Published: July 28, 2020

SPONSORED CONTENT FROM AAO-HNS ACADEMY ADVANTAGE PREMIER PARTNER: THE DOCTORS COMPANY

While most resources are directed at screening for COVID-19 and treating affected patients, there is another important aspect of the pandemic: the impact on your patients’ mental health. Anxiety is being exacerbated by patients’ mistrust of the healthcare system and fear that they or their loved ones will contract the virus. A recent survey indicated that 67% of people have increased levels of stress since the start of the COVID-19 outbreak.

Academy AdvantageDoc Co

Reopening Your Practice: Avoid Risks when Treating Stressed Patients during COVID-19

While most resources are directed at screening for COVID-19 and treating affected patients, there is another important aspect of the pandemic: the impact on your patients’ mental health.1

Anxiety is being exacerbated by patients’ mistrust of the healthcare system and fear that they or their loved ones will contract the virus. A recent survey indicated that 67% of people have increased levels of stress since the start of the COVID-19 outbreak.2

What are some warning signs or cues that show a patient is in emotional distress? Watch for the following signs when seeing a patient onsite or via telehealth:

  • Changes in appetite, sleep, and/or behavior
  • Nonverbal cues during an interview
  • Decreased or no energy
  • Changes in cognition
  • Feelings of hopelessness/helplessness, being overwhelmed, irritability, fear/worry
  • Withdrawal from friends/family and activities
  • Increased conflict within relationships
  • Lack of follow-through with seeing therapist and/or psychiatrist
  • New somatic complaints
  • Excessive smoking, drinking, or using drugs

If these warning signs are missed and an adverse event—such as suicide—occurs, the healthcare provider may face the risk of a medical malpractice claim.

While the vast majority of your patients who are anxious and stressed about the COVID-19 virus are not suicidal, it is important to keep in mind the possibility of suicide as you complete your assessment. A helpful resource is the Suicide Prevention Toolkit for Primary Care Practices (http://www.sprc.org/settings/primary-care/toolkit) from the Suicide Prevention Resource Center and the Western Interstate Commission for Higher Education Mental Health Program.

The above key elements of the Stress First Aid peer support model3 have been linked to better functioning during times of ongoing stress and should be used in discussion with patients showing signs of anxiety.

During these discussions, explain to patients the importance of self-care during times of stress and the importance of staying connected to their support system. Provide positive encouragement and reinforcement.

 

References:

  1. Diamond R. Watch for the signs: Screen all patients for suicidal thoughts. The Doctors Company. Published November 2016. Accessed May 19, 2020. https://www.thedoctors.com/articles/watch-for-the-signs-screen-all-patients-for-suicidal-thoughts/
  2. Qualtrics. The other COVID-19 crisis: Mental health. Published April 2020. Accessed May 19, 2020. https://www.qualtrics.com/blog/confronting-mental-health/
  3. National Center for PTSD. For Leaders: Supporting Your Staff During the Coronavirus (COVID-19) Pandemic. Published April 9, 2020. Accessed May 18, 2020. https://www.ptsd.va.gov/covid/COVID_leaders_support_staff.asp

 

 

More from August 2020 – Vol. 39, No. 7
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BOG Model Society Award
The Metro Atlanta Educational Society for Otolaryngology-Head and Neck Surgery (MAES/OHNS) is the recipient of the 2020 BOG Model Society Award. The goal of MAES/OHNS is to provide education and scientific programs and seminars to otolaryngologists and other physicians and healthcare workers in a way that can be applied to the day-to-day clinical treatment of patients.
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BOG Practitioner Excellence Award: Kathleen C Y Sie, MD
The recipient of the 2020 BOG Practitioner Excellence Award is Kathleen C Y Sie, MD, division chief, Otolaryngology Head and Neck Surgery at Seattle Children’s Hospital; director of the UW Medicine Childhood Communication Center; UW Richard and Francine Loeb Endowed Chair in Childhood Communication Research; and UW professor of head and neck surgery.
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Coding Update: How to Report CPT 31298
In January 2018, the Centers for Medicare & Medicaid Services (CMS) implemented significant changes to the functional endoscopic sinus surgery (FESS) and balloon sinus dilation (BSD) family of codes, revising these code sets to bundle frequently reported codes within each family together.
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Over the past several months, members have alerted the Academy’s Health Policy Advocacy team that they have been receiving sinus surgery reimbursement denials from Aetna. In these denials, Aetna states that the procedure is considered experimental/investigational. In response, the Physician Payment Policy (3P) workgroup, supported by Health Policy Advocacy staff, have been working with Aetna to gain insight into these denials.
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2020 AAO-HNS Election Results
The AAO-HNS extends its greatest appreciation to the candidates of the 2020 election for their dedication and willingness to run for office and serve the AAO-HNS and its members. The Nominating Committee presented the membership with an outstanding slate of candidates. The AAO-HNS thanks the Committee for its meaningful deliberation. Albert L. Merati, MD, and the Nominating Committee are pleased to announce the results of the 2020 AAO-HNS Annual Election.
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Humanitarian Travel Grant: Otolaryngology in Uganda
In November 2018, I had the opportunity to participate in a surgical mission trip to Kampala, Uganda, as part of the Head and Neck Outreach (HNO) team from University Hospitals Cleveland Medical Center. This is a well-established medical and educational exchange with the Uganda Cancer Institute (UCI) and the Makerere University School of Medicine.
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In September 2019, during the AAO-HNSF Annual Meeting & OTO Experience in New Orleans, we presented an airway panel titled, “Challenging Bronchoscopy: Dos and Don’ts for a Successful Procedure.” Our target audience was diverse—the resident-in-training, the physician on call and covering for airway emergencies, as well as the airway expert interested in simulation as an educational tool.
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Eustachian tube dysfunction (ETD) is a common diagnosis in general otolaryngology practice. Most patients present with mild symptoms of aural fullness, hearing loss, tinnitus, and otalgia. Despite the prevalence of ETD in children, a standardized approach to diagnosis and management in the adult patient has been lacking.
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Home cybersecurity, like other types of security, requires a layered, in-depth approach. Every device on your home Wi-Fi needs to be secured. The basics include ensuring every connected computer has anti-virus and malware software, all software is updated and patched on a regular basis, and tablets are kept up-to-date with patches and only run trusted apps (no jailbreaking your phone). Following these basic cybersecurity practices is good but not enough.
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Corneal Neurotization for Trigeminal Anesthesia
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Service and Leadership Awards
A special thank you to Albert L. Merati, MD, AAO-HNS/F Immediate Past President and Chair of the Board of Directors Awards Task Force. Through the task force’s inaugural work, led by Dr. Merati, the AAO-HNS/F streamlined the application and submission process to identify and recognize individuals for their notable contributions to the profession and the communities they serve.
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Douglas D. Backous, MD, has a large ear and neurotology practice with Proliance Surgeons at Puget Sound ENT in Edmonds, Washington. He performs inpatient and skull base surgery at the Swedish Neuroscience Institute in Seattle, as well as outpatient otologic surgery in Edmonds and at a satellite facility, Ear Nose and Throat Associates, in Puyallup.
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WIO Celebrates 10 Years
2020 has certainly been an uncertain and thought-provoking year thus far, with the global pandemic and the recent civil rights movement leading to a great deal of self-reflection concerning the way we “do” medicine and live our day-to-day lives. One constant through all of these ups and downs has been the bright light of the upcoming Women in Otolaryngology (WIO) Section’s 10-year anniversary during the AAO-HNSF 2020 Virtual Annual Meeting & OTO Experience.
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The Administrator Support Community for ENT (ASCENT) developed a certification program in 2005, the Certification in Otolaryngology Practice Management (COPM), to set the bar for ENT practice management. The program was developed to test competency and knowledge in six key domains of ENT practice management. They include basic ENT knowledge, finance and accounting, marketing, operations, technology, and human resources.
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At the Forefront
The AAO-HNS extends its greatest appreciation to the candidates of the 2020 election for their dedication and willingness to run for office and serve the AAO-HNS and its members. The Nominating Committee presented the membership with an outstanding slate of candidates. The AAO-HNS thanks the Committee for its meaningful deliberation. Albert L. Merati, MD, and the Nominating Committee are pleased to announce the results of the 2020 AAO-HNS Annual Election
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