Is it Now Time for Patients to Return to Their In-person Out-patient Appointments? • Well defined, comprehensive, procedures and training provided to all staff, with special emphasis placed on disinfecting frequently contacted surfaces.
BY JAMES M. SCICCHITANO
The COVID-19 pandemic has drastically altered a patient’s perception of even the most routine outpatient medical visits. With every appointment reminder from their providers comes a lingering thought that persists throughout a patient’s mind: “should I keep this appointment?” The pandemic has forever transformed how healthcare services are delivered; telehealth appoints are the new norm, PPE and social distancing are compulsory, and even controlled medications can now be phoned in or e-prescribed to your pharmacy. However, are virtual appointments sufficient to address all of a patient’s health concerns? How do patients with greater health needs weigh the risks of delaying much-needed care against potential exposure to the deadly virus? Can physicians even uphold the same standard of care conducting a virtual appointment compared to in-person visits? To quote one of my physicians: “we are equipped to deal with this virus and keep our patients safe, but our diagnostic and interventional effectiveness can only be maximized when we are face-to-face with our patients.” As a healthcare administrator for Orlando Heart & Vascular Center and Orlando Endocrinology, part of my job entails communicating with local physicians and the surrounding community the various endeavors that our organization is undertaking. This includes the steps that we are taking to protect our patients and reduce the risk of transmitting COVID-19. In addition to the national standards mandating everyone wear a mask, maintain social distancing, and frequently use hand sanitizer, our organization provides care for an older demographic of patients and, as such, dictates that we are held to a higher standard. To protect our patients and provide a diverse range of options to accommodate their needs, Orlando Heart & Vascular Center and Orlando Endocrinology have implemented the following protocols:
• Social distancing training merged with our customer service standards, after all, we should be courteous when reminding patients to social distance. • Occupancy limitations which not only focus on the buildings as a whole but also limits the number of patients or personnel in a particular room or gathering area. • Temperature checks and screening questionnaires requiring patients to report any symptoms, potential contact with someone exhibiting symptoms, and any recent COVID-19 testing. • Staff, particularly medical assistants must instruct patients to be mindful and avoid frequently contacted surfaces and apply hand sanitizer at our several newly installed hand sanitizer stations. • Of course, we offer telehealth appointments, contactless payment options, and have waived all late/no show fees. We do not believe our patients should have to pay for exercising caution during these difficult times. Though this is not an exhaustive list of the numerous safeguards we have put in place to ensure the protection of our patients and staff alike, it lends credence to steps that we believe to be necessary to reinforce the confidence of our patients whose health needs are better served by face-toface appointments. From a diagnostic standpoint, it is extremely difficult to effectively assess and treat patients from a virtual or telehealth platform. Using our organizational specialties as examples, an arrhythmia is best diagnosed with an EKG and an assessment by our cardiologists with their stethoscope; screening a diabetic’s foot for loss of protective sensation is best diagnosed by our endocrinologist using monofilament. Many media outlets and data-driven healthcare institutions report dramatic increases in the number of patients who are delaying care due to fears of contracting COVID-19 and spreading it
• Unique departmental mandates for employee PPE, ranging from face masks for receptionists to full, head to toe, PPE attire for our Cardiac Catherization Lab personnel.
to their loved ones. In their abundance of caution, however, patients who have chronic conditions, or conditions yet to be diagnosed, suffer from the progression of those symptoms. This can further complicate their condition, potentially irrevocably, and lead to an increasingly bleak prognosis. It is not uncommon for a patient’s symptoms, left untreated, to advance to the point of requiring admission to the emergency department and suffer life-altering progression of their symptoms. The situation is not without hope, because patients can take steps to assume greater control over both their personal health needs and their environmental risks associated with COVID-19. Patients are encouraged to take the initiative to reach out and inquire with their health care provider(s) asking, “what steps has your organization taken to protect me and my family’s well-being from COVID-19?” Are they going above and beyond the call of duty? Or simply maintaining the minimum standards mandated by local and state governments? The answer could be telling and paint a picture of the physicians who you trust with your health and well-being. In our experience, the minimum standards are insufficient and unacceptable when assuming responsibility for the health needs of a vast patient population with conditions that increase their vulnerability to the deadly COVID-19 virus. As healthcare providers, we also find it unacceptable for patients who are forced into delaying care out of fear of risking exposure to the virus and even futile if their condition, left untreated, produces the same result of being admitted to the hospital. With that in mind, our recommendation as healthcare professionals, is to keep your in-person appointments for serious conditions or concerns. There are two ways a patient discovers they have a serious health condition: either they are evaluated and informed by a healthcare provider, who can then begin immediate treatment, or the health condition is left undiagnosed and untreated and they find out in the emergency department. A patient retains control of their health by leveraging the power of information. Information on how their providers are coping with the pandemic, and information regarding their health gained from a face-to-face visit with their physician.
James M. Scicchitano graduated from both the MHA and MPA programs at UCF. He is the healthcare administrator at Orlando Heart & Vascular Center.
13
||
ORLANDOMEDICALNEWS.COM
||
O C TO B E R 2 0 2 0
