Fear is what kept patients away from the doctor’s office during the stay-at-home order as COVID-19 spread rapidly. Now, physicians on the frontlines when it comes to caring for those with life-threatening chronic conditions fear another crisis has arrived.
“We’re seeing a lot of anxiety and stress. People have lots of questions about COVID, their risk, how they can reduce their risk,” Rush University Medical Center’s Dr Steven Rothschild said.
What Rothschild is not seeing is a lot of patients in the office.
Right now, about 30 percent require in-person visits. Telemedicine and video calls make up the difference.
There’s been a shift, he says, from in-person care to more self-monitoring.
“To check sugars at home, to get on the scale, to check their own blood pressure,” he said.
Blood pressure cuffs are in the mail. The Rush University Medical Center practice has been sending them out to patients throughout the stay-at-home order.
“There’s still a lot of times you need to examine somebody,” Rothschild said. “If someone with heart failure tells me they are short of breath, maybe it’s heart failure, maybe its asthma or maybe it’s COVID-19. We need to sort that out. I’m not going to do that over the phone.”
Like most primary care physicians, he’s now witnessing the aftermath of missed appointments. And for some patients, the damage is done.
“I think we’re seeing some worsening of hypertension and diabetes control in particular, the big two chronic conditions we see a lot of,” he said. “Partly because people are anxious, partly because people, if they don’t take it upon themselves, and we haven’t connected with them yet, are sometimes running out of medications.”
Not Patricia Hunt. She has diabetes and monitors her blood sugar levels at home. But she kept her appointment last week and made the trip to see Rothschild.
“I could see where everyone had masks on, everyone had gloves on, and they cleaned everything, wiped down everything,” she said. “So I felt pretty good.”
The practice and the protocols have changed to keep visitors and staff safe.
“The waiting room is empty. We have been controlling the flow of patients so that there is no more than one person in the waiting room at a time,” Rothschild said. “Before you walk in a room, every surface that you might touch has been sanitized. And when you leave, every surface will be sanitized again. Everybody should be able to come to the office, get the preventive care they need, get their chronic care managed and feel completely safe about it.”
As patients weigh the risks of venturing out during the COVID-19 pandemic, Rothschild said the risk of not connecting with your doctor could be far greater than the virus itself.
“Even during stay-at-home orders, people were going to the grocery store, people were going to the pharmacy, they were running errands,” he said. “Some people were super careful, some people not so much. The good news is 90-plus percent of people who get COVID will have mild to no symptoms. In the meantime, if you are walking around with high blood pressure, it’s damaging your heart, it’s damaging your kidney. There is no ducking out of that.”
One of the biggest concerns doctors have right now is delayed childhood immunizations. Rothschild says to keep those appointments.