What has been the pandemic’s main effect on your practice?

Apr 08, 2020

"I’m only seeing patients I absolutely have to see, like a catheter change or a stent removal. We’ve postponed things like vasectomies," says one urologist.

Urology Times reached out to three urologists (selected randomly) and asked them each the following question: What has been the pandemic’s main effect on your practice?

“It’s had a dramatic impact since we can’t do elective surgeries and probably can’t for most of April.

I’m only seeing 2-3 patients a day in the office. I’m doing FaceTime visits, and audio visits with patients without technology. I’m only seeing patients I absolutely have to see, like a catheter change or a stent removal. We’ve postponed things like vasectomies.

We’re temporizing a lot of problems. We’re giving antibiotics more easily, without cultures like we normally do, to keep our patients home and safe.

We’re struggling to reschedule 6-8 weeks out, particularly elderly and frail patients. We’re anticipating very little productivity this month. Staff members are struggling to make ends meet with significantly cut hours.

Patients we can’t reschedule, we do with telemedicine visits. I’ve never done telehealth before, but the Shannon Medical Center has really helped us figure out what we need. We’re learning new telemedicine codes. My understanding is that the governor has decreed that insurance companies honor telemedicine visits. There’s a lot of hearsay, but we don’t expect a lot of denials we might’ve had previously with telemedicine.

I brought my iPad in and I see patients in their living rooms. I just saw a guy out building a fence in West Texas, so it’s different.

I don’t like it is much as patients coming into the office. But we can do things with telemedicine, particularly for patients who live far away. It may be something that becomes a part of our practice going forward.

Right now, we’re just treading water.”

Brad McIver, MD

San Angelo, TX

Next: “Some docs are pretty busy; some would like to be busier."“Some docs are pretty busy; some would like to be busier.

We have 150 physicians in Maryland, Tennessee, Colorado, and Arizona.

Although in office, we’re only seeing urgent and emergent cases, we have a large telehealth operation. We’re fortunate. We had started a small telehealth pilot program, planning to roll it out gradually. But this crisis was a call to action. We had the infrastructure, so we could quickly scale up to meet our patients’ needs.

With the government relaxing telehealth rules, especially for Medicare recipients, it opened the door for our entire population. This week, it wouldn’t be surprising if we see 400-500 patients a day via televideo, across all four states.

In office, our patient volume is dramatically reduced. We don’t keep significant numbers of physicians or staff in the office. In most facilities, we have patients come in, check in, give us their cell phone number, then wait in their cars so they’re not congregating in the waiting rooms.

We’ve closed probably half our offices and furloughed a number of staff because we can’t afford to keep all of our facilities open when we’re seeing 20% of our usual patients. Ultimately, we have to be able to see patients who need help.

We haven’t furloughed any doctors at this juncture. They’ve been extraordinarily flexible in making sure we can continue seeing patients, whether in the office or via telehealth.

Getting supplies and equipment is difficult. There were a lot of things we used to take for granted that now require a lot of effort.”

Steve Bass (CEO, large group)

Baltimore

Next:"We are open and taking all the precautions."“I work part-time in a federally qualified health center for the underprivileged with no insurance, but we also see patients with insurance or Medicare.

We are open and taking all the precautions. Nobody stays in the waiting room. They come in, check in, then we tell them to stay in their car, and we’ll call them and pick them up when it’s their turn.

We haven’t had to take any other precautions because we have no virus in our county yet. But we are in pretty cautionary mode. Things are going pretty good. It hasn’t affected us yet, but I don’t think it will continue like that.

Most of the patients are nonemergency. So it hasn’t started affecting our patient load yet. I’ve only had a few patients not show up for appointments.

We’re very comfortable here. It’s a small town, but we draw from a large area. I can’t say it will continue because we have coronavirus occurring just a few miles south of us in another county.

Also, in urology a lot of patients, being older, are hearing impaired. Before, staff would be a couple feet away and speak loudly. Now, the distance is quite substantial, so I can actually hear them yelling. It’s funny how you see the difference.

Personally, we haven’t had contact with our grandkids for two weeks, because we’re elderly and our son doesn’t want to put us in jeopardy.”

Krikor Partamian, MD

Saint Joseph, MO