DENVER, April 18, 2020 /PRNewswire/ -- In response to current media stories regarding Low T Center's commitment to meeting the needs of Colorado patients during this COVID-19 Emergency, Low T Center provides the following for immediate release.
On April 9, the Colorado Department of Public Health & Environment released its 4th Updated Public Health Order (PHO) 20-24, encouraging Critical Businesses to remain open: "Critical Businesses, as defined below, are exempt, subject to certain limitations, from this PHO and are encouraged to remain open." Part C of PHO 20-24 states, "Any business . . . engaged primarily in any of the service activities listed below, may continue to operate as normal." PHO 20-24 defines a Critical Business as "Healthcare Operations, Including: . . . clinics, and walk-in health facilities . . . Medical . . . care, including ambulatory providers . . . [and] laboratory services." On April 6, 2020, Governor Polis issued Executive Order 2020 024 stating, "I direct all Coloradans to stay at home, unless necessary to provide, support, perform, or operate Necessary Activities . . . Necessary Travel or Critical Businesses as such terms are defined in PHO 20-24 . . . " The Order provides that "Necessary Activities" include . . . "Engaging in activities . . . including, but not limited to . . . without limitation, obtaining medical supplies . . . obtaining durable medical equipment, obtaining medication, [and] visiting a healthcare professional . . . " On that same day, the Governor issued an amended Executive Order D 2020 027, prohibiting voluntary or elective surgical procedures, if same could be safely postponed for at least three months.
Low T Center is a multi-specialty medical clinic with forty-six clinic locations spanning eleven states. Low T Center is not a hospital or outpatient surgery or procedure provider. It is not a gym or supplement store. Each clinic operates a certified and licensed moderately complex CLIA/COLA medical laboratory facility, which can accommodate a variety of important medical diagnostic tests. Pursuant to recently issued Department of Homeland Security regulations, Low T Center's facilities and its healthcare team members are classified as part of the Essential Critical Infrastructure Workforce.
Low T Center physicians treat chronic health diseases and conditions, as well as acute medical issues, ranging from low testosterone, to obstructive sleep apnea (a respiratory condition), to hypertension, high cholesterol, thyroid disorders, severe allergies, cardiometabolic issues, and other conditions that make men feel bad, and if left untreated, can be life-threatening. These conditions are often correlated with a serious medical condition known as hypogonadism. Hypogonadism is a clinical syndrome that results from the body's failure to produce physiologic concentrations of the hormone Testosterone. Hypogondal men require medically necessary hormone therapy to restore normal body functions. Failure to adequately treat and monitor these conditions can lead to serious problems such as heart disease, diabetes, obesity and cancer as well as adversely effecting overall well-being and quality of life. Treatment for hypogonadism is recognized as "medically necessary" by every major insurance carrier in Colorado.
Proper treatment of chronic hypogonadism requires office visits, labs, and continued therapy. For the individuals that require this therapy, interrupting, deferring or otherwise discontinuing therapy for a period of three months would lead to severe adverse effects, and place these patients at risk. Similarly, failing to provide treatment for diabetic patients, patients suffering from respiratory disorders, and serious cardiologic issues, is simply not acceptable, and would be contrary to the treatment guidelines employed at Low T Center. Remote treatment protocols are enabled for patients whose medical conditions do not require an in-person visit to the clinic.
For many of our patients, Low T Center is the sole provider of their preventive and primary care services. As noted above, in addition to having extensive clinical and research experience in diagnosing and treating hypogonadism, Low T Center also provides vital and continuous life-saving evaluation, diagnosis, treatment, and control of a variety of chronic, serious, and potentially life-threading disorders including cardiometabolic health, obstructive sleep apnea, hypertension, cholesterol disorders, metabolic syndrome, diabetes, and other chronic men's health issues including cardiovascular risk assessment and prevention. Because of the nature of the practice, many patients require close follow-up including appropriate physical exams as well as critical laboratory services, that if delayed "for a minimum of three months" would place these patients at "undue risk to both the current [and] future health of the patient." The treatment programs for these chronic, progressive and potentially fatal conditions (if not appropriately diagnosed, managed, and treated) are evidence- and guideline-based using the most recent literature and approaches and have been developed by a protocol committee comprised of medical school faculty and Harvard-trained distinguished leaders in their respective fields.
Consistent with Executive Order D 2020 027, these important primary care assessments and treatments cannot be delayed (as with any primary care office) as there would be 1) "a threat to the patient's life," 2) "a threat of permanent dysfunction of an extremity or organ system," (e.g., chronic limb ischemia risking amputations or progression of chronic kidney disease or heart failure.) These conditions require close physical and laboratory follow-up and monitoring of both the disease as well as the response to therapy. Furthermore, there is 3) "risk of . . . progression" particularly of the target organs of hypertension, cholesterol disorders, and diabetes manifesting as preventable strokes, heart attacks, limb damage, blindness, kidney failure, and heart failure - all of which require close medical management and adjustment of medical therapy to prevent.
Executive Order D 2020 027 rightly lets "the doctor make the decision," by granting the "treating medical facility" the exclusive discretion to determine whether a three month delay or interruption in treatment would risk the health of the patient. It would be unfortunate indeed that a hypertensive Coloradan would die, because the access to the care he needed, was postponed for three months. The Governor's Order expressly recognizes this principle, by leaving the classification of "voluntary" to the patient's medical professionals.
Low T Center does not believe Governor Polis' Order prohibits Coloradans from obtaining medically necessary treatment for diabetes, hypogonadism, hypertension, hypercholesterolemia, receiving allergy antigens, obtaining medical laboratory testing, receiving treatment for thyroid disorders, obtaining continuous positive airway pressure devices for the treatment of respiratory conditions, or any of the other medically necessary services provided to patients at Low T Center healthcare facilities. The Order uses the words "without limitation" which means Low T Center's patients should have the right to visit their healthcare provider - without limitation, for these important continuing care services. By signing the Order, Governor Polis assured Coloradans that they would be able to continue to receive their medical care during this time, by expressly classifying these activities as "Necessary Activities." Low T Center physicians, nurse practitioners, and medical staff are persons involved in operating a Critical Business which are necessary to help patients with these Necessary Activities.
Also, very relevant to the current COVID-19 crisis, outpatient centers like Low T Center significantly reduce the likelihood of requiring care in both Emergency Departments and acute care hospitals - where patients may have enhanced risk of both contracting SARS-CoV-2 and developing a potentially life-threatening and/or fatal complication of COVID-19.
Finally, Low T Center's protocol committee has mandated a series of workplace safety initiatives designed to implement social distancing guidelines. The clinic operational teams continue to adhere to enhanced cleaning and sterilization protocols. Sick persons or those exhibiting any COVID-19 like symptoms are prohibited from coming to work, but may work from home in some situations. Consistent with good medical practice, all team members are required to wash hands and use hand sanitizer between each patient visit in increasing frequency throughout the day. Patients are educated about covering coughs and sneezes, and recognizing signs or symptoms associated with COVID-19.
Low T Center's healthcare team members recognize their role as healers, and status as members of critical infrastructure, and are committed to remaining available to protect patients' rights, while adhering to all public health orders and directives issued in this state.
Media contact: David J. Moraine, J.D., M.A., LL.M. Chief Legal Officer, [email protected] 469-990-3626