SAN ANTONIO — Many people have stopped going to the doctor for wellness visits or have put off medical issues that need attention for fear of catching the coronavirus.
Answering your questions is Dr. Monica Kapur, a primary care physician and Chief Exec. Officer for University Medicine Associates at University Health System.
Are you concerned there are people who are delaying immediate needs because of fear?
Dr. Kapur: "I've seen a decrease of almost 50% in our urgent care facilities. We developed screening processes, not just in our express med clinics or our urgent care clinics but also in our emergency departments. What that allowed us to do is when you enter into any of those facilities, ask your questions and then isolate you right away to a location where you are separated from everybody."
When are telephone appointments recommended and when is it proper to have an in person appointment?
Dr. Kapur: "What we've been trying to do as much as possible, any minor acute care and chronic condition visits, either through telephone or video visit. The ones that we truly do not want anybody to be waiting for are the true medical emergencies. If you do need to avail those emergency services do not delay that. We want you to come to the ED, come to the urgent care unit. We all worry about the worst case scenario which is we don’t want something bad to happen to you or your loved one. If you’re having a chest pain you want to make sure you are not having a heart attack, because having a heart attack alone will increase your chances of dying from a heart attack significantly."
What precautions should I take if I need an in-person doctor visit for somebody with a compromised immune system?
Dr. Kapir: "A lot of times doctors are still able to do a face-to-face video visit and be able to take care of you as well as they might have done in an in person visit. If you do need to be coming into the facility we always encourage you to follow infection control guidelines. Make sure you are always wearing a mask, carry her hand sanitizer with you, try not to touch any unnecessary services that you don’t have to, minimize your interaction with anybody else, and notify the front desk and staff when you reach there so they can at least go ahead and have you be seated in an exam room by yourself. All of these things will help you in terms of the fact that you are well taken care of even though you have an immuno-compromised condition"
Should we be scheduling in-person annual checkups?
Dr. Kapur: "The majority of adult wellness visits can be video visits. It's the pediatric visits which truly need vaccinations that have to be done in person, but even that can be done with minimal interaction with the staff as well as the provider. What we have done is implemented processes so that we can separate our healthier patients from our sicker patients, so that parents, when it comes to children for their wellness check and parents and adults for their annual wellness check can come into our facilities."
Are there other types of exams besides wellness visits that you need to do in person?
Dr. Kapur: "As we have multiple elderly patients and we have chronic conditions, when they do come for their annual physical exams as a part of their physical order we do lab tests and radiology testing sometimes and those at this point have been put on the backseat. As we move forward especially for patients with chronic medical conditions it may be important for these people to come in so at least they can get their labs done during those visits. It’s already been two months and COVID seems to be lingering for sometime and it’s not going to go away, so we have to adapt ourselves and see how we can provide a better environment for our patients coming into our facilities, so they can continue keeping up with his wellness visits either for pediatric or for adults."
How should we go about getting a refill?
Dr. Kapur: "At UHS our pharmacy came and said they would start delivering their patients medications at home. As time has gone by physicians have requested patients to be seen and so what we are doing now is offering a telephone visit or televideo visit so your meds can be refilled."
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