CVMC Primary Care Physician Dr. Jennifer Borofsky

Dr. Jennifer Borofsky, Medical Director, Family Medicine - Mad River

Coming Back to Inpatient Medicine to Support the Hospitalist Team

Posted on Monday, August 3, 2020 by UVM Health Network - CVMC

In the early days of CVMC’s pandemic response effort, leaders were very concerned about possible staff shortages due to exposures, quarantines, and illness brought on by the novel coronavirus. Hospitalists—physicians who specialize in the care of hospitalized patients—were considered particularly vulnerable to exposure and potential understaffing.

Dr. Jennifer Borofsky, medical director of CVMC’s Mad River family medicine clinic in Waitsfield, was one of one of several primary care providers who volunteered to pick up shifts in the main hospital, giving the hospitalist team a deeper bench as they prepared for a potential surge of COVID-19 patients.

“I felt a duty to jump back in because I had that experience not that long ago,” says Borofsky.

Before she joined the Mad River practice in 2016, Borofsky had previously worked as full-time hospitalist at UVM Medical Center in Burlington, while also working part-time per diem shifts as a hospitalist at CVMC.

Borofsky is quick to add that her colleague Dr. John Wilson and several other primary care physicians also volunteered to support the inpatient team, shuttling between the hospital and their practices as they continued to care for patients via phone and video visits.

With Borofsky and Wilson at the hospital, the Mad River practice relied heavily on patient care support from the team’s physician assistant, Shayne Foley, and from Alison Hobart, a nurse practitioner based at CVMC’s nearby family medicine clinic in Waterbury.

“Shayne and Ali really held down the fort, taking turns being in clinic and doing telehealth visits,” says Borofsky. “They picked up a ton of work.”

Amidst all of the uncertainty surrounding the outbreak, Borofsky says being back in a hospital setting was different this time around. “I remember feeling nervous and worried, especially as we followed the news coming out of Italy and saw what they were going through. You couldn’t help wondering if a similar surge in cases might overwhelm our health care system here.”

Concerned about the risk of transmitting COVID-19 asymptomatically to her family, Borofsky stayed in a relative’s nearby condominium for a week and a half.

“Fortunately, CVMC and Vermont as a whole responded so well to the crisis we never saw the big surge we were expecting,” says Borofsky. “With such low prevalence in our area, I realized my risk of exposure just wasn’t as high, so I moved back home.”

Borofsky and her fellow primary care physicians worked regular shifts at the hospital for about a month before scaling back. Even as their clinic visits have returned to pre-crisis levels, many have continued to pick up per diem hospital shifts on weekends.

“We’re well acclimated to the hospital now,” says Borofsky. “If we do see a surge in cases, we’re ready to shift gears again.”

Back at their practice in the Valley, Borofsky and Wilson both say the experience, while stressful, has made them better doctors.

“It’s good to connect with our inpatient colleagues,” says Borofsky. “It’s also fun to practice different types of medicine, to dust off those inpatient skills, and connect with patients in a different setting.”

Borofsky and Wilson are also grateful to the Mad River community for supporting their efforts. “Everyone’s been so gracious and flexible with us as we’ve had to modify our schedules to be at the hospital when it was necessary,” says Borofsky.

With continued low prevalence of COVID-19 in the Valley and Central Vermont, Borofsky and her colleagues remain confident in the masking, screening, check-in, and sanitization protocols CVMC has put in place both at the hospital and in the practices.

“At this point, I have far more concerns about people not seeking the care they need, than I have about their risk of exposure,” says Borofsky. “We want everyone to know we’re open, and safe.”

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