As an infectious disease specialist, I have experienced firsthand how frightening new, dangerous and exotic-sounding viruses can be for patients. The current Ebola concern in the U.S. is a perfect example. Though domestic transmission has been limited to two people (other Ebola patients treated in the U.S. have contracted the virus overseas), patients’ concern over the deadly virus is escalating as suspected cases — often the result of similarities with other maladies — are a regular occurrence.
The situation can be challenging for many primary-care physicians, who are fielding frantic questions from concerned or symptomatic patients wondering if they’re at risk or potentially have the disease. Rather than a challenge or an annoyance, physicians should embrace the questions as opportunities to solidify their role as medical educators for their patients. Physicians should be the source of truth, the source of calm and the source of organization at a time of medical uncertainty.
Getting Educated on Ebola Causes, Symptoms
To perform the role of patient educator effectively during a public health crisis, physicians need to take a few steps. The first is utilizing public health tools to check when a virus or bacteria has become a significant risk. That’s no different from knowing when there’s a measles outbreak or a food-borne disease outbreak.
When Ebola moves from an unlikely overseas threat to a real public health risk in the U.S., physicians must know about it. They can do that by regularly checking the websites of the World Health Organization, the Centers for Disease Control and Prevention and their state and local public health departments. They also can sign up to get regular reports, bulletins and alerts from each agency as well as from their own state and local medical societies and specialty boards.
The second step is getting up to speed quickly on a disease outbreak once it has been identified as a public health risk. Ebola virus disease is an exotic disease that few practitioners in the U.S. have been educated about, let alone have treated.
It’s unrealistic to expect primary-care doctors to track every emerging virus that’s out there. But now that Ebola has been identified as a public health risk, it’s critical that practitioners get educated on the basics. Those basics include knowing how Ebola virus is contracted, how the virus spreads, the disease’s symptoms and treatments and how healthcare practitioners can safely treat potential Ebola cases without becoming ill themselves.
[Editor’s Note: Please visit McKesson’s UPrevent resource center for strategies to prevent infections including Ebola, in healthcare settings.]
Knowing What to Say — and Not Say — to Patients
By taking those two steps, physicians can prepare to handle the anticipated inquiries from worried patients. Ebola still is rare in the U.S. as compared with other common infections that we all get this time of year. Unfortunately, its symptoms — fever, malaise, nausea and vomiting, stomach pain and diarrhea — are similar to those caused by more common ailments.
Consequently, the first thing a physician should do when dealing with a concerned patient is to learn about the patient’s exposure history. In other words, is there a reason to think that the patient was exposed to the virus? What is his/her travel history? Did the patient come in contact with a person known to have the disease or known to have been exposed to the disease?
Absent any possible exposure, physicians should reassure worried patients that their symptoms likely are the result of a more common illness like a cold or flu. They should focus on diagnostics and treatments for more likely ailments. To further allay fears, physicians can direct concerned patients to resources that provide credible medical information about Ebola.
Those are the “dos.” There also are a few “don’ts” for physicians in dealing with the current Ebola scare in the U.S. Any proactive mass educational outreach should be thoughtful, targeted and concise, so as not to unduly generate concern or foster misinformation. Furthermore, routine testing for Ebola without clinical history or exposure history is of dubious value.
Unless there’s a significant exposure history or another reason that raises a serious suspicion, doctors should not test for Ebola just because patients think they have it. Ultimately, vigilance for possible cases, combined with calming reassurance in low-risk situations, allows physicians the opportunity to best support their patients.
In the end, this is about a conversation between physicians and their patients and an opportunity for a physician to educate a concerned patient about a new disease. In that relationship, the physician must serve as the voice of medical reason at a time of uncertainty for many patients.