En español | Busy medical waiting rooms are likely a thing of the past. Since the start of the coronavirus outbreak, doctors’ offices throughout the country have scaled back staff, postponed preventive appointments and switched in-person visits to online video chats as much as possible.
However, as states begin to ease their stay-at-home restrictions, medical offices are doing the same by opening their doors to more patients with nonurgent medical needs. Here's what to expect when you need medical care now.
Can I go to my doctor's office? Depends on where you live
It's important to note that physicians’ offices haven't closed due to the coronavirus. Many have remained open to “see patients that they thought really needed to come in,” says Patrice Harris, a psychiatrist and president of the American Medical Association (AMA). It's just that now, some are starting to take on less critical visits, as well. But that, of course, depends on where you live.
Skipping care during the coronavirus outbreak
Nearly half of American adults (48 percent) say they or someone in their household have postponed or skipped medical care due to the coronavirus outbreak, according to a new poll from the Kaiser Family Foundation. And about 11 percent of those who missed out on medical appointments say their condition worsened as a result.
However, as stay-at-home restrictions ease and medical offices resume more routine appointments, most of those who avoided the doctor’s office during the first few months of the pandemic (68 percent) plan to make up for the delayed care in the next three months.
Doctors in Virginia, for example, received the green light to resume non-emergency care at the beginning of May; practices in Oregon and Alaska have also started welcoming nonurgent patients back to their offices.
One Medical, a primary care group with locations nationwide, recently started accepting more routine in-person appointments in its Northern California offices. Other sites are expected to follow, with the exception of New York. “The real distinction there is that the prevalence of community spread of COVID in New York is a very unique environment in terms of the volume of spread,” says Leah Rothman, a family physician and regional medical director for One Medical in Northern California.
The “reopening processes will vary,” community by community, based on “the evidence and the data around COVID-19,” Harris says. Physician practices are “following state and local public health guidelines,” and are “working with state and local health officials,” she adds.
The best thing to do is to call your doctor's office to discuss what is ideal for your particular situation. Even if your physician has started physically seeing more patients, she or he may still prefer a telehealth visit. If the doctor wants to see you in person, the staff will likely want to walk you through any new rules and safety precautions.
"Physicians do not want our patients to think that they are alone in trying to figure out when to come to the doctor,” Harris says. “We definitely want them to call in.”
‘The new normal': Temperature checks, masks, waiting in your car
William Anderson, who oversees a 90-physician practice in Northern Virginia, says he and his fellow doctors started increasing in-office appointments two weeks ago, and they have met the “significant pent-up demand” with several safety precautions.
Some of these measures are predictable — all patients must wear masks and are screened for fever and other symptoms of COVID-19, the illness caused by the coronavirus. Other changes are more innovative. For example, Anderson's practice has practically eliminated the traditional waiting room, and instead encourages patients to wait in their cars until they receive a text from the office to come in for their appointment.
"It's allowed us to leverage technology to make it more convenient,” Anderson says. “You can come in the door and go right back to the exam rooms. You don't have to wait.” Preregistration and advance checkout also eliminate the need to stand in a line with others before and after your appointment. “And I think that adds to the convenience and access,” he says.
Some practices will space out appointments to keep the number of people in the office to a minimum, making it easier for everyone to keep their distance from others, the AMA's Harris says. The AMA also recommends that doctors limit the number of visitors who come with a patient to an appointment, so be sure to ask about any new rules when you schedule your visit.
"The new normal is going to be the new normal for a long time, and it will be different,” Harris says.
How to prepare for a doctor visit
You can do a few things ahead of your appointment to ensure your in-person visit goes smoothly. Anderson recommends packing a cloth face covering and some hand sanitizer for when you don't have immediate access to soap and water. It's also a good idea to write down your health conditions and the medications you take ahead of time so you don't leave any off during your visit. And don't forget to include any drug allergies you may have.
"It's important for providers particularly to know if you have diabetes or if you are immunocompromised, for example. So from a patient standpoint, keep that information and carry some protective equipment with you,” Anderson says.
Without a vaccine, risk for exposure to the coronavirus can be anywhere. But if patients and staff follow the safety precautions put in place, a trip to the doctor's office should be a relatively safe experience. “It's probably more dangerous to go to a grocery store than it is to come and see us in our office,” Anderson adds.
When to go to the emergency room
In addition to a decline in routine visits in the last few months, physicians’ offices have also noticed a steep decline in the number of patients coming in for acute care. Hospital emergency rooms across the country have also reported a marked drop in visits since the start of the coronavirus outbreak — and experts say this is a concerning trend.
"I know that folks have been worried about going to the emergency department, but if they would have thought of calling 911 before COVID-19, they should remember that they should continue to do that during this pandemic,” Harris says.
Difficulty breathing, difficulty speaking, chest or upper abdominal pain, uncontrolled bleeding and changes in vision all warrant trips to the emergency room, according to the American College of Emergency Physicians. Injuries such as twisted ankles or noncompound fractures can often be taken care of in a physician's office or urgent care center, Anderson says. But it's always a good idea to call ahead to make sure.
"We don't want anybody to delay those things, because delayed primary care actually turns into emergencies,” One Medical's Rothman adds.
Telehealth is here to stay
Even with routine appointments back up and running in some areas, telehealth is expected to stick around. That method of health care delivery has “expanded rapidly during the crisis,” according to the nonpartisan Kaiser Family Foundation. In mid-April, the Cleveland Clinic reported that demand for virtual visits was up more than 1,000 percent since the start of the outbreak. Other polls have found that more than 20 percent of adults have used telehealth services during the pandemic.
"I think telehealth is here to stay because of the convenience and access piece of it,” Anderson says. “It also allows us to do some interesting things with care management for chronic disease … it allows us virtual triage options, and I think it will show a reduced cost of care in the long run because patients have more available access to ask questions and get the care that they need” virtually.
That said, telehealth will never replace in-person visits, Harris says. Instead, it will likely “be integrated into our overall new health ecosystem.”
"There will continue to be a role for telehealth, but we will have to make sure that role is in the service of patients and that we continue to see good outcomes,” Harris adds.