Op/Ed

Letter to the editor: Porter prepares, is ready to serve

I am an ER doc. I am lucky. I work in a place where I get the chance to help people when they are worried, sick, or in pain. I get to work with members of an incredible healthcare team and solve mysteries, provide reassurance, and feel connected to my community in ways that many do not. It is a gift and a privilege to do this. Thank you for this gift. 
I have worked in the Porter Emergency Department for 12 years. The “guy” who hired me, Dr. Fred Kniffin, handed me his ED director job in 2012 as he moved upwards in the ranks of administration. As you might imagine, he is a really hard act to follow. I have a running commentary in my head when things get rough and it always returns to the same core question: “What would Fred do?” 
Over the past several weeks of accelerated administrative tasks on our Porter campus in response to the COVID-19 pandemic, I have thought long and hard about the answer to this question. Some answers are easy. Deliver quality care: check. Help patients navigate safely through the system: check. However, in the end, I am left with the daunting task of doing something that Fred always did so magically with our community: write a letter. 
I will take all sighs of disappointment as my challenge and my honor. I won’t get this right the first time, but I will try like heck to move forward, and as much as I would love for Fred to write this letter, he’s too busy back in the trenches taking care of this community alongside his colleagues and ancillary staff. I remind you of this because it’s true and it’s also important for all of you to know that we are here for you when the pain, the fear, and the uncertainties about your health arise. 
The COVID-19 pandemic cannot stave off other medical problems that people undoubtedly will encounter: appendicitis, kidney infections, heart attacks, strokes, just to name a few. We are here for you.
Truthfully, our circa 1996 Porter ER footprint presents some challenges for segregating patients with acute medical emergencies from predominately respiratory urgencies, but we have worked hard to identify rooms that are better suited for specific chief complaints. We also installed a new triage system prior to entering the ER with the goal of routing respiratory complaints safely through the department. Our primary care team is also helping with separating respiratory and non-respiratory complaints so that patients will not fear that the offices or hospital is a COVID-19 exposure risk, any more than going to the grocery store is. We have decided that Express Care will not be seeing respiratory complaints, but instead will commit to acute urgent issues of the non-respiratory type: lacerations, sprains, rashes, urinary tract infections, etc. 
All of these changes are our best efforts to protect our patients and healthcare workers during these challenging times. Quite honestly, what keeps me up at night is worrying about patients suffering at home with medical concerns out of fear of coming to have them evaluated. Sure, this happens naturally once in a while on a bad snow day, but a sustained period of delay in medical care because of fearing COVID-19 is an unintended consequence that ER providers fear the most. We are here for you.
When I drove down South Street to go to work the other day, there was a sign on a telephone pole that offered words of encouragement for those of us heading to work. It made me tear up as I drove by. This is an amazing community, with thoughtful creative wonderful people. I am incredibly energized by your commitment to embrace this odd new world of social distancing and “quarantine,” which directly helps me strategize and prepare for what might lie ahead. 
Maybe it shouldn’t surprise me that Vermonters are so capable of following directives to stay home and hunker down — isn’t that why a lot of us live here in the first place? Great job, team, keep it up. I will refrain from a “flatten the curve” speech at this time. You get the idea, you know the drill, and as best I can tell, you are doing it. I am lucky.
I have no idea what the future will bring. Like all of you, I read blogs, articles, and news feeds that seem surreal and distant. I am working hard with the rest of the hospital administration, plant operations and colleagues to figure out how to safely take care of ALL patients that come to Porter seeking care. My team and I will do our best to be thoughtful and responsive as we grapple with the changes and challenges in the coming weeks. Thank you for all that you are doing out there in the community to support each other and your healthcare team through these uncharted waters.
I am an ER doc. I am lucky. We are here for you.
Amanda Young, MD
Medical Director of Hospital Based Services
Emergency Medicine
Porter Medical Center UVMHN
Middlebury

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