COVID-19 7/26/2021

July 29, 2021

As I’m sure everyone knows, We are in the early stages of an uptick in cases, hospitalizations, etc.   Mask mandates are being reinstituted in many “hot spots” and continue to be resisted.

The “Delta variant” has displaced earlier variants, and appears to be more contagious, owing to it replicating at a much more vigorous rate (1000 fold!) and therefore spreading much more virus.  It is not clear at this time that the Delta variant causes more severe illness.

It was always clear that the currently available vaccines would not prevent infection (and therefore would not prevent replication and spread of the virus).  Serious disease and death declined drastically in countries where immunization was widespread (particularly in Israel and the United States).  This was predicted by the initial studies of the vaccine which gained them Emergency Use Authorization by the FDA.

But with the emergence of the Delta virus and its spread internationally, disease levels have increased.  At this time, according to the most recent figures that have been reported, 97% of patients hospitalized with COVID-19 are carrying the Delta variant, and very few of those patients were previously immunized.

While the Pfizer, Moderna, and Johnson  & Johnson vaccines are still effective against severe illness from the Delta variant (more so the Pfizer and Moderna products) there are “breakthrough” infections in the vaccinated population.  Please see https://www.npr.org/sections/health-shots/2021/07/28/1021888033/breakthrough-infections-may-cause-long-covid-symptoms-small-study-suggests  for a discussion.

From a practical point of view we don’t need to go into lockdown but please maintain caution.  Wear masks when out in public.  It is too early to go into crowds, even masked, especially if there are large numbers of unmasked individuals.

 

It is with mixed-feelings that I am announcing my intention to retire at the end of March 2022.  While it continues to be an honor to work with you towards the goal of achieving a better state of health, this is my 48th year of medical practice and the time for retirement has come.

I am sending this letter out 9 months in advance to give everyone that I’ve seen in the last 3 years enough time to make other arrangements for ongoing care. This is especially true for those of you for whom I am prescribing any kind of prescription drug on a chronic basis.   I will not be ordering refills that would extend past my retirement date.

I am making efforts to find someone that can continue your homœopathic care, should you so choose, but it does not appear likely that I will be successful.   There are vanishingly few MDs or DOs entering homœopathic practice.  The rate of new entries from the Naturopathic profession (ND) is only slightly better.  As time goes by I will inform you on my website of homœopathic practitioners in southern New England that might be open to taking on new patients.

Regarding your medical records, a very complex issue:

  • I will retain them for 7 years after your last visit, as required by law.
  • My electronic medical record (EMR) can print out a Continuity of Care Document (CCD) which summarizes your care since 2010, when I first began using the EMR. This includes demographic data, allergies, medications (past and present), dates of treatment, vital signs and some, but not all, lab reports, diagnoses, and assessments and plans.
    While the CCD does not include my detailed notes on your homœopathic case, it contains the essential data that another physician might need in order to continue your care.
    The fee for printing the CCD will be $ 0.30/page.  This report is likely to be 8-10 pages at a minimum but could go much higher if I have been seeing you for a long time.
    There may be certain consultation notes or imaging studies that also should be included, but this will need to assessed on a case-by-case basis and done manually ($0.65/page).
    The CCD (and indeed your entire EMR) can be transferred electronically, if your new physician uses the same EMR as I (PracticeFusion). Arrangements can be made to do so at no or minimal cost to you.  Physicians using other systems might be able to do so but the process is likely to be cumbersome.  Other forms of electronic transfer may be possible but might violate HIPAA regulations.  More information on this will be made available on my website should it turn out to be feasible.
  • My EMR can also print out a complete record of all visits since August of 2010 (when I first started using the system). The fee for this will be $0.30/page).  Any other information from your paper chart (pre-August 2010) will need manual selection and photocopying which will be charged at $0.65 per page plus postage costs, to be paid when you pick them up or before we mail them to you.
    In the case of a new homeopathic practitioner, they will usually want to take your case “fresh” and would likely to be overwhelmed by the amount of data in my notes. If you will not be transferring care to a physician who understands homeopathy, the vast bulk of your record will not be meaningful to them.
  • As you know from talking with me while I’m transcribing almost everything you say, my notes are long, and the page count can be high. The longer and more often that I have seen you, the more this will add up.
    My office notes also may contain information which is highly personal.  When I photocopy records for insurance companies I redact information which I consider to be too sensitive, using a thick black magic marker.  This is not going to be possible now as I am looking at transferring records for several hundred people.

As you can see, transferring and copying records will be a big job that will take a lot of time and effort for both Donna and me.  If you will not be seeing me between now and my retirement and you wish to have your records transferred in some form, I would greatly appreciate knowing that as soon as possible so that I can plan accordingly.

After this letter, all further notices and details regarding my retirement will only be available on my website (www.drshevin.com/journal).  For those few of you who are not able to utilize the internet, please let Donna know so that we can make other arrangements for you to continue to be informed.

Samuel Hahnemann MD, who systematized homoeopathic medicine in the early 19th century, wrote:

“The physician’s highest and only calling is to make the sick healthy, to cure,  as it is called.”

Thank you for giving the opportunity to work with you towards realizing that ideal.