Members of the American Academy of Physical Medicine & Rehabilitation:
Our country is in the midst of a medical pandemic. The AAPM&R (Academy), including its volunteer leaders and staff, have enormous empathy for our members, their patients, and families as COVID-19 has disrupted every aspect of our personal and professional lives. Together, we need to find the resilience to persevere for our personal and our patients’ health and well-being. No single medical society, organization, or government has a playbook that can clearly guide any of us through this unprecedented crisis. As a result, we have seen the expression of many different statements and opinions regarding how to navigate the impact of COVID-19 on the delivery of care. The Academy is acutely aware of these multiple perspectives and is extremely sensitive to supporting our members through this turbulent time.
Physiatrists must and will remain steadfast in caring for their patients at this critical moment. Given the mandates from the
WHO,
CDC, and other governmental agencies, there is no “business as usual” and we must now engage with our patients through different means. Therefore, the Academy is strongly urging our members in the outpatient community to immediately transition to virtual medical appointments (e.g., telemedicine) for those patients who do not have emergent or urgent medical conditions. Such action will reduce the risk of both exposure and transmission of COVID-19 between and among patients, providers, and medical staff, and is in line with current guidelines. The Academy is working diligently to provide information and guidance regarding these tools. CMS has relaxed
regulations and penalties regarding communication devices that can be used. Further, the Academy is advocating for the prompt and unburdened reimbursement of these virtual medical visits including telephone calls.
To those physiatrists with inpatient-focused practices, the Academy stands firmly behind you and your commitment to your patients. We understand that some physiatrists might need to shift their role to meet urgent needs in our community. Your roles are invaluable and we support your efforts.
The Academy also recognizes the value and importance of medical procedures for patients with a variety of neurological, musculoskeletal, and pain conditions. However, to protect patients and providers from undue exposure and transmission risk associated with direct patient care and associated travel, and to preserve personal protective equipment (PPE) for more urgent patient care needs, the Academy is recommending that all elective, non-urgent, procedural-based diagnostic and therapeutic interventions be postponed until such time as the current risk level has been re-assessed by CDC and other authorities. It is understood that patients with unmanageable conditions may require urgent procedures and we believe that physiatrists should continue to provide compassionate care, using their best professional judgment and published CDC guidelines in guiding their shared decision making with patients about performing or delaying such procedures.
The immediate future is unknown and overwhelming for us all. Eventually, this crisis will pass. Regrettably, many people will suffer in different ways. We realize that some of our members, especially those in private practices, will suffer more direct financial consequences than those working in large institutions, though no one will be untouched. While personal and patient safety is paramount, survival of our members’ medical practices is extremely important. The Academy will continue to strongly advocate for the immediate reduction and relaxation of regulatory and administrative burdens on members, confirmation of telehealth reimbursement, government aid for struggling private practices, the ongoing educational needs of those in training, and guidelines for the provision of face-to-face care that must occur for some of our patients, the most vulnerable in the health care system.
Finally, we have been conditioned to the term “social distancing.” While physical distancing may be medically necessary to mitigate the spread of COVID-19, in the spirit of supporting our peers, let us physically separate but not socially isolate. Stay safe!
Board of Governors
American Academy of Physical Medicine and Rehabilitation
AAPM&R COVID-19 Resources (continually updated):