Frontline clinicians deserve hazard pay


These are interesting times.  Our schools are shut down.  Transportation halted.  Businesses shuttered.  Public spaces abandoned.  Cities locked down.  Stock markets crashing.  It is the greatest disruption to life we have faced since 9/11, and this will last much longer. It’s not hyperbole to say that we are on a wartime footing, and every aspect of life has been affected by this battle with COVID-19.  A national emergency has been declared, and many are making sacrifices to help stem the spread.  Our soldiers in this battle are our first responders, paramedics, nurses, and doctors who are caring for patients in this time, all while exposing themselves to great risk.  While healthcare providers, by and large, would run into a burning building to save someone because that’s the way we are wired, it is time for society to recognize these sacrifices and offer hazard pay for those who are willing to continue doing their job while jeopardizing the health and well-being of themselves and their families.

Hazard pay is “a form of compensation granted to staff members who have been requested to remain and report for work in duty stations where very hazardous conditions exist.” There are many jobs in which exposing oneself to increased danger results in increased compensation.  There has been a pretty penny paid to government security contractors such as Blackwater (now Academi) to compensate ex-military personnel for taking dangerous assignments that put their lives at risk.  Rightfully so, how much is one’s life worth?  Now we are facing an illness that has brought new meaning to the term “occupational hazard” for so many providing care and seeking to preserve the life and health of others.

Before COVID-19 made its way to the U.S., it took the lives of several doctors including, tragically, the Chinese physician who was the first to raise the alarm about the virus.  Now there are at least two emergency physicians in the U.S. who have become ill and are in critical condition.  Certainly, personal protective equipment (PPE) lowers the risk of transmission, but never to zero.  The sad state of current affairs, however, is that PPE is having to be rationed because many hospitals are running out of this basic necessity in the midst of the crisis.

Before COVID-19 commandeered the headlines, the media narrative regarding the rising price of healthcare often portrayed physicians as the root cause of the exorbitant costs.  Nevermind that some of these ‘sources’ were often disguised special interests of the insurance lobby.  The insurance industry’s war on physician salaries placed patients in the cross-fire of the balanced billing battle that was nearing resolution with insurance-friendly legislation prior to this pandemic.  This battle has already decreased insurance reimbursement to thousands of emergency providers across the country, and no doubt, caused staffing cut-backs that are inevitable in any industry grappling with decreased revenue.  I hope and pray that we have the resources to take care of those insurance executives or legislators when they need us.

Though not nearly to the level of insurance industry CEOs, frontline providers are generally compensated fairly.  Deservedly so given the great training and responsibilities that come along with the job.  The calculus has changed, however, and now those of us on the frontlines of the coronavirus front must ask ourselves, how much is it worth to place my life in danger?  What is the potential cost to the health and long term provision of our families?  I think most will answer the call regardless, but we as a society should recognize the potential sacrifice being made and consider the value we place on the lives of our healthcare soldiers on the frontlines of this war.

Josh McKinney is an emergency physician.

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