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Michigan: Doctors have discretion on nonessential procedures

Doctor's coat
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Michigan hospitals and physicians have “broad discretion” to decide whether to delay procedures during the pandemic, the state said in new guidance issued in the face of pressure to let providers do more as the curve of coronavirus cases flattens.

Dr. Joneigh Khaldun, the state’s chief medical executive and chief deputy health director, wrote the memo Sunday. It came six weeks after Gov. Gretchen Whitmer restricted all nonessential medical and dental care to ensure that the health care system had enough capacity and equipment to treat COVID-19 patients and to limit the virus’s spread.

The governor’s order remain in effect but “is intended to be flexible, preserve clinician judgment and encourage consideration on an individual basis of which patient services can be safely delayed without resulting in a significant decline in health,” Khaldun said.

In-person contact should be limited as much as possible, she said. But if clinicians determine it is necessary, they should take steps such as asking patients to wait in their cars until their appointments, requiring masks and having separate entrances for healthy and sick patient visits.

Khaldun encouraged providers to prioritize appointments for their most vulnerable patients and to consider allowing visits for immunizations.

“Recognize that procedures or visits that were not time-sensitive several weeks ago may now be, based on clinician judgement,” she wrote.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.