The message is clear: It is important to #MaskUp to protect others from SARS-CoV-2, the virus that causes COVID-19. While Americans are increasingly adopting the use of cloth face masks to help curb the spread of COVID-19, some people still object to wearing them. To continue to reinforce the public health message on wearing masks with patients, what should physicians and other health professionals be doing at the bedside or in the exam room?
It is critical that physicians help patients understand their risks for transmission through clear and simple communication that is firmly rooted in science. The AMA is partnering with other leading health organizations to encourage people to mask up to stop the spread of COVID-19.
Five AMA members took time to discuss how doctors can best handle this sometimes touchy subject with patients and help spread the message to mask up. They are:
- Ricardo Correa, MD, endocrinology fellowship program director and the director for diversity at the University of Arizona College of Medicine in Phoenix.
- Meena Davuluri, MD, MPH, a urologist and health outcomes fellow at New York-Presbyterian/Weill Cornell Medical Center in New York City.
- Pratistha Koirala, MD, PhD, an ob-gyn resident at Danbury Hospital.
- Nicole Riddle, MD, a staff pathologist at Tampa General Hospital for Ruffolo, Hooper and Associates in Tampa, Florida, and associate professor and associate pathology residency program director at University of South Florida Health.
- Megan Srinivas, MD, MPH, an infectious diseases specialist and translational health policy research fellow at the University of North Carolina at Chapel Hill.
Here is what these physician experts had to say.
Avoid judgmental tone
When addressing mask wear in the exam room, “ask in a nonjudgmental fashion,” said Dr. Srinivas. “People are honest with you, the same way we talk about seatbelts or alcohol. We’re very trained in this method of trying to be nonjudgmental in our questions and framing.”
“For so many of us right now, it’s something that naturally comes up in the conversation,” said Dr. Koirala. “When they come to see us in the office, they’re actually not allowed in without a mask on” so the conversation “happens right away.”
“As physicians, we screen for multiple things, including habits of diet and exercise,” said Dr. Correa. “Screening patients for the use of masks should be an important part now of the patient’s history and physical.”
Make masking up the norm
“When my patients ask me about mask wearing, I’m up front about the fact that maybe it’s not the most comfortable thing in the world to do it on a day-to-day basis,” said Dr. Koirala. But, she reminds patients, “you’re doing it not only for your own health, but also for the health and wellness of everybody that you love and care about.”
She added that simply reinforcing masking up as the norm can go a long way toward communicating the right public health message. “The more that we do things to normalize mask wearing, the more likely it is that people are going to wear masks.” Dr. Koirala said.
“Leading by example is the best way to encourage anyone to do anything,” added Dr. Davuluri. “We’re all wearing our masks and we’re encouraging our patients to wear masks. That’s the easiest and most effective way to get that message out there.”
Learn from AMA President Susan R. Bailey, MD, about why it’s time to #MaskUp.
Help patients find the right fit
While some people might say they have trouble breathing while wearing a mask or other face covering, Dr. Riddle says it is important to help patients work through such obstacles.
“Maybe it doesn’t have the right fit. Maybe it’s too tight,” she said.
This is when physicians can recommend trying a different fit or style because masks “are made differently, or even if you wore one that was slightly looser like the regular cloth ones. And you can have it open just a little bit on the edges where the air can come in and out to make it easier to breathe, but will still catch everything,” explained Dr. Riddle.
“It’s a new piece of clothing. The first time some people wear a belt, you don’t love wearing a belt. It feels weird,” said Dr. Davuluri. “That’s really what this is. It’s getting someone used to a new piece of clothing, but, fortunately, it’s a piece of clothing that helps prevent a very contagious disease.”
Learn about seven questions patients might ask about managing risk and wearing masks.
Share positive messages
“We should start giving hope instead of the message being, ‘If you don’t wear a mask, you will kill others,’” said Dr. Correa. “The message should be, ‘If you wear a mask, this can end,’ or something like that in a positive way, because human beings usually are more prone to not accept something when there is no hope.”
Just staying on top of the news or catching up on social media timelines can bring some patients to despair, causing “more depression,” Dr. Correa said. “We need to start recreating and saying there is hope and we have the solution in our hand—we can make this change.”
Centers for Disease Control and Prevention (CDC) Director Robert R. Redfield, MD, explained the protective value of face masks during a recent episode of “Conversations With Dr. Bauchner.” Read the JAMA editorial that Dr. Redfield co-wrote, “Universal Masking to Prevent SARS-CoV-2 Transmission—The Time Is Now.”
Turn to the data
Physicians can rely on the mounting evidence showing how effective masks can be in preventing transmission of SARS-CoV-2.
“There’s a lot of data we can go off of. We can look at our international counterparts and see those that implemented early mask strategies and those that didn’t, and the difference in their infection trajectories and how a lot of them have even returned to completely normal life at this point,” said Dr. Srinivas. “A perfect example is Iceland, where they didn’t have a mask mandate and they put one in place. Within three weeks they saw a drastic decline.”
The epidemiological experts at the University of Washington’s Institute for Health Metrics and Evaluation are estimating that if 95% of Americans wore masks, the expected U.S. death toll between and Nov. 1 would be cut by nearly 34,000 cases.
“We know that if I’m wearing a mask and you’re wearing a mask, that risk of transmission is very low,” said Dr. Davuluri.
“If there was a drug on the market that could save as many lives as wearing a mask could save, it’d be a billion-dollar drug. That’s how effective they are,” said Dr. Koirala. “This is one of the most effective things that people can do to show that they care not only about their own health, but about the health of their family and the community that they live in.”
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August 14, 2020 at 07:00PM
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Time to mask up: 5 keys to effective exam room talk with patients - American Medical Association
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