Protecting Retired Healthcare Workers in the Direct Clinical Setting...

Lately, there have been a number of calls for volunteerism by retired physicians and nurses in the healthcare setting. This call is coming more frequently from my colleagues in government and the clinical setting. While I understand the principle, I think some elements are not being fully considered and could have a harmful impact if not done right.

Old Sam Whittemore.

In my second book, addressing senior healthcare and social issues, I tell the story of Sam Whittemore, the oldest known combatant of the American Revolution. It’s a good story, but I won’t tell it again here. I used it to encourage seniors to engage in service and to show an example of vital assistance by an 80 year-old.

Let me be clear, I am not advocating geriatric combat units. For the inherent and evident reasons, I am also offering a word of caution about rallying retired physicians and nurses to bolster the healthcare workforce in the time of COVID-19. Why?

Let’s review who is at their most vulnerable for severe outcomes and death. It is an individual over the age of 60, and those with comorbidities and medical conditions. In addition, we are also hearing stories of shortages of personal protective equipment and some shortcuts being taken.

I cannot think of a better recipe for increasing the number of critically impacted and dependent patients than to encourage seniors to exponentially increase their contact with this very contagious virus. In fact, done incorrectly, this could counteract the intended goal.

When the senior workforce works.

For several years I was the medical director for a FEMA/USAR team, and in order to enhance our manpower needs during predeployment physicals and medical screening, we recruited and enjoyed the support of the retired physician’s organization of the Harris County (Texas) Medical Society. They were impressive, inspiring and a Godsend.

That was a good use, but I will be frank in saying that I would not call upon those same noble men and women to respond to this threat. In part, because I would feel terrible if any of them met with illness or death, and also because, I don’t think they are the best front line resource.

Engaging the retired.

In terms of enhancing the response, perhaps the best use of this precious intellectual resource would be in remote video oversight of junior physicians and nurses, non-traditional aides and caregivers, and home health consultation via telephone and other remote and protected situations. Additionally, if provided tele-triaging templates, these retirees could be a massive force multiplier for public health and healthcare.

An admonition to the noble volunteer.

No matter your age, if you are considering volunteering in a direct clinical setting, please review your risks. If you are older, immunosuppressed, recently post-surgical yourself, have moderately or poorly-controlled medical conditions, consult with your trusted healthcare provider and determine how you might best serve.

The poet, John Milton famously said, “They also serve who only stand and wait.” This might be a time when art and life have a potential for mutual enhancement. A nurse or physician who maintains the greatest PPE of all, social distance, may sustain much longer, serve much longer, and ultimately avoid becoming one in need for these limited medical resources.

There is much truth in the grim adage, “A dead responder doesn’t save anybody.” In the age of COVID-19, ill-planned utilization of retirees, could doubly rob the response, by taking down an intellectual resource and creating another in-patient requirement. Hopefully, this consideration will help.

Matthew Minson, MD is a physician and has served as a senior health official at the local, state and federal level. He is the author of a series of books championing individual health and social advocacy published by Texas A&M University press and has been a contributor to C-Span, NPR, and PBS. His website is www.preparetodefendyourself.com