CME) mandates that are a condition of license renewal. IMS worked closely with the Governor’s Office and the Board of Medicine to resolve this issue as part of the governor’s March 22 public health emergency declaration. The new order suspends license expiration dates for the duration of the emergency declaration as well as CME deadlines, and allows physicians to continue providing care.

    Financial Sustainability

    Revenue lost as a result of canceling elective surgical and non-urgent medical procedures is going to have substantial financial implications for many Iowa practices. Similarly, the costs of donated medical supplies for shuttered clinics, and the increase staffing, supply, and operational costs for those practice providing COVID-19 testing and treatment is going to be significant. IMS and the AMA are urging Congress to move forward with any potential measures to help restore the long-term fiscal sustainability of medical practices once the pandemic has stabilized and the healthcare system is able to return to normal operations.

    Good Samaritan Protections

    Iowa’s emergency declaration provides Good Samaritan liability protections for healthcare workers who volunteer to help fill workforce shortages in clinics responding to COVID-19. IMS is pushing for greater legal protections to protect all healthcare workers as they meet the challenge facing our state. On the federal level, IMS and the AMA are also pushing for Congressional action to ensure sufficient Good Samaritan protections are in place.

    3/23/2020: This is a rapidly evolving situation. Please continue to consult the IMS COVID-19 Resource Page for the latest information. For more information IMS efforts or assistance for your clinic, please contact Kady Reese or Dennis Tibben with IMS.


  • Friday, March 20, 2020 3:36 PM | Anonymous

    Practices across the state are reporting dwindling supplies of personal protective equipment (PPE) and additional staffing needs as they ramp up testing and treatment in response to the growing COVID-19 pandemic. Governor Reynolds has issued a Public Health Disaster Emergency Declaration to help respond to this rapidly evolving situation.

    Requesting Additional PPE & Medical Supplies

    In an effort to improve response for immediate needs for Personal Protective Equipment (PPE) from healthcare providers across the state, the Iowa Department of Public Health (IDPH) has revised the guidance for reporting PPE shortage and requesting stockpile supplies. IDPH requests that any practice or facility whose PPE supplies are within seven days of running out (at current, optimized usage rates), contact their county emergency preparedness and response agencies.

    Supplies will be distributed based on immediacy of need and those who are providing immediate direct care. Currently stockpile supplies available via area response agencies and the State Emergency Operations Center (SEOC) are:

    • N95 masks
    • Nitrile Gloves
    • Surgical Gowns
    • Surgical Masks
    • Face Shields or Goggles

    Urgent requests, as defined above, are able to be filled within 2-4 days of request, subject to availability of supplies. Revised and all subsequent requests should include quantities needed to sustain 7-10 days of supplies at current usage rates (optimized). For guidance on how to optimize usage of existing PPE, please review Strategies for Optimizing the Supply of PPE from the CDC.


    Volunteers Needed

    During this period of clinic shutdowns for some specialties, physicians and clinical staff are encouraged to consider volunteering to help with triage to expand capacity for those clinics screening and treating patients for COVID-19. Volunteering for this disaster response will not impact unemployment benefits for those who are receiving them as a result of their clinic temporarily shutting down.

    The governor’s emergency declaration also allows physicians, physician assistants, nurses, and respiratory therapists whose Iowa licenses have expired or lapsed within the past five years to provide assistance and treatment of COVID-19 patients without having to obtain an active professional license.

    Interested individuals are encouraged to register as a willing and able volunteer through the Iowa Statewide Registry of Emergency Volunteers (i-SERV) – the Iowa Department of Public Health's secure online registry for individuals wishing to volunteer in the event of a large-scale disaster or public health emergency. Volunteers maintain the option to accept or decline any opportunity. Volunteers may also reach out to their local public health department or county emergency management agency to offer their services and seek opportunities. Due to the Governor’s Public Health Disaster Emergency Declaration, individuals who volunteer to respond to the COVID-19 pandemic are granted liability immunity for their service.


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