Statement by Dr. Lee

Update by Dr. James Lee, 3/27/20

Much has changed and much has not changed as our medical and personal lives have flipped upside down in the past two weeks.


For us at FCP, maintaining our strict patient surveillance and triage remains our biggest and most stressful challenge. Overall lack of covid 19 testing has us “lurking in the dark”. Reportedly there are relatively few cases in Frederick County and no reported pediatric cases but the unsettling knowledge that children (and parents) may present asymptomatically or with minimal symptoms obviously concerns us. Our triage struggles to ascertain not only the status of the patient but relevant family, work and travel history. That all takes time and can be confusing.


Although our PPE is adequate, we always feel we should ration. Other supplies too are limited. Flu and RSV testing for example, helpful to rule our other causes of Covid 19 – like illness, may or may not be available.
Staff safety and morale weighs on all of us. For me, what we see and hear at the national level plus the concern and admiration that I have for my colleagues who are on the front lines in ERs and ICUs is hard to shake. They are the true heroes!


Time lines and expectations are no more clear to us than they are to you- we hear what you hear from our governmental agencies and politicians . As Dr Fauci stated, the virus decides the timeline, not us.


We are also an independent, small business and like many of you, we have bills to pay and payrolls to make. We’ve been asked and want to limit “non essential” sick and well visits to our office – that is proper medical care for the present but not a good long term sustainable business plan.


Fortunately, we have a very conscientious practice administrator and although nobody can plan for such a major disruption in operations, we think and hope the underpinning of our practice is strong and our staff is excellent, dedicated and committed. And I am similarly committed to them.
So we’re hanging in there, fighting the good fight and trying to keep our head above water (sorry, that is a lot of metaphors!) and we’re trying to adapt as best we can with strict separation of sick and well, seeing some of our patients curbside (just to be on the safe side) and have revved up telemedicine. Guess what? It doesn’t always go smoothly!


We’ve been advised to batten down for a 2-3 month “siege” with the philosophy being plan for the worse and hope for the best. And that may be a best case scenario.


Very fortunately, Frederick County is not an epicenter for high covid 19 activity and we have good linkages to both our hospital and health department to monitor conditions and trends.


The medical toll is one thing, the economic and mental health toll is arguably as daunting and concerning. Our friends at the United Way and the Mental Health Association are right with us to support families in need, especially as we wait for federal relief. Our psychology and behavioral health colleagues stand in the wings – let’s hope there isn’t too much pent up business for them!


Medical practices like ours are indeed the front line troops for now and for as long as it takes to confront this public health crisis. I take comfort in knowing that the foundation of my practice is strong and my staff is excellent! We listen and respond to leaders in our profession to help us navigate these rough seas. We’ll hang tough- because we are you and you are us!


Now go wash your hands, take in some nice, deep clearing breaths and enjoy the warmth of an early spring day.

Update by Dr. James Lee, 3/20/20

It’s been a challenging week, a tough week, a surreal week. In over three decades of practicing medicine, I’ve never experienced anything like it. It’s our turn, the health profession, to stand up to an unknown threat – doing it with incomplete information, incomplete preparation and incomplete resources. We’re concerned if we’re doing it right – for our patients and for our own families.


From early morning huddles, to relentless phone calls, to donning Darth Vader protective gear, to mastering new technologies like telemedicine – we’ve tried our best.


I can’t express my appreciation, respect and, frankly, love that I have for my staff who have bravely stood up during these stressful times . In many ways, we’re you – parents, mothers and fathers, neighbors and friends who face the same fears and concerns that you do. But it’s now our turn and we’ll do our best to help you, educate you and hopefully keep you out of harms way.


We don’t know what’s around the corner, how long this will go on for and what impact it will have on all of us – medically, financially or emotionally. But all I do know is that I wouldn’t want to stand side by side, work side by side or laugh and cry side by side with any other group of professionals or, frankly, just good people, than my staff and I’m beyond fortunate to have them working at FCP . . .and so should you!


We’ll see ourselves through this – somehow – gosh knows hopefully not for an extended period and we’ll fight the good fight – hopefully with grace, determination and professionalism.


Now it’s time to get back to a phone call…

Statement by Dr. James Lee, 3/17/20

Coronavirus spread and surveillance continues to be a public health emergency as it impacts our entire country. Although there are few reported in our community, it’s unclear how wide spread it could be.

Fortunately, the severity of a coronavirus infection in our pediatric population is low and reassuring. However, it appears to be easily contagious and is increasingly severe in the older age group. Currently, testing is not available in our community. We also are concerned that mildly or minimally ill patients can still have the virus.

The AAP is strongly advocating to keep children out of the health care system as much as possible. During this early pandemic phase, minimizing visits of all types can hopefully prevent “accidental spread.” This is true in all settings and why the government has requested minimizing group gatherings to very small numbers. We hope that this lessens accidental exposure and can “flatten the curve.” The more we can prevent now, presumably we can lessen the time period of the pandemic.

Health Care Systems and medical care providers are the front line and are already stretched thin. Inadequate testing and inadequate protective clothing puts us all at risk. This is especially true for hospitals, emergency rooms, etc.

We all must play a role to protect one another and especially those most at risk for getting severely ill.

At FCP, we are actively “triaging” all our patients- sick and well- and are cancelling/delaying well visits and follow ups in our older age groups. Well care for small babies and toddlers is still in place and we have set up sick and well sides to our practice but request only a single parent attend the visit with no other siblings. Potentially unwell parents should not come in either and we ask for your honesty in this regard. We will see your children but we must not pose any health risk to anybody.  

Additionally, we are capable to do “road side visits” in our parking lot if approved by our triage system. We are activating a telemedicine link where we can interact face to face (but must be a medically secure link) to help make medical judgement and decision making together.

Again, our primary goal is to properly triage all patients and prevent or avoid unnecessary appointments during this critical time period. Our triage system is available during our working hours, which will be standardized from 9 am to 5 pm until further notice. Our on call doctors are available after hours for emergency concerns.

Please be reassured that we are actively engaged with local, regional and national medical centers, organizations and governmental agencies for help, guidance and proper management of our patients.

This is a scary time, for all of us, and we advocate social distancing as a good practice in general for all families and age groups. We don’t know what to expect or what is around the corner and as much as we want to be reassuring, we also want to emphasize that this is not the time for “business as usual” and its certainly better to err on the side of caution than not.  

Please look to us to help and problem solve. Thank you in advance for the trust and faith you put in us to make the best medical decisions for your family.  

Please refer to the evidence based and government agencies for the most reliable and up to date information on COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/prepare/children-faq.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fchildren-faq.html

https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx

https://coronavirus.maryland.gov/

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