Natural Disasters: How Physicians Can Manage

Over the last few decades, the number of natural disasters has greatly increased. Natural disasters – earthquakes, fires, floods, tornadoes, and hurricanes – are all unexpected events that create significant potential losses. As a physician, if there is one thing that you understand, it is the unexpected. Every new season brings with it a new set of likely challenges – flu outbreaks, flu vaccine recalls, and more. However, after a natural disaster, physicians are needed more than ever because one of the most important problems that occurs is the breakdown of health infrastructure.

Recent natural disasters - hurricane Irma, hurricane Maria, hurricane Harvey, California wildfires, Montana wildfires, New Orleans tornado, and more - resulted in massive destruction, causing countless deaths and billions of dollars in property damages. The problem with such natural disasters is that they are never-ending. They will continue to take place and most of them will take place with little or no warning. For this reason, it is important to always be prepared – both as a healthcare professional and as a devoted family member. Luckily, with the rise of modern medicine, telemedicine is helping to bridge the gap between unequipped facilities and disaster-stricken populations. A recent study found that telemedicine can improve survival rates and decrease mortality rates related to natural disasters. During a telemedicine consultation, you can virtually diagnose and treat medical issues such as chest pain, pregnancy complications, diabetes, cuts and bruises, high blood pressure, anxiety, and more. You can assess and manage patients’ conditions by advising them whether they are experiencing a medical emergency or the effects of stress are impacting their mental well-being. Below are some of the ways in which telemedicine has helped those affected by hurricane Harvey and hurricane Irma:

• American Well is offering victims of hurricane Harvey free telehealth visits for their medical needs and psychological counseling;
• Teladoc is providing free online counseling sessions for victims of hurricane Harvey in evacuation areas;
• Doctor on Demand is providing free virtual medical services to all individuals within the Florida state;
• Florida Hospital is connecting users to medical providers on its eCare app;
• Miami-based EpicMD, along with the charities it is partnered with, is reaching out to victims in Houston by offering free virtual medical services;
• Nemours Children’s Health System is offering virtual visits via its Nemours CareConnect app to pediatric patients in Florida and Georgia;

Above all, preparing for natural disasters involves creating a disaster preparedness plan and getting help from participants within your community. Yet, being a healthcare professional, you need to create two different types of disaster preparedness plans: one for your family and one for your practice (patients in need). With your family, discuss matters such as:

• What types of emergencies are mostly likely to happen in the areas where you live and work;
• What responsibilities each family member will have in case a natural disaster strikes;
• What to do in case you have to evacuate your home;
• What to do in case you are separated during an emergency;

Moreover, it is important that you put together a disaster kit (water, batteries, flashlights, food, medication, etc.) and a folder with financial documents such as copies of bank statements, property lists, your family’s medical information, cash, and other important information. If evacuation is necessary, you should take all of these items with you.

During a natural disaster, you play a significant and necessary role as a healthcare professional. As it is your right to care for your family, it is also your responsibility to reduce patient mortality and morbidity rates. For example, during the Atlanta ice storm, physicians and staff members divided their responsibilities and worked together as a team. Those who lived closer to the hospital provided assistance there, while those who lived further away opened up their homes to victims and checked in on the families of colleagues stuck at the hospital.

The first step to creating a disaster and recovery plan for your practice is securing your data. Make sure that all patient electronic health records, employee information, accounting and billing systems are safely secured because without them, you do not have a practice. Next, you need to secure your physical assets (computers, medical equipment, security systems, etc.). Divide responsibilities among your staff members so that each individual is prepared to execute their given tasks in case of emergencies. The third step involves setting up an employee portal for guidance and updates in case of an emergency evacuation. This, of course, also means communicating with patients through alert blasts and letting them know if your practice is going to be closed and where they can reach you in case of an emergency. The fourth step involves creating an emergency kit with contact information and basic supplies (first aid supplies, blood pressure cuffs, basic medications, phone chargers, stethoscopes, etc.) in case you need to run out and offer assistance from another location. Finally, it is important that you find out what kind of coverage you have and confirm that it is up to date.

Disasters need to be followed by quick decisions and responses. The consequences of natural disasters can greatly impact delivering health care services in times of need. Different disasters demand different needs, depending on where they have occurred, at what hour, and the extent of their severity. Responding to natural disasters involves ensuring that each individual receives proper care and lives are preserved. If anything, the recent natural disasters have demonstrated just how invaluable social media can be in times of a crisis. In fact, during hurricane Harvey, a great number of individuals reached out through social media and other platforms:

• On Twitter, individuals posted their addresses and the addresses of family and loved ones in need of help;
• On Instagram, users posted images of shelter, contact information, and other resources to help those in need;
• On Facebook, volunteers joined together to offer help to those in need;
• On Airbnb, individuals turned their homes into shelters free of cost
• On “Harvey Relief” (similar to Google Maps), individuals in need were able to drop a pin on their location and request help;

Another example is when hurricane Harvey flooded Houston. VillageMD, a national provider of primary care services for physicians, reached out to patients before, during, and after the disaster. With the help of cloud-based medical records and patient communication systems, they were able to send out text messages and emails to more than 160,000 patients before the storm hit – reminding them to refill necessary prescriptions, pick up prescriptions, and more. The messages also let patients know that the VillageMD’s call center would be available for assistance and if it closed, it would stay in touch through a 24/7 on-call team of physicians. “Building in that redundancy reduced anxiety among our patients” said Clive Fields, MD, VillageMD’s medical director. Field’s went on to say “My dad was a family physician for 50 years. When I tell him about how we are checking on patients at home, he says, ‘Son, I always did that. House calls a what you did on the way home’. He always knew which of his patients were in the hospital, which were vulnerable at home. Now with the help of data and high-tech communications, we may be getting back to primary care as it used to be, back to high-touch care. It’s not about hurricanes or EHRs, after all. It’s about relationships.”

Within a matter of minutes, natural disasters can cause devastating consequences and overwhelm an entire population. While you cannot prevent disasters, you can at least plan and prepare for them. Preparedness and adaptability are the two main components for healthcare professionals and healthcare practices facing natural disasters. If you are prepared for what might happen, you can respond and recover more quickly once the emergency has passed. You will also be in a better position to offer help to other individuals who still need it.