Encouraging booster doses for Americans already immunized against SARS-CoV-2? Absolutely.
Requiring Medicaid to cover and pay for stand-alone counseling for COVID-19 vaccines for children? Well, sure. In fact, we asked for this.
Now if only we could give the administration a booster dose of whatever medicine would remind it of a lifesaving truth: Family physicians are uniquely powerful allies in this battle — fighters ready for more reinforcement than I see in this latest plan.
Let’s start by backing up to the part about vaccine counseling. The White House is pledging Medicaid payment for stand-alone talks about children’s COVID vaccines — kids’ but not adults’. The AAFP advocacy I linked to on that subject pushes for full coverage of such counseling, apart from vaccine administration, for all patients from Medicaid and Medicare and commercial insurance. Particularly when so much disinformation has polluted a commonsense conversation about the COVID vaccines (including boosters and doses for children), there’s no good argument against simple, universal coverage for vaccine counseling from trusted primary care practitioners, even when the patient is vaccinated elsewhere. That’s why we’ll continue that pressure.
As for the vaccines themselves, the administration clearly means well with the part of the plan that would stand up “family” clinics where kids and adults can get their COVID-19 shots together, making it “easy for parents to get their kids vaccinated with over 35,000 sites that parents know and trust, including pharmacies, pediatricians’ offices, children’s hospitals and school-based clinics.”
Notice the big item missing from that list?
Though we’re heartened that federally qualified health centers and rural health clinics are on the “family days” list, it’s very frustrating not to see all primary care clinics on that roll. As recently as September, when the campaign to vaccinate teens was on the horizon, we reiterated our eager readiness to be at the top of the list. In many parts of the country, family physicians practice but pediatricians do not. Meanwhile, large pharmacy chains are reeling from staff shortages that have left patients — some of whom have been given uncompensated vaccine counseling by their primary care physicians — with long waits or else unvaccinated.
So the Academy is obliged to point out again that its members are already running the nation’s most established, most trusted, most reliable, most relationship-oriented family clinics. You’d think by now an administration that not long ago thanked family physicians for their work over the past two years wouldn’t require a reminder that the wheel need not be reinvented here.
The administration also says its plan will improve access to rapid COVID tests and require that commercial insurers reimburse enrollees for them. I have a couple of thoughts about this.
First, the Academy advocates hard for family physicians to enjoy greater administrative simplicity, and your patients similarly deserve to avoid insurance red tape such as having to wait for money back from a fraught retail purchase that delivers a result without counsel. (CDC guidance says patients taking such tests in order to travel abroad should get that counseling via telehealth consultation with the test manufacturer, but that’s far from ideal.) Second, the plan’s promise to get more free tests to underserved communities is a good, necessary step. For Americans to benefit from this home-screening tool and help to stop the virus’ spread, though, tests must be widely and dependably available; right now, in the middle of the holiday season, supply continues to lag. This makes it all the more important that we also ensure physician practices have a robust supply of rapid tests to use in their offices.
The White House also again encouraged Americans to mask up indoors and in public. By now, however, that can sound like mere lip service. Our members know that masking absolutely and unequivocally works, and, especially in the absence of new masking mandates, the administration should repeat that advice loudly and forcefully.
The president last week asked Americans to be watchful about the omicron variant without panicking, and the White House’s new plan correctly emphasizes caution and reassurance. Family medicine practices are one-stop shops for just this approach, from testing to counseling to vaccinations to boosters. Better yet, they factor their patients’ full medical histories into the conversation.
That’s why, throughout the pandemic, we’ve clamored for primary care inclusion in various governmental plans to stabilize public health. This has led to plenty of good results for Academy members as you’ve worked to save lives. We’ve gotten through to policymakers before. We’re just going to have to do it again now.
Stephanie Quinn is senior vice president of advocacy, practice advancement and policy.
Stephanie Quinn, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy. Read author bio »