Doctors’ offices should be exempt from OSHA’s unique rule


A single interim federal rule for protecting healthcare workplaces from COVID-19 may be appropriate for hospitals and long-term care facilities, but creates onerous and redundant requirements for physician offices and physicians. outpatient clinics.

WADA urges Occupational Safety and Health Administration (OSHA) to exempt 161,977 physician offices and 10,568 mental health physician offices from its Interim Final Rule (IFR) Temporary Emergency Standard (ETS) on exposure to COVID-19.

“Given all the experience and steps that medical offices have already taken to address infection control issues with COVID-19, WADA urges OSHA to immediately exempt physician offices from ETS and to don’t move forward to make the ETS interim final rule permanent, ”AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to Labor Secretary Marty Walsh.

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A possible exemption for medical offices is included in the ETS, but it would require screening all non-employees and barring them from entering the office if they have or are suspected of having COVID-19. The broad definition of COVID-19 symptoms would prevent the entry of many patients with general symptoms, including: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle aches or pains, headache, new loss of taste or smell, sore throat, stuffy or runny nose, nausea or vomiting, and diarrhea.

“In reality, medical offices are placed in an untenable position having to choose between seeing patients who may have these common symptoms – but not actually COVID-19 – or refusing to provide services in order to take advantage of the exemption”, indicates Dr. Madara’s letter. “The exemption, while well intentioned, is impractical and could reduce access to care for patients and disrupt continuity of care. “

Dr Madara also noted that doctors’ offices have taken many steps to stem the transmission of COVID-19, including investing in technology, rapidly adopting telehealth, revamping planning practices and purchasing significant quantities. personal protective equipment and disinfectants, often at inflated prices.

His letter notes that many provisions of the IFR appear to duplicate existing infection control standards that the practices have already implemented, rendering them unnecessary. Other provisions impose new requirements and costs that constitute unfunded mandates on practices struggling to remain open and financially viable during the year and a half of the COVID-19 pandemic.

These unfunded mandates include new requirements for heating, ventilation and air conditioning systems, as well as paid time off for employees who develop general symptoms of COVID-19 or have been in contact with a colleague with COVID-19. .

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OSHA, an agency of the US Department of Labor, released the COVID-19 health care ETS – with little or no notice – in the Federal Register 21st of June. The ETS entered into force on that day.

Comments on the interim final rule were expected on July 21, and WADA said the quick deadline did not give doctors or other healthcare stakeholders enough time to review the IFR and provide an significant contribution to OSHA. Due to advocacy from WADA and other stakeholders, OSHA has extended the comment deadline to August 20.

Dr. Madara called on OSHA to provide a real opportunity to engage in meaningful dialogue with physicians and the healthcare community on the scope and need for HTA for medical practices.

The AMA COVID-19 Resource Center offers clinical information, guides and resources, as well as updates on advocacy and medical ethics.

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