PSVMC hospitalists are go-to team for complex COVID cases

Author: Kevin Olson, M.D., chief executive, Clinical Programs, Providence Oregon

When COVID first hit Providence Oregon hospitals in March 2020, no one knew how to care for these very ill patients. Like their counterparts around the world, Providence doctors and caregivers struggled to save their patients. They risked their own lives and constantly worried about infecting their families.

At Providence St. Vincent Medical Center, a small group of hospitalists decided among themselves they would volunteer to take on the most severe COVID cases, relieving that responsibility and worry from their colleagues. Now 20 months later, this dedicated group of hospitalists continues to be the go-to team for the hospital’s most complex COVID cases.

They are emotionally and physically tired, they know a lot more about COVID than they did a year ago, and they share their frustrations about Oregonians who choose not to be vaccinated. They also support and rely on one another, and their team grows stronger every day.

Alison Ma, M.D., is one of the medical directors of the hospitalist program at Providence St. Vincent. She is enthusiastic and grateful for this special team: Brent Kimberly, D.O., Christine Stock, M.D., Edyth Lee-Barnes, M.D., and Lela Gonzales, M.D.  

“At first, it was really scary. No one knew how transmissible it was, and there was this fear of taking it home to our families and infecting them,” said Dr. Ma. “A lot of the doctors lived away from their families to protect them. In the early days, testing was limited, and there was a national shortage of PPE.”

With a lot of collaboration among providers, nurses and caregivers in key areas such as emergency services, infectious disease and respiratory therapy, the hospitalists and intensivists learned the best strategies for caring for patients with COVID.

“As we gained expertise and as people became more comfortable, a few hospitalists said they didn’t mind taking care of the bulk of these patients. They were willing to take on more, so that their colleagues could focus on other patients,” said Dr. Ma. “It morphed into a dedicated team of four doctors on this special team.”

Two of the hospitalists are a few years out of their residency; the other two are seasoned doctors. All of them learn from – and lean on – one another.

All hospitalists are accustomed to dealing with stressed out families who want answers and frequent updates. That’s just part of the job. But with COVID, there are added stressors since family members can’t visit their loved ones in the hospital. That translates into many extra hours every day and night for the hospitalists, calling family members to give updates and answer questions. Sometimes there are multiple family members calling, all wanting to talk about their loved one.

Caring for patients infected with the delta variant – the vast majority of whom are unvaccinated – has been particularly challenging. That’s especially true when patients and families sometimes display antagonistic attitudes toward the very people who are working to save their lives.

To help lift each other up, the tight-knit group relies heavily on each other. They try to do COVID-safe activities outside of work together, said Dr. Ma. Sometimes they play golf or tennis, or they arrange group camping trips to get out in nature. In the midst of it all, they try to think of ways to thank their nursing colleagues, knowing they’re as exhausted as the hospitalists.

They also get support from Providence’s Compassion Program, including from doctors such as Mark Rosenberg, M.D., and Charlotte Ott, M.D., who are experts in physician wellness. Providence has worked hard to provide additional staffing, including from locum providers. “That’s really expensive, but Providence has committed to providing that help for us,” said Dr. Ma.

Even aside from COVID, hospitalized patients are increasingly more complex than even five years ago, she said. But with the pandemic, “We don’t get those bursts of happiness in between fatigue, simply due to the volume of patients and the complexity of their illness. We just don’t have time,” said Dr. Ma. “We still love caring for people, and that hasn’t changed. Whenever we can help people, it reminds us of why we do this.”

Providence’s hospitalists at each of our facilities have given so much of themselves as part of our COVID response. Thank you for your commitment to our patients and your colleagues.