By Dennis Thompson HealthDay Reporter June 17, 2020, at 7:00 p.m.
WEDNESDAY, June 17, 2020 (HealthDay News) -- A
ruptured appendix is one medical emergency that a general surgeon colleague of
Dr. Jacqueline Fincher hadn't treated for more than 15 years in their small
town of Thomson, Ga.
That's because the signs and symptoms of
appendicitis are so well-known that nearly everyone gets to the hospital well
before an inflamed appendix has a chance to burst.
But then came COVID-19.
"In the month of March he had two,"
said Fincher, president of the American College of Physicians. "It's
because people were afraid to go to the doctor or go to the emergency room.
They sat at home and got really, really sick, and ended up going to the
emergency room and having a much more difficult course."
Even though the United States is emerging from
lockdown, Americans worry that many folks remain too fearful of contracting
COVID-19 to get the medical care they need to prevent a serious illness from
becoming a medical emergency.
More than half the participants in a recent
poll (54%) said they are concerned that their health or the health of a loved
one is at risk because they've delayed treatment for medical problems,
researchers at Fairleigh Dickinson University in New Jersey found.
Further, more than a quarter (27%) said they
will not go to a doctor's office except for emergencies, until either a vaccine
or a treatment for COVID-19 is available.
"If individuals are not seeking medical
care when they should, it may mean that they're missing vaccinations. It means
that perhaps they have a condition that's going untreated, or perhaps they need
an adjustment to their medications," said Julie Kalabalik-Hoganson, chair
of pharmacy practice with Fairleigh Dickinson's School of Pharmacy and Health
Sciences in Florham Park, N.J. "It has a lot of implications that we're
worried about."
There's no doubt the pandemic caused a serious
financial hit to doctors' offices.
In April, use of health care services declined
by 68%, with a 48% reduction in revenue compared to the same time the previous
year, according to a new report from FAIR Health, a nonprofit group that
examines health sector economics.
For many doctors, telehealth provided a
much-needed financial lifeline, the FAIR Health report says.
Fincher agreed, noting the pandemic response
caused a loosening of regulatory restrictions around telemedicine and prompted
many insurers to pay the same rates for a telehealth visit as they would for a
regular office visit.
"It was an absolute lifesaver,"
Fincher said. "Wow, it opened up. Everybody was on telehealth really
fast."
About a quarter of people in the Fairleigh
Dickinson poll said they'd used online video conferencing to see a doctor or
health professional since the pandemic began, and nearly three-quarters said
the experience was the same or better than an in-person medical visit.
Telehealth likely helped the wellness of many
locked-down people dealing with chronic medical conditions like high blood
pressure, emphysema and diabetes, Fincher said.
Doctors have kept tabs on people's health by
having them regularly check their own markers, using home versions of the
devices used by medical experts, Fincher said.
Folks these days use glucometers to check
their blood sugar, thermometers, pulse oximeters to measure the oxygen in their
body and other devices on a regular basis at home, then transmit their numbers
to their doc.
"A blood pressure monitor and a scale go
a long way in helping us to monitor your health and follow you outside of the
office," Fincher said. "Those devices are very helpful for us as
physicians to monitor key things that keep you out of the hospital, keep you
out of the emergency room. We can delay to some degree your chronic medical
visit during this strange time of pandemic."
However, it's hard for telemedicine to capture
everything a doctor can observe in person, said Dr. Gary LeRoy, president of
the American Academy of Family Physicians.
"I start my examination and my assessment
of my patients from the moment I see them walk into my office," watching
how they move, how they sit, how they're dressed and how alert they appear to
be, said LeRoy, a family physician in Dayton, Ohio. "Sometimes that's my
first tip that something just isn't right with their situation."
The reopening of America has led to a bit of a
rush to the doctor's office, he said.
"Our patients are anxiously wanting to
come back in person versus on a video screen or by telephone," LeRoy said.
"My personal practice has totally flipped, in the sense that the
overwhelming majority of my patient visits now are in person."
But there remain many who are simply too
fearful of COVID-19 to go have their health concerns addressed. The new poll
jibes with a Kaiser Family Foundation health poll from May, in which about half
of adults said either they or a family member had postponed or skipped medical
care due to the pandemic.
Doctors need to keep promoting the precautions
they've taken to prevent COVID-19 transmission in their offices, Fincher said.
For example, Fincher's practice holds an acute
respiratory illness clinic every afternoon, out of a tent behind the office.
People with COVID-19 symptoms can be treated without setting foot inside the
office.
"We do all the history-taking over the
phone with them while they're sitting in our parking lot, then we bring them
out under the tent and examine them," Fincher said.
Masks are required in offices, and every exam
room is thoroughly cleaned between patients.
Some patients are reluctant. "I'll ask
them, 'Well, are you going to the grocery store?'" Fincher said.
"Most of the time they say yes and I tell them, 'Well, I can promise you
my office is way safer than the grocery store.'"
More information
The U.S. Centers for Disease Control and
Prevention has more about COVID-19.
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