Fierce Q&A: Prepare your practice to handle a public health crisis


As of Tuesday, more than 100 people across the United States have been infected with--and 12 have died from--a fungal form of meningitis contracted from contaminated steroid injections used to treat pain. According to the Centers for Disease Control and Prevention, as many as 13,000 people may have received contaminated medicine, and the number of cases is expected to rise.

Physicians who may have distributed injections from the New England Compounding Center in Framingham, Mass., which has voluntarily recalled all of its products, are advised to follow guidance issued by the CDC on how to determine and address patients' risk for contracting the disease.

Meanwhile, potentially affected patients are left anxiously assessing whether they're experiencing symptoms of meningitis, which range from neck stiffness to sensitivity to bright light. "Even if symptoms seem mild, call your doctor anyway," CNN advised.

Although this particular outbreak will affect a very small number of practices, such as those that specialize in pain management, similar scenarios can and do occur in all types of healthcare settings. Pediatrics, for example, is particularly prone to managing fast-erupting public-health concerns and crises.

To provide insight into how all types of practices can prepare for and handle such situations, FiercePracticeManagement spoke to Jesse Hackell, M.D., (pictured right) vice president and chief operating officer of Pomona Pediatrics PC in New York, and Scott Needle, M.D., a Florida pediatrician who is also member of the American Academy of Pediatrics' (AAP) Disaster Preparedness Advisory Council and consults with the Pennsylvania Chapter of the AAP on ways to increase communication and partnership between public health and primary care pediatricians.

FiercePracticeManagement: What's the first step practices should take in managing an outbreak crisis?

Hackell: Get your facts straight. You don't tend to get most of these things through official channels at first.


"The physician has got to be proactive in locating the actual facts because what comes across in the press is not always factual."

The most recent thing that hit us was a concern about arsenic being present in infant rice cereal. There were published reports, and we started hearing about it. Only after that, did we start to get some statements from the FDA. The physician has got to be proactive in locating the actual facts because what comes across in the press is not always factual. And even if it is initially, it's a lot like playing a game of telephone as the information gets passed along, especially through the Internet. If you don't have time to get a handle on the details immediately in the middle of the day, you may have to tell the patient, "I don't know," and call back after you find out.

Needle: One of the first things everyone can and should do is sign up for alerts from the CDC, as well as state and local health departments so you get your information as it breaks from a trusted source. Emails from the CDC, for example, include not just a summary of the news to date but also recommendations for clinicians and patients.