Dr. Ralph brath has been in charge since 7. April supply doctor for the district of bad kissingen. This task is precisely defined for counties in the bavarian "emergency plan for corona pandemic precisely defined. In this function, brath is now to establish a permanent link between the catastrophe protection management group and the physicians in private practice. For this reason, he has also been assigned staff at the district office, with whom he forms a task force, according to the authorities.
Ralph brath is now responsible not only for patients in his own practice, but also for outpatient medical care in the entire district. As a supply doctor, he now has to consult more often with the doctors at the health insurance companies and contact the nursing facilities in the district. What is the supply situation there?? Are cases of covid-19 infection occurred? Is there sufficient protective equipment? Where there may soon be a shortage?
30 to 50 daily withdrawals
One of his tasks is to organize the county test center for corona patients in oerlenbach. He has drawn up a service plan, together with various doctors, says brath in an interview with the editorial team. "These colleagues test on site, he says. Occasionally, he has also stepped in. Helpers of the red cross were there to assist, for example when the test tubes had to be closed, labeled and put in place. According to brath, an average of 30 to 50 throat swabs are taken per day in oerlenbach from people who had to register with their family doctor beforehand.
Brath is also responsible for setting up so-called "focus practices" to treat covid 19 patients who do not need to go to a hospital but who, for certain reasons, require treatment by a general practitioner. Not every doctor can or wants to treat such patients, says brath, because, for example, the necessary protective equipment is simply not available. Therefore, there are now about ten of these focal point practices in the district.
Dispute over responsibilities
This also applies to dental practices, says brath. Because one must consider that people who already carry the corona virus often did not know about their infection because they have no symptoms. For the attending physician, every treatment is in a sense a gratuity hike. Good protective equipment is therefore the top priority, so that employees and other patients of the practice are protected, says brath. Because in the case of an infection, the respective practice had to be closed under certain circumstances.
The shift in responsibilities between physicians and the state has led to disputes here and there, even in bavaria. For where the medical profession has otherwise managed itself, the bavarian state government is now intervening. The medical associations both in the federation and in bavaria have already clearly criticized this in the recent past. But the declaration of a disaster situation gives bavaria the power to reorganize familiar structures and, to a certain extent, to interfere with the work of practicing physicians.
Circulars to institutions
This also affects the allocation of doctors for senior citizens and nursing homes. In wurzburg, for example, only a small number of doctors are allowed in and out of the respective homes in order to keep the number of contacts to the outside as low as possible. In the district of bad kissingen, this restrictive approval has not yet taken effect, says brath. "We are in the discovery phase." Nevertheless, the homes had already been informed by circular letter to keep the residents' contacts with the outside world as low as possible.
As far as equipping the doctors' offices in the district with protective material is concerned, the stores are mostly empty, she said. Because the state obviously could not supply enough masks and disinfectants. "But this is a nationwide problem", says brath. "But what we get, we distribute immediately." Occasionally, however, "signs and wonders" still happened. So brath got for his own practice on friday morning, 17. April, in fact, a free delivery via the health insurance association. The contents: 200 mouth-nose protectors, 20 FFP2 masks, 150 disposable gloves and a liter of disinfectant.
Protective material supplied
Immediately afterwards, he made a call to the family doctors in bad kissingen and heard that they had also received a similar delivery, says brath. However, he has not yet been able to find out whether all other general practitioners and specialists in the district have also been supplied with protective material. What brath missed in the package he received, however, was that it again did not include protective gowns.