I'm going to use this thread as an ongoing list of all of the things primary care docs can be trying to get ahead of in the next couple of months, anticipating a potential second wave....

First let's do vaccinations pneumococcal for eligible adults, all of your infant vaccines (pediacel, prevnar 13, rotavirus, MMR, meningococcal conjugate, varicella), adolescent vaccines (hep B, meningococcal polysaccharide, HPV), your shingrix boosters....

osteoporosis stuff: don't forget about those prolia patients. BMDs? Remember not to overdue it (every 2,5,and 10 years in low/mod/high risk patients), but not a bad time to get them done before the fall.

Paps? There's no perfect time to do them, but we're getting them all done now while COVID-19 numbers are relatively low. Otherwise we may not have a better chance to do them before summer 2021.

Diabetics: having them all call in BP readings, sending bloodwork over to labs, in-person neuropathy screens only for those who are particularly high-risk. Otherwise everything else diabetes-related over the phone.

Who else needs BPs? We're making sure that we have a BP on file in the last 6 months for anyone with DM, CAD, CHF, CKD, HTN. If their last BP was over 3 months ago and not at target, get them to call another one in. We have quick BP clinics for those who can't get their own cuff.

As @LisaEsther6 points out, get your PPE sorted out now. Assume the worst for the fall. If for some reason you didn't have a patient portal for the spring, get one for the fall. Makes virtual care far easier, messaging, pictures, etc. Lots of vendors out there.

Liver disease patients: get your liver function tests up to date. Cirrhosis patients, get their ultrasound liver (q6mo) to assess for HCC. Chronic hep B patients, make sure their bloodwork is up to date. Same for HIV patients. Make sure vaccinations are up to date for both groups

Cancer follow up: City-dependent for access to mammos for breast cancer survivors, making sure prostate cancer survivors have had their yearly PSA, cystos for bladder ca surveillance, skin checks for melanoma survivors.

EGDs for Barrett’s surveillance is tricky, as many centres not doing many EGDs at all.

Echos for follow up of dilated roots, aortic stenosis? If they can wait until 2021, great, otherwise squeeze them in now.

What am I specifically punting on for this year? Screening mammos, FIT (not even available in Ontario right now), AAA screening, Adacels. These were all low value even pre COVID, not worth your valuable time right now.

Also a good time to catch up on patients on certain meds who need bloodwork for monitoring: thyroid replacement, antihypertensives, antiepileptics, NOACs (yearly Cr), digoxin, rheum drugs, lithium, antipsychotics, etc

STI screening: underappreciated even pre-COVID, likely a huge burden of disease out there now. In the next week or so I’ll unveil a screening project we’ve been working on.