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COVID-19 Update

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Don't Avoid Your Doctor During the Coronavirus Pandemic

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As the COVID-19 pandemic continues and stay-at-home policies are in place, you may think it’s risky to seek medical care, even if you or a loved one are sick.

Brian Hasselfeld, M.D., is assistant medical director for Digital Health Innovations at Johns Hopkins. Barry Solomon, M.D., M.P.H., is chief of the Johns Hopkins Division of General Pediatrics and Adolescent Medicine and a professor of pediatrics. Together, they explain that you can — and should — get the care you need, and answer questions on how telemedicine can help.

Is it safe to go to the doctor?

The media are reporting that fewer people are going to their medical appointments or seeking medical help out of concern about COVID-19 — the disease caused by the coronavirus that’s led to the global pandemic. Even emergency rooms across the country are seeing fewer patients for serious health problems, such as heart attack, stroke and acute appendicitis.

But doctors note that waiting too long to get help for life-threatening conditions can be more dangerous than infection with the new coronavirus.

Hasselfeld confirms that trend within his team, Johns Hopkins Community Physicians, noting that the numbers of patients the group is seeing has declined by 20% to 30%.

“People are trying to observe physical distancing and avoiding unnecessary exposure, such as going to the grocery store,” he says. “But in terms of medical care, providers are worried, since ignoring serious signs and symptoms can be dangerous.”

When should I see a doctor in person?

“If you’re experiencing a medical issue or change in your health, call and talk through your symptoms with your doctor,” Hasselfeld says. “Certain problems may require going to the office, an urgent care facility or emergency department, and your doctor can offer advice.”

Here are just a few examples of health issues that warrant an in-person trip to get help:

Call 911 if you experience:

  • Chest pain, pressure in your chest, shortness of breath or other heart attack symptoms
  • Sudden numbness, weakness, confusion, loss of vision or other stroke symptoms
  • Difficulty breathing
  • Heavy bleeding
  • Significant injury or trauma
  • High fever
  • Possible broken bones

When in doubt, call 911

Many other symptoms and signs can indicate a medical emergency. When in doubt, call 911 or, if readily reachable, your primary care practitioner or nurse hotline. Explain what’s happening, answer their questions and follow their instructions.

If your doctor has prescribed tests such as bloodwork, X-rays or MRIs, ask your doctor if these might be able to wait. If the doctor feels the tests are too important to postpone, it’s important to follow through and get your tests.

When should I take my child to the doctor?

Pediatrician Barry Solomon agrees with Hasselfeld’s points about seeking medical care. “During the current health crisis, we need to keep our patients and communities safe from vaccine-preventable diseases,” he says. “While much can be accomplished through telemedicine, some children with chronic health conditions may need to visit their pediatric subspecialists. Practices are adjusting their workflows to make sure visits can be conducted as quickly and safely as possible.”

Should I hold off getting my child vaccinated?

Solomon says that while there are reports of parents avoiding taking their kids to the doctor during the COVID-19 pandemic, it’s essential to keep up with well-child visits and immunizations. “Pediatric practices are prioritizing in-person visits for newborns, infants and children through 24 months of age,” Solomon says. “Visits are also important for school-age children and adolescents who are due for routine immunizations.”

Talk to your pediatrician about which visits are most essential, and which, if any, can be conducted by phone or other means.

What are medical care facilities doing to keep patients safe?

Your primary care doctor will take steps to keep possibly contagious patients apart from those who are visiting for non-COVID-19 reasons.

“A lot of outpatient settings are keeping separate waiting rooms for people with possible infectious illness, screening symptoms, and adjusting their office hours to see non-COVID-19 patients during certain time slots,” Hasselfeld says.

Home care is still essential for some people who are housebound, and the visiting practitioners on his team are still traveling to patients’ homes and caring for them in person while using precautions.

“But,” Hasselfeld adds, “a lot of that care can be — and is being — done through telemedicine or when needed, over the phone.”

How is telemedicine helping people during the COVID-19 pandemic?

Telemedicine allows doctors and other health professionals to “see” patients using phone or video. Hasselfeld says that almost 100% of providers at Johns Hopkins Medicine have telemedicine available, and more than 80% of his team’s daily patient visits are conducted using these methods.

“First and foremost, providers’ goals should be ensuring patients get the care they need, regardless of method,” Hasselfeld says. “Video and telephone can deliver that care in a safe way.” He says that in one recent week, Johns Hopkins Telemedicine used video or phone to facilitate as many as 5,000 telemedicine visits daily across the health system. “A lot can be accomplished,” he says.

What services can telemedicine provide?

Hasselfeld says, “Video visits can help doctors take a history and even perform some aspects of a physical exam. Obviously, where technology is today, it’s not a total replacement for in-person care, but it’s providing us a means of diagnosing and advising patients.”

If you’re working with a physical therapist, you might be able to use telemedicine techniques to keep up with your recovery. Though hands-on manipulation by the therapist isn’t possible, Hasselfeld says that practitioners are creating online videos, which, like fitness videos, can demonstrate PT techniques and exercises, and keep patients working and improving their health.

Is telemedicine hard for patients?

Not necessarily. If you’re thinking about trying a video visit, the experience might be more user-friendly than you would guess. The technology supporting the practice is evolving especially quickly due to the demands of the COVID-19 pandemic.

Phone communications with the doctor are familiar and comfortable for most people. During the public health crisis, a phone call can replace an in-person visit for routine follow-ups, prescription refills and questions about your care.

Hasselfeld says that, compared to just a few years ago, switching from in-person to telemedicine visits might feel more natural to patients. He notes that more people than ever before are incorporating technology into their daily lives.

“Patients are getting more used to interacting with these platforms, visiting with friends, working and ordering groceries. For years, health care was behind on these technologies, but we’re catching up fast in this pandemic. Patients are learning how convenient telemedicine can be.”

Telemedicine: No computer skills? No problem.

For those who are not particularly tech-savvy, Hasselfeld says, “We can work with patients leading up to the visit, and walk them through the steps to get them connected. For instance, there are online videos that explain what patients need to do, and Johns Hopkins provides resources for setting up video visits.”

Administrative and support staff are important to this effort. He says that with physical distancing measures in place, doctors’ offices are adapting their front desk processes to accommodate virtual patient visits.

“Many practices are training medical assistants and front desk staff to ‘check the patient in’ and walk them though the virtual visit. We’re working hard to get both patients and our own team acclimated.”

Will my insurance cover a telemedicine visit?

A quick phone call to your insurance provider can help you find out if telemedicine visits are covered. Hasselfeld has noticed that as the COVID-19 pandemic pushes more practitioners to use telemedicine, the insurance industry is, for the most part, stepping up.

“We’ve been fortunate in that most insurance companies have expanded coverage to telemedicine during the pandemic, including Medicare and Medicaid,” he says. “We hope that coverage remains once the crisis is over.”

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Coronavirus (COVID-19)

What you need to know from Johns Hopkins Medicine.

Posted April 30, 2020

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