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Your Healthcare Reboot in the Time of Covid-19
What’s changed, what’s stayed the same since Covid
By Elyse Notarianni

Whether you now have regular video-chats with your doctor or have recently been back to the office for the first time in months, you’ve probably noticed lots of changes meant to keep everyone safe. Here’s a glimpse into what healthcare looks like in the midst of a pandemic.

 

A new type of appointment

Telemedicine became the new norm when stay-at-home orders were issued. Even though waiting rooms are open again (with added precautions), digital appointments are here to stay.

Josh Mleczko, DO Capital Health

“Even as patients are starting to come back into the office more, we’re finding a lot of people are sticking with telemedicine appointments because they’ve realized just how much more convenient they are,” says Josh Mleczko, DO, a family physician at Capital Health.

These visits, he says, have been effective to address a variety of problems, from treating behavioral concerns like anxiety or depression to triaging possible Covid-positive patients before they head to the ER. But what has surprised him is the ease with which his patients have caught on.

“I really thought there would be issues with patients not understanding the technology or not having a device, but we haven’t seen that at all,” he says. “It’s especially surprising to see how my older patients are willing to learn.”

It can come with drawbacks, like the inability to check for vital signs. But, he says, the benefits far exceed the limitations.

“I don’t see many negatives here,” he says. “Overall, it gives our patients better, quicker access to their doctor so they don’t fall off the medical grid during a pandemic when they need their doctors the most.”

 

What to expect when expecting in a pandemic

The process of exhaustively reexamining prenatal care over the last few months has led to some welcome and unexpected changes, says Dipak Delvadia, DO, a physician with Virtua OB/GYN in Voorhees.

Dipak Delvadia, DO
Virtua OB/GYN

“The pandemic restrictions have actually created an opportunity for us to review and simplify maternal care,” says Delvadia.

Among the improvements, Virtua OB/GYN has cut down on the number of face-to-face appointments that were the norm for expectant mothers. Instead of coming in once a month, expectant mothers now go in every 6 weeks. In the interim, medical staff do telehealth check-ups.

“We’ve learned to be more efficient during our appointments,” Delvadia says. 

“That’s not to say women receive less care. It’s the exact same level of care – just better streamlined. It’s made a really big difference by helping them feel at ease without overwhelming them with appointments.”

Delivery-room procedures have changed too – for the better, he says.

“Before the pandemic, there could be almost too many people in the delivery room – partners, parents, a mother- and father-in-law, sometimes even grandparents,” Delvadia says. “It was too much. Now we only allow one support person in the room, and our patients have been a lot more comfortable with that.”

 

Too much, too soon

The last few months, many people found themselves either turning to exercise to help them through the pandemic or letting their workout routines lapse. Orthopedic specialists have recently started treating both types of people.

Merrick Wetzler, MD
Advocare South Jersey Orthopedic Associates

“I’ve seen ramped-up occurrences of injuries like knee and shoulder problems since coming back and fully reopening the office,” says Merrick Wetzler, MD, an orthopedic surgeon at Advocare South Jersey Orthopedic Associates.

When evaluating your exercise routine, there are two tendencies to watch out for, he says.

“For people who turned to physical activity as a coping mechanism, it’s important not to overdo it,” he says. “Overuse can lead to more damage than gain.”

And if you took a break, it may not be best to jump right back in full throttle.

“The worst thing you can do is take months off and then try to start back up where you left off,” says Wetzler. “If you were running 10 miles before the gyms closed then stopped, don’t think you can come back months later at the same level.”

“Doing too much too soon,” he adds, “will leave you extremely sore at best and injured at worst.”

Don’t wait it out

If fear of Covid is keeping you from seeking healthcare, the good news is that new health policies and procedures are making hospitals and doctor’s offices safer than ever. Thomas Dwyer, MD, tells his patients there’s no need to delay their joint replacements or spinal surgeries.

Thomas Dwyer, MD
Inspira Health

“I can unequivocally say that it is safe to return to your hospital for an elective surgery,” says Dwyer, chief of orthopedics at Inspira Health.

Walking into the hospital now is a completely different experience than a few months ago – in a good way, he says. Before coming through the door, all patients are screened for possible symptoms or exposure to the virus. Anyone with a temperature over 100.6 degrees is regarded as possibly Covid-positive, and Inspira will reschedule their appointment and arrange for testing.

Inside the building, the changes are subtle, including the fact that all food has been removed from vending machines to keep people from touching the buttons – and that’s just the start of it. And of course, you won’t catch anyone without a mask.

“Hospitals have not only met CDC guidelines for keeping patients safe from coronavirus, we’ve also refined our policies over the last few months,” says Dwyer. “You should have absolutely no reservations about scheduling your elective surgery.”

 

Examine your safety

When it comes to procedures outside the hospital, cosmetic surgeon Lyle Back, MD, says the question isn’t whether or not a procedure is safe – it’s about the practice’s commitment to keeping you healthy.

Lyle Back, MD
Cosmetic Surgery Center of Cherry Hill

“We can’t make a list saying here’s what’s safe and here’s what’s not,” says Back, founder of the Cosmetic Surgery Center of Cherry Hill. “Every situation is different.”

Take, for example, a haircut. Two members of his staff had booked appointments at different salons. One immediately received expectations about safety, masks, social distancing and disinfection protocols. The other, he says, didn’t hear anything, and showed up to see some less-than-ideal safety measures. Needless to say, she did not keep that appointment.

“We wouldn’t say that getting a haircut is a dangerous task in itself, but in that situation, it wasn’t safe,” he adds. “The same is true for cosmetic surgery procedures – they’re as safe as we make them.”

Back has implemented 25 new safety policies and procedures for his practice. He encourages patients to look into the office’s protocols to make sure they’re comfortable with the added protections.

“People want to feel secure,” he says. “If you go to an office that focuses on your health first and foremost, you should be able to get those procedures done without worry.”

Emergency response

At the beginning of the pandemic, many sick patients who would have gone straight to the ER in normal times sought care elsewhere or put off addressing their problem. Some feared catching Covid-19 or overrunning the healthcare system at a perilous time. But as coronavirus cases have dropped in New Jersey, that’s no longer necessary, says Henry Schuitema, DO, director of emergency services and clinical outcomes at Jefferson Health New Jersey.

Henry Schuitema, DO
Jefferson Health New Jersey

“Early on, we appreciated not having so many patients because we didn’t have the room to isolate them,” he says. “But now, there’s no question that if you’re having serious symptoms, whatever they might be, you should have no reservations going to the ER.”

Jefferson’s ER is getting close to reaching its normal volume of patients after dipping down to almost 50 percent at the height of the pandemic, he says. When patients come through the ER doors today, they are immediately tested for Covid. Patients spend a very limited amount of time in the waiting room, which is disinfected frequently, and everyone must wear a mask at all times.

“At this point, the most dangerous thing you can do is not seek medical care when you need it,” he says. “We’ve implemented every precaution to keep you safe in the ER.

August 2020
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