Physicians in cardiology, primary care and urgent care share what you can expect, and what not to, when you come for an appointment.
With Pennsylvania and New Jersey now in re-opening phases of the COVID-19 pandemic, folks are getting out and about more – to favorite restaurants, shops and other places that are open again. Of course, responsible businesses are taking precautions, including social distancing rules, requiring face masks and providing hand sanitizer to keep themselves and those they come into contact with safe.
Jefferson Health takes all of those steps and much more to ensure that all of our patients and healthcare providers are safe at all of our locations. You can read more about the specifics of those steps here: JeffersonHealth.org/Safety.
If you’re feeling sick, have a chronic condition, or require urgent care, it’s especially important, now that conditions have eased somewhat, that you not delay your health care, including testing and treatments.
However, returning to a clinical setting may be especially stressful. We spoke with physicians in cardiology, primary care and urgent care to get a better sense of what to expect when you come for an appointment.
Cardiology: Stressing Safety, Maintaining Quality
“Number one, we want each of our patients’ communication with their doctor, whether it be in person or by telehealth, to be as safe as possible,” says cardiologist Dr. Howard Weitz of the Jefferson Heart Institute. “Outpatient offices have significantly ramped up capacity and have done so with patient safety in mind.”
Immediately upon arriving for their appointment, each patient has their temperature checked. If they have any fever, their appointment is put on hold and they are told to see their primary care physician instead.
“Our goal is to meet the needs of all of our patients, with either ‘in-person’ visits or by telemedicine if the patient’s condition warrants that approach,” says Dr. Weitz.
No Waiting Time
If a patient arrives with a homemade mask, they will be provided a surgical mask to wear instead for extra caution and protection. In order to keep the number of people in the clinic at any one time low, patients are encouraged to arrive alone to their appointments. Visitors or companions are asked to wait in a separate waiting area. The patient, meanwhile, is escorted directly to an exam room, where insurance coverage and other matters that would normally take place at the front desk are now completed. Time normally spent checking in at the front desk and then sitting in the waiting area have been eliminated to promote social distancing.
One thing that hasn’t been reduced, stresses Dr. Weitz, is cardiologists’ interaction with patients: “We haven’t minimized that because what might seem like small talk to the patient is really important history acquisition.”
Time normally spent checking in at the front desk and then sitting in the waiting area have been eliminated to promote social distancing.
Echocardiograms – for example, heart ultrasounds – and cardiac stress tests are still available. Like the cardiologists and nurses, the technicians administering these tests are clad in appropriate personal protective equipment. Exam rooms and testing labs are sanitized between each patient’s occupancy, and interaction between the technician and patient is minimized and handled from a safe distance.
“Our team of physicians, nurses and medical assistants meets several times a week to monitor how well we’re doing, how the patients are doing and any process improvements we can make to enhance the patient experience,” Dr. Weitz concludes. “We are here for our patients, and we’ve always been there to meet their needs – as safely as possible.”
Family Medicine: More Telehealth, Reduced Office Appointments
Jefferson’s family medicine physicians offer primary care to patients of all ages, from infants to palliative care. Among the services they provide are: annual health evaluations; flu shots, allergy injections and vaccines; preventive care, health screening and physical exams for individuals of all ages
Since the pandemic began, medical students and medical assistants have been contacting patients not only to remind them of exams and other services they’re due to have but also to arrange telehealth and phone visits with their doctors when these are deemed appropriate, reports director of clinical operations Jackie Raab. The team has also sent some patients hypertension equipment so they can monitor their blood pressure at home.
Even so, in-person appointments are available but are restricted to three per hour to eliminate or minimize use of waiting rooms – where seats have been reduced and reconfigured to six feet apart for social distancing. Patients are checked in at the entrance by a registrar when available, or at kiosks which are wiped down after each use. Patients are asked to come alone if possible or to bring only one companion with them if necessary.
Medical assistants at the clinic’s entrance are checking patient temperatures when they arrive, and any patients who have a fever or any form of upper respiratory symptoms, such as a cough, shortness of breath, or chest pain are seen in separate rooms to prevent potential exposure throughout the practice. All staff wear face shields or surgical masks and goggles while seeing patients.
Urgent Care: When You Need Care Urgently
“We’ve made some changes to make patients and staff safer and feel more comfortable,” says nursing director Thomas McLaughlin, who manages urgent care services at Jefferson. “For starters, we’re limiting the number of visitors in our facilities by asking patients’ companions to wait in their cars or outside. We text them when the patient is ready to be met at our front door to be taken home. We make exceptions if the companion serves as the patient’s caretaker, or if the patient is a minor and the companion is their parent or guardian, in which case one is allowed inside with the patient. Another alternative is if the patient wants their spouse to participate in the visit with the doctor, in which case we let them do so from outside on Facetime or speaker phone.”
At larger Urgent Care locations, some waiting room chairs have been removed so patients waiting inside are six feet away from one another. At smaller locations, all chairs remain in place but some are turned to face the wall, indicating that they cannot be used. Patients for whom there are no available chairs are lined up outside the facility or in the hallway leading to the facility’s entrance, with markers six feet apart on the ground indicating where they must stand.
Reducing Face-to-Face Time
At the facilities’ entrances, signage instructs patients that if they have such symptoms as fever, cough, or shortness of breath, to please call from their car or outside so that a medical assistant can take their history remotely, rather than have those patients fill out a form in the waiting room, around others. The patient is then met at the entrance by the medical assistant and taken immediately to an exam room and given an iPad. To reduce time in the exam room with the patient, a physician uses another iPad to conduct a virtual interview via Skype to determine if the patient needs to be given an antibody test.
“While examining patients, our doctors wear a hairpiece covering and face shields,” says McLaughlin. “At times, they may also wear an N95 surgical mask, and, if the patient is suspected of having COVID, a gown and gloves as well. Conversation between doctor and patient may be a little briefer than normal, and the doctor may stand farther away than the patient is used to. But once the examination begins, the doctor will approach the patient and do whatever is necessary, including checking the patient’s lungs. Their personal protective equipment ensures the safety of both the patient and the doctor.”
As a final precaution, exam rooms are wiped down thoroughly between patients.
Don’t Delay Your Care
Since long before the COVID-19, Jefferson’s Division of Infectious Diseases has provided outstanding research, education and clinical care. We have followed CDC guidelines and put our considerable expertise to use in safeguarding Jefferson Health staff, students and patients. Your safety here is always of paramount importance.