Why Must My Special Needs Patients on Medicaid Continue to do Masked Speech Therapy?

Please end the healthcare mask mandate!

Happy Monday! Welcoming back Dr. Kristen Walsh, who explains why she felt compelled to write a letter to New Jersey Governor Phil Murphy.

-Natalya & Dana

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This is not my first email to NJDOH requesting rescindment/removal of Governor Murphy’s Executive Order stating that masks must be worn by all persons, at all times, in healthcare settings statewide. I am really hoping that New York state dropping their similar mandate will provide some momentum this time. For context, most private practice doctors and dentists no longer require masking in their offices in NJ, but if you work in a health system or academic setting, you’re stuck until this EO gets rescinded. In NJ, this means that my special-needs patients on Medicaid have to do speech therapy masked, which in my opinion puts them at an unfair disadvantage.

Here’s hoping things change soon!

Dear Governor Murphy & New Jersey Department of Health,

Hi, I am a physician and am wondering when you are planning to retire/reverse/rescind your EO mandating masks in all healthcare settings. We seem to be on the other side of the respiratory surge, and furthermore there is a new Cochrane review restating that community masking does not impact viral spread. Even for inpatient settings, it seems like we should be back to our 2019 standards of only masking for respiratory patients.

I have had to wear a mask in the clinic where I work for almost 3 years, and it is becoming increasingly difficult to do my job this way.

I have many patients who have never seen my face.

New Jersey Governor Phil Murphy

As a pediatrician, it is crucial that I make a personal connection to wary toddlers, anguished teens, and everyone in between, and masking severely impacts my ability to form a bond with my patients.

A smile from the doctor can go a long way towards easing children’s fears. There is evidence that masking impairs the reading of emotions across all ages, but more so in younger children. I myself have been vaccinated, boosted and had COVID. Many of my patients/parents have expressed that they, too, have either natural immunity, vaccine immunity, or both, and do not see the importance of being mandated to wear a mask.

Multiple European countries are now treating COVID as an endemic respiratory virus and are no longer mandating masks in healthcare settings.

At this stage of the pandemic, when we have great community protection from both vaccination and prior infections, it does not make sense to tie these policies to case numbers any longer. Further, in our hospital, most COVID + hospitalized patients are found incidentally rather than being hospitalized for COVID.

Can you tell me what the endgame is here? Are we stuck in masks forever, even in the outpatient environment?

I think we can all acknowledge that the pediatric mental health crisis is much more threatening to kids’ health than the current strain of COVID. Given the shortage of pediatric mental health practitioners (especially for kids on Medicaid), primary care doctors are truly the “front line” in this crisis.

It is my strong professional opinion that forcing both me and my patients to wear masks in all interactions is now counterproductive and inadvisable, as it is close to impossible to provide acceptable care for mental health conditions when the patient, doctor and parents cannot see one other’s facial expressions. 

I hope we can soon join our neighbor, NY state, who is dropping masking requirements in hospitals and health care facilities as of Feb 12, 2023.

Thanks,

Kristen Walsh, MD, FAAP