Don’t Delay Returning for Medical Care

Question: When was the last time you saw your doctor? If it’s been a while, you’re not alone. In the midst of COVID-19, many were advised to put off medical care, and some still feel hesitant to return for checkups or procedures.

We spoke with David Buchholz, MD, general pediatrician and senior founding medical director for primary care at Columbia. We discussed patients’ concerns about returning for regular care and the measures Columbia practices are taking to keep patients and providers safe.

What should patients be aware of as they think about returning for care?

“I think every patient should be aware of the lengths we’re going to in order to protect them,” Buchholz says. “We’re not only looking out for the safety of our patients, but also our providers, our staff, and everyone who comes through our practices.”

What measures are practices taking to ensure everyone’s safety?

COVID-19 screening is extensive, with checks taking place before and after arriving for an appointment, Buchholz says.

“We’re doing everything we can to keep people with COVID-like symptoms separate from healthy people,” he says. “If you show symptoms, you will be directed to a different space. We do not want people with symptoms in the same space as others, so we're constantly working on making sure everything stays separate.”

He notes that some practices are instituting separate scheduling and time slots for at-risk patients. Other practices are scheduling healthy patients for the morning and those who screen positive for the afternoon, so that the two populations never interact. Other practices have designated clinics for those with COVID-like symptoms, with a separate location seeing all other patients.

“Through space and time, we are doing anything and everything we can to make sure that the two populations don't cross,” Buchholz says.

Practices are also making every effort to allow for social distancing, taking measures to reduce or even eliminate time spent in waiting rooms.

“Where possible, we've lengthened our hours of operation so we won't have as many people coming in at any given time,” Buchholz says. “In many cases, it allows people to go straight into an exam room and never be in a waiting room.” If you do find yourself in a waiting room, practices have rearranged those spaces to allow six feet of distance between patients. Masks are always required.

Buchholz also recommends that patients take advantage of the Connect Patient Portal and app.

“Now, people don't even need to stop at the reception desk,” he says. “You can check in online, pay your copay, and sign any documents online. We have mostly gone paperless, and we’ve mostly eliminated the need to queue at the reception desk.”

What recurring concerns are you hearing from your patients?

“The people who are coming back to see us aren't as worried. It's the people who aren't coming back for care who are most concerned,” Buchholz says. “We know that people are reluctant to come in, and we are offering telemedicine visits for anything that can be done through telemedicine while still providing good care.”

For those who are returning in person, Buchholz notes that most want to see health care workers practicing what they preach.

“They don't want to see medical personnel without their masks on, they want to make sure that we are cleaning their exam rooms between every use, and they want to be able to practice social distancing,” he says. “Patients have been diligent in letting us know of any issues during their visits. They not only want to be sure that we're taking great care to protect them, but also to protect ourselves. And we are.”

Can you speak to the risk of delaying routine care, or delaying care for emerging issues?

“I’ll tell you a story about what can happen when you avoid medical care,” Buchholz says. “My mother is 83 years old. And because of her age, she's at incredibly high risk for COVID-19. She's been scared to death to leave her home.

“I got a call recently and found out that she had a lot of swelling in one of her legs. As a general pediatrician, I knew almost immediately she had a deep vein thrombosis. I found out that she had been dealing with this issue at home for two full weeks and couldn't walk anymore. And finally, out of panic, she called me,” he recalls. “She was more scared about leaving her home and going to the emergency room than she was concerned about taking care of her leg with a blood clot. Thankfully she’s okay now, but it could have been a serious situation.”

Buchholz urges patients to call their doctor if they have concerns about the precautions their providers’ offices are taking to reduce exposure.

“We have taken every measure at Columbia, NYP, and Weill Cornell to ensure that all of our patients are completely safe when coming back in. We really do guarantee that, and we want people to come in who need to come in and not delay any of their care,” he says.

What about people who are feeling healthy but are due for preventive health care, such as mammograms, vaccines, or teeth cleanings? Should they schedule these visits now or wait for a COVID-19 vaccine?

"Routine care should not be delayed at this time," Buchholz says. 

“If you have any concerns or questions, you can always call us,” he says. “If you’re feeling anxious, we can have a conversation about what’s possible over telemedicine, but in some cases, an in-person visit will be necessary. In any case, we just don't want people to delay care. Rest assured that we are taking every precaution to ensure your safety when you come in for a visit.”