Docs: During Pandemic, Don’t Postpone Routine Medical Care

By: Alan Pollock

Topics: Health , COVID-19

With COVID-19 case numbers still well under control on Cape Cod, people are once again venturing out to visit restaurants, stores and their favorite haunts, albeit while socially distancing and wearing masks. Doctors say it’s time to return for your regimen of routine medical care as well.

That may not be possible everywhere yet, but under Phase 2 of Gov. Charlie Baker’s economic reopening plan, health care providers are allowed to resume ambulatory in-person routine care. That means that as practices are able to do so, they can once again provide less urgent preventative services, procedures and care, like routine dental cleanings and certain elective procedures. But that doesn’t always mean a face-to-face visit with a doctor.

“We have been providing routine acute care and followup of chronic conditions throughout the pandemic,” said Dr. Matthew Libby, medical director at Outer Cape Health Services’ Harwich Port Health Center. “We do this via tele-health when appropriate, but also have been able to safely bring patients into our health centers when needed as well,” he said.

With COVID-19 under control locally, at least for now, the focus for health care providers is preventative medicine.

“We have provided pediatric well-visits throughout the pandemic, and will soon be resuming adult wellness visits with a special focus on those who are overdue for key screenings or who are otherwise high-risk or have limited access to care,” Libby said.

When visiting any medical office, expect a few changes. The lobby may be closed, and you might be asked to wait for your appointment in your car. Expect to have your temperature checked right away, and to face a series of questions about whether you’ve experienced COVID symptoms or been around someone who might have the illness. The result is a higher level of safety than ever before.

“Like hospitals and other healthcare settings, we have kept current on best practices around infection control. We screen all staff, patients, and visitors for COVID symptoms or contacts, and check temperatures. Everyone in our health centers follow social distancing guidelines and wear masks when in proximity with others,” Libby said.

Dr. Gregory Monfette of Advanced Family Dentistry of Cape Cod in Orleans said dental offices have been practicing a high level of infection control since the AIDS epidemic, but additional safeguards are now in place.

“Most of the additional measures we are taking have not been difficult to implement, outside of the increased costs. The most difficult to implement has been eliminating the waiting room for the time being,” he said. “We have seen that some patients do not have cell phones and thus do not have the ability to call when they arrive. This, coupled with the COVID screenings for each patient, has added a lot to my front office’s workload, but they are doing extremely well,” Monfette said.

Monfette said few of his patients seem anxious about returning for dental care, but a few have requested appointments later in the summer or in the early fall. He said he hasn’t encountered many people who’ve postponed necessary dental work after having been seen for a cleaning.

“We certainly do not want patients delaying important routine care,” Libby said. “The risk could result in chronic conditions becoming uncontrolled, or patients experiencing symptoms that go undiagnosed. This is why we are encouraging patients to stay connected with us — virtually and/or in person,” he said.

Health care providers struggle financially when they are unable to see their normal volume of patients. Cape Cod Healthcare CEO Michael Lauf recently said that revenues in June were down about 30 percent from the prior June, since restrictions on many elective procedures remain in place. The company has brought back at least 220 of the 585 employees it furloughed during the height of the crisis, and hopes to restore more positions.

The financial squeeze on health care providers isn’t limited to hospitals. At his practice, Monfette has installed special air filtration units, new flooring that can be easily disinfected, and various other safety improvements. There’s also the cost of additional personal protective equipment (PPE) for his staff.

“While my cost may be increased, I am fully aware that many people on the Cape have been negatively impacted financially by the COVID crisis. To increase my fees or add a ‘PPE fee’ for each visit in order to account for the increased PPE cost does not seem right currently,” he said. “Some insurance companies are reimbursing a flat rate per patient for increased PPE. However, outside of this, my fees have remained the same, in hopes that people will resume their dental care as normal.

“The last thing I would want is for increased cost to be an additional deterrent for people from the dental chair,” Monfette said.