At the start of the year, our patients, communities, friends, and families in Los Angeles faced an urgent environmental health crisis. Devastating wildfires displaced thousands across the region, raising serious short- and long-term health concerns and forcing the temporary closure of health care facilities at a time of great need.
As the Los Angeles community embarks on its long journey of recovery, physician and health care delivery system leadership is needed now more than ever.
Kaiser Permanente Southern California is committed to broadening care access and meeting the health needs of those affected by the fires, whether it’s the physical effects of proximity to the fires or the mental health impact of experiencing a traumatic event.
As we do so, I am reminded of Kaiser Permanente’s response to the Maui wildfires of 2023, where, in the face of tragedy, we were on the ground collaborating with community partners and providing vital support for medical as well as behavioral health needs.
Fires and other disaster-related disruptions can strike at any time—but lessons learned from our time in Hawaii can help guide our responses to them, particularly as we seek to rebuild here in Los Angeles. Here are a few ways physician leaders can enhance their resilience to aid LA’s recovery and prepare for future similar events.
Be Agile
In times of crisis, resources must go where they are needed most—and physicians are one of the most valuable resources available. In Maui, Kaiser Permanente deployed two mobile units and staffed local shelters to treat patients who were displaced. Our value-based, integrated care delivery system facilitated this efficient deployment of resources, allowing physicians to work across various specialties, services, and functions to quickly mobilize. This experience helped inform our response in LA, where Permanente physicians and community partners staffed local shelters and formed triage care teams.
Physician time is invaluable—and in the face of disaster, this becomes even more clear. During and in the weeks following environmental health crises, it is vital that doctors are as available as possible to focus on what truly matters: caring for those in need. Kaiser Permanente deploys supportive technologies, like telemedicine, which can connect patients to physicians whenever and wherever they are needed via a laptop or mobile phone. AI technology, including a clinical documentation assistant tool, also reduces administrative burden on physicians by giving them back crucial time to provide care for those affected.
As physician leaders look for ways to meet the increased health needs of their communities, they can reach out to local shelters and affected health care providers to donate time or care for patients otherwise left without access. Deploying mobile teams to provide “street medicine”—care outside of a medical setting that addresses the needs of people who have been displaced or are experiencing homelessness—if resources allow, is a wonderful way to meet those in need where they are. For example, Kaiser Permanente deployed its Mobile Health Vehicle to the Westwood Recreation Center to provide essential medical services for those in needs.
Know How to Leverage Supply Chain
We learned crucial lessons from the Maui wildfires about the importance of a robust and adaptable supply chain. Following the August 2023 Maui wildfires, Kaiser Permanente Hawaii quickly deployed mobile health vehicles from Oahu and California to support the affected West Maui community, including the Lahaina area where their clinic was destroyed. This experience highlighted the necessity of ensuring the availability of vital medical supplies, such as medicines and personal protective equipment, especially during a crisis. When disaster strikes, these materials can become more difficult to source, a situation often exacerbated by disaster-related shipping and transportation interruptions. Without these resources, care can be delayed, contributing to less-than-optimal health outcomes for patients and increasing overall costs to the health system. This is why a robust and carefully curated supply chain is so important for every health care organization.
The National Product Council, Kaiser Permanente’s innovative, physician-led supply chain model, helps physicians nimbly adapt to external disruptors like natural disasters and product shortages. The collaboration between clinicians and the Kaiser Foundation Health Plan and Hospitals Supply Chain Services organization ensures proper deployment and use of medical products across the system.
Now is the time to examine supply chain structures. Physician leaders can guide crucial reforms to medical supply procurement that prevent care interruptions—potentially saving lives during and in the weeks following a natural disaster.
Prioritize Self-Care
The people who brave life-threatening conditions to provide care to those affected by wildfires and other disasters are without a doubt heroes—but no one is invincible. Ensuring those on the frontlines remain safe and healthy is imperative to efficient disaster response and one of the most important roles physician leaders must take on during a crisis.
Every disaster is different, but in each case, steps must be taken to protect frontline medical workers. Access to protective equipment, like masks to prevent smoke inhalation in the case of fires like those in Maui and Los Angeles, is essential. The better we care for physicians and other clinicians, the better they can care for those most in need.
The need to care for frontline medical workers does not stop with the conclusion of a disaster. These environmental crises are traumatic, for both people directly affected by them and those providing emergency care, who are also often members of the communities that they serve. For example, the Hawaii Permanente Medical Group provides free employee assistance to its physicians, clinicians and staff. In Southern California, during the wildfires, physician peer-to-peer wellness advocates across our 13 medical centers were tapped to ensure physicians knew exactly how and where they could receive mental health support if they needed it.
Physician leaders cannot predict when disasters will strike—but they can take steps to prepare for and respond to them effectively. As the city of Los Angeles comes together to rebuild and restore needed health care access, I hope, too, that physician leaders can rally to ensure their health systems are ready to support patients in their time of need.
Ramin Davidoff, MD, is executive medical director and board chair of the Southern California Permanente Medical Group; board chair and CEO of The Southeast Permanente Medical Group; board chair and CEO of the Hawaii Permanente Medical Group; and co-CEO of The Permanente Federation.
