Guess what? Most doctors do not plan to help in a major disaster. Isn’t that a sobering thought?

Why Don’t Doctors Volunteer?

Doctors don’t know what roles we might have, and we are rarely included in disaster planning. This leaves us unsure of ourselves (and since we doctors can have big egos,  we sometimes choose to avoid things that we won’t seem good at). In addition, it takes time to prepare – something we are quite short of with our busy practices. Admittedly, there are also legal, financial and logistical barriers, many of which I hope to address in time. But you should be aware that, when asked, many doctors say they will just stay home – obviously not the right response.

Hospital Doctors

Let’s talk about what we need doctors for. Obviously, physicians involved in trauma care will rule the hospital. This includes emergency room doctors, general, trauma, and thoracic surgeons, neurosurgeons, and orthopedists, but don’t forget anesthesiologists and radiologists to support the various surgeons. Hospitalists do the general care of hospitalized patients, and intensivists manage the most critically ill and injured.

What about other specialties? More babies are born in the weeks following disasters, so obstetricians should plan on being busy. There’s a nice little article about birth rates after disaster on the Life’s Little Mysteries blog (http://www.lifeslittlemysteries.com/1161-birth-spike-after-natural-disasters-earthquake.html). More importantly, studies show that disasters affect pregnancies badly, particularly when occurring early in pregnancy. Communities will need obstetricians more than ever for at least 9 months after a disaster.

Stress and physical exertion associated with disasters make heart attacks common in both victims and rescuers. I hope we’ll have cardiologists, particularly if they do cath lab procedures that won’t tie up operating rooms. And I think 9/11 has made us all familiar with respiratory problems from breathing in byproducts of damaged buildings, so I’d like a few pulmonologists around as well.

Outpatient Doctors

So the above doctors are likely needed in the hospital. Primary care is noticeably missing, but pediatricians, family practitioners, and internists don’t get to stay home. Instead, we need you for outpatient care more than ever. First and foremost, hospitals will be overrun with severe traumas. The emergency room may turn away routine patients because they are not sick enough. And walking wounded don’t need hospital level care but still need someone to help with injuries. Hospital level patients with pneumonia, dehydration, or other medical problems may even be transferred to alternative care sites if the hospital is full with more severely sick or injured. Medically fragile home patients may be placed in specialty shelters, and even regular shelters need standard medical care, particularly for things related to crowded living conditions. So primary care doctors – WE NEED YOU! Although these tasks may seem outside your current comfort zone, you can do it. You just need to remember skills from pre-hospitalist days.

We also need creative ways to keep clinics open, even if power is out and computers are down. The level of care will not be the same , but patients still need doctors for all the same things they do in non-disaster times. Can you imagine cities without routine medical care? Unfortunately, this might be the outcome without advance planning.

If your specialty isn’t on the list, are you home free? Not a chance! If I didn’t mention your specialty, guess what? It’s because I ran out of room.  Leave me a comment and I’ll convince you why you’re needed.

Include Doctors In Planning

It’s time to take doctors into consideration in emergency planning. I spend much of my time thinking of ways to include them, and I love to work together on this with emergency planners. If you are a lay person, your job is to ask your doctors at every visit about plans for emergency response. Doctors want to appear knowledgeable,  so if enough patients question them, it might prompt action. If nothing else, you can refer them to this blog to start learning. Don’t let doctors be the missing link that blocks community recovery.

Stay safe,

Sheila

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Comments
  1. Its like you read my mind! You appear to know a lot about this, like you wrote the book in it or something.
    I think that you can do with some pics to drive the message home a little bit, but
    other than that, this is great blog. A fantastic read. I will definitely be back.

    • disasterdoc says:

      Thanks for the comment. I first got sucked into emergency preparedness when I tried to figure out what my physician role would be in a disaster, only to discover no one could tell me. When I asked my fellow docs, they said they would go to the hospital, or more often, they would stay home – neither of which is the best response. I’ve been working on this issue ever since, with slow but definite progress, at least on a local level.

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