Sitting at home on a Sunday night, waiting for a nor’easter that’s apparently headed for the East Coast. We hear that there has been warmer weather in the Arctic, which is pushing colder air south, creating an inverse polar vortex, whatever that is. Cold and snow.
Right now, patients, doctors, nurses, staff, and all the rest of the team that make up our practice, are sitting at home trying to figure out whether they’ll be able to safely make it in, to come in for their appointments and to come to work tomorrow. Depending on what the morning commute looks like, many people will try and slog in, walking across the park or from their apartments nearby, while those that depend on trains or the snow-covered highways and streets of New York will probably choose to stay at home for safety’s sake.
And many are rightly fearful of coming in and then getting trapped, with no way to get home if the situation deteriorates. No one wants to sleep over in their office.
What’s remarkable, as our practices have changed in the past year, is it we’re probably ready to pivot many (but not all) of these patients’ office visits into virtual visits. Right now, we’re averaging between 20% and 30% of our visits each day as virtual, checking in with our patients who still want to stay away from public transportation and crowded waiting rooms and hospitals in general.
True, there has certainly been a selection bias, and those with smart phones or broadband Internet at home, unlimited minutes on their data plans, and higher levels of tech literacy have certainly been the majority of patients who’ve taken to this new way of getting care.
First thing in the morning tomorrow, our phones, if there are enough people around to answer them, will probably be deluged with people seeking to cancel or reschedule their appointments or, if they’ve done one before, probably requesting the changeover to a video visit or a telehealth call. No one really wants to brave a whiteout, slippery roads, or Snowmageddon, just to get their annual physical done.
I remember the morning of September 12, 2001, the day after the horrific attack on our country. All members of our healthcare force were mobilized, awaiting the torrent of injured survivors that never came. And then one lone patient walked over from his home nearby for his routine annual physical, saying he had waited so long for this appointment he wasn’t going to miss it now.
For the most part, labs can wait, and updating the rest of patients’ healthcare maintenance can be done virtually or at some point off in the near future. But of course, there may be a few who will brave the storm, and perhaps a few where this particular visit may make all the difference. We need to make sure we don’t put things off too long, because there are many things that have been delayed already by the past year’s pandemic.
But over the past few months we’ve done a lot of catching up. People have gotten their mammograms done, come in for their pneumonia vaccine and tetanus boosters, gone to the pharmacy for their flu shots and shingles vaccines, and even completed their delayed colonoscopies with a pre-procedure COVID-19 swab done to ensure they were safe to come in.
We all remember when we were little, the excitement of sitting by the radio, waiting for the announcement that schools were closed — that slow painful wait as the announcer scrolled through all the different schools until they finally announced yours, that amazing rare thing, a snow day. I think it’s going to take a lot more than the predicted foot of snow to completely shut us down, but we’ve learned how to make do and take care of people while they are safely in their homes. And now even providers can practice while safely in their homes.
Unlikely that we are all going sledding tomorrow for a snow day, but perhaps we can provide care and comfort to our patients from the warmth of our living rooms with our fuzzy slippers on and comfy sweatpants below the view of the video camera. Or, as sometimes happens, the Storm of the Century could just drift off to the north, or head out to sea quicker than expected, and we end up with just a little bit of rain.
We’ll just have to wait to see what tomorrow will bring.
Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine from the perspective of his own practice.
Source: MedicalNewsToday.com
