COVID-19’s Personal Impact
Whether it’s due to physical distancing, more staff working from home, or the surge in remote visits, some personal interaction is lost, Dr. Hopkins said.
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August 2020“Human contact is important to our work,” he explained. “My job is drastically harder because I’m trying to interact with a 5-year-old or a parent with a mask on. Trying to assess hearing loss is harder. And it isn’t just patient interactions that are more difficult right now—provider interactions are harder, too. Right now, we would be celebrating our program’s graduates. Naturally, there’s some dissatisfaction that we can’t do that, and we can’t get together as colleagues.”
Telemedicine is challenging in otolaryngology because our examinations are almost physically impossible to do over a computer screen. We look inside deep, dark places. It’s a totally appropriate surrogate for office visits that don’t require physical exams. … Beyond that, though, so much of what we do is procedure-based. —Marc G. Dubin, MD
From March through May, many otolaryngology patients simply didn’t seek care for conditions that weren’t considered urgent, although they impact quality of life, Dr. Dubin said.
“Patients can’t hear, they can’t breathe through their nose, they have a nagging sore throat, they can’t smell. Before all of this, people were filling our offices to get care for these complaints. For months, they ignored what may be indicators of more serious conditions for which an evaluation should not be delayed. Now, I hope that they feel, ‘If I can get a haircut, then it’s OK to see why my nose is bleeding every day.’”
With current safety measures in place, if COVID-19 cases surge this fall, Dr. Dubin said he believes that local hospital capacity and intensive care unit (ICU) bed availability should dictate how practices continue to offer care for those nonurgent conditions.
“Assuming that facilities have the PPE they need, I’m hopeful that we can ensure that elective healthcare access is maintained both at an outpatient and ambulatory surgery center level,” he said. “While we certainly don’t want elective medical care to be a drain on the system, at some point, this care needs to be provided.”
Susan Bernstein is a freelance medical writer based in Georgia.
COVID-19’s Economic Damage
In March, otolaryngology practices across the country drastically reduced in-person appointments in favor of telemedicine or phone visits, and patients postponed elective surgeries for months. Billing rates for virtual visits are lower than in-person visits for most payers, said Brandon Hopkins, MD, a pediatric otolaryngologist at The Cleveland Clinic. The clinic didn’t lay off or furlough staff during this period, but discretionary spending is on hold, he said.