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The Importance of Primary Care During the COVID-19 Pandemic

Dr. Holly Mintz shares the importance of keeping your appointments with your primary doctor amid the COVID-19 pandemic.
The Importance of Primary Care During the COVID-19 Pandemic
Featured Speaker:
Holly Mintz, MD-Vice President and Chief Medical Officer, Elliot Medical Group Elliot Health System
Holly Mintz, MD, is a practicing pediatrician at Elliot Pediatrics of Bedford, a department of Elliot Health System (part of SolutionHealth), with over 20 years of experience. She also serves as Vice President and Chief Medical Officer of Ambulatory Services for the Elliot Medical Group.
Transcription:
The Importance of Primary Care During the COVID-19 Pandemic

Bill Klaproth: So what are the consequences of delaying routine visits and vaccines? When can telemedicine visits come in handy? And when is it necessary to see your PCP in person? All good questions. So let's get some answers and learn about the importance of primary care during COVID-19 with Dr. Holly Mintz, vice president and chief medical officer of ambulatory services for Elliot Medical Group, part of Solution Health. This is the Solution Health Podcast. I'm Bill Klaproth, Dr. Mintz, thank you so much for your time. It's great to talk with you. So why are routine visits to a primary care provider or a PCP so important for patients of all ages.

Dr. Holly Mintz: Much of the care that we provide in the office are preventative visits. and that entails all the things that we do to help to make sure that people stay healthy and that anybody with a chronic illness remains healthy. We want to make sure that their chronic illnesses well-managed and, in addition, there are vaccines that we provide at preventive visits that are very very important in light of COVID we certainly don't want to lose the immunity that we have in the community for other very serious illnesses.

Host: Right. And staying healthy now is really more important than ever, especially during a pandemic like COVID-19. So what are the consequences of delaying routine visits and vaccines?

Dr. Mintz: Well, when people have chronic illness, if the chronic illnesses not well-managed, they can lead to complications, which then leads to emergency room visits and hospitalizations. For instance, if somebody has a wound that's not well cared for or diabetes, that's out of control. If they're not monitoring and managing these illnesses, then there are significant complications that require hospitalization. And ideally, we want to keep everybody out of the hospital. So in addition, there are communicative diseases such as, for instance, whooping cough that tends to cause six months or so of illness in people and can be very serious in young infants and if we are lax in our ability to keep everybody up to date with their immunizations we will see a resurgence of those illnesses.

Host: Right, so on certain things like whooping, cough, delaying care really can put someone at serious risk. So when does telemedicine come in handy? We've heard a lot about telemedicine during COVID-19. When is that appropriate?

Dr. Mintz: So there are a lot of things that we can managed via telemedicine. For instance, we can provide guidance regarding issues and problems. We can adjust medications. We can certainly encourage people to make sure that they're staying healthy, staying active, eating right. We know that this situation has been a complete change in everybody's usual, daily lives. in addition, I think telemedicine can be helpful because there are a lot of people that are facing issues with anxiety and depression over family members that are sick or loss of jobs. And I think it's really important to be able to touch base with the providers to discuss these concerns. So although everything can be done over telemedicine, certainly a lot can be done over telemedicine regarding the monitoring of ones care.

Host: Telemedicine certainly has been a benefit for a lot of people during COVID-19. So, Dr. Mintz, when is it necessary then to see your PCP in person.

Dr. Mintz: We have certainly learned through this experience; what visits are appropriate for telemedicine and what visits requiring in person visit. There are times that we need to either exam a part of the body that you can't do over telemedicine. Or obtain vital signs or tests or deliver vaccinations or other screening tests, other things that allow for prevention of many illnesses. However, there are many things that we can do via telehealth. For instance, behavioral health visits have been a wonderful example of visits where we've actually increased the care that we're able to deliver for patients because there are often challenges in getting to the office. So there are a lot of visits where there are mainly information gathering or counseling or therapy that can be done over telemedicine, in person is still important when something has to be done at the office.

Host: And so we give a full rounded picture of every angle. When might it'd be a good idea to postpone a primary care visit?

Dr. Mintz: So I would say that, during COVID, when there was a stay at home order, it was very important for us to only see people in person who absolutely needed to be seen and we did everything that we could over telemedicine. Now that we have the adequate PPE and we're taking precautions in the offices, any time again a test needs to be done, a screening test, blood drawn, part of the physical exam needs to be completed. We have provided a safe environment for patients to come in. They're significant screening that's done prior to the patient coming in the office, as well as when they get to the office. We're encouraging a decrease in the number of people that accompany patients to the office. So, when something needs to be examined or vital sign needs to be taken, it is important to go for an in person visit with the appropriate precautions taken.

Host: And many parents are weighing the risks of skipping or delaying their child's well visit to protect them from COVID-19. What advice would you give parents?

Dr. Mintz: I think that the well visits are even more important than usual for those that potentially don't need a vaccine, some of those can be done via telemedicine. Again, we are assessing the entire health picture of the child and this is a very anxiety producing time right now. So it's even more important for providers to be able to assess child's level of, you know, the feeling of wellbeing, how they're coping, if they're getting any social interaction, if they're getting physical activity, if they're, eating healthy, et cetera.

So I think that the visits where a vaccine is required, for certain ages needs to come into the office but much can be done via telehealth for now. It's not the most ideal, because of course we'd like to do a physical exam and weigh and measure the child. But I think there's a lot of important issues that need to be addressed with kids right now and they need to have the ability to express concerns and fears with someone they trust, which would be their provider.

Host: Right. That is so important. And then people still are concerned about seeing their primary care physician or visiting the hospital because they feel that that's where the COVID is. So what steps can and do doctor's offices take to prevent the spread of germs, even during a normal cold and flu season?

Dr. Mintz: Well, the first thing we do is we screen all patients before they come into the office. And we ensure that if anybody's having symptoms that they're not seen. As you can imagine in a usual day in the office, we see many, many people with symptoms such as, you know, runny nose or a cough or a fever. We are actually not seeing any of those patients in the office right now and are deferring those to other clinics that are specially set up for patients with those symptoms. Or we are trying to manage those patients via telehealth without bringing them into the office. So we're being very careful about who we are bringing in and we have specific sites set up for people to be seen if they have fever or cough or runny nose, we again screen at the entrance of the patient and whoever is accompanying them to the office. In addition, we are taking extra precautions with cleaning. We usually clean between patients and we're being extra cautious about that as well as ensuring that everybody in the office, including staff members or providers are all masked. And we are ensuring that all patients and whoever is accompanying them are masked in the office.

Host: And then on the flip side, Dr. Mintz, what steps should patients take to prevent the spread of COVID-19 when preparing for an in-person doctor's visit?

Dr. Mintz: So I think it's important for them to ensure that they're not coming to the doctor with the symptoms that are consistent with COVID, which again sounds completely counterintuitive because normally we see people in the office who are sick. If people have symptoms of COVID-19, including fever, cough, runny nose, we need them to call the office prior to going to the office to ensure that they are scheduled in the appropriate place. So if. anybody was symptoms has an appointment for you routine scheduled visit and realizes that they have symptoms, we would like them to call the office so that we can make sure that they get the care that they need either by delivering a telehealth visit or rescheduling their visit to when they are not having any symptoms.

Host: And then lets talk about testing which is more widely available, would you recommend it and why or why not?

Dr. Mintz: So I think the testing capabilities have greatly expanded. Of course. So initially we certainly were very, very limited with both PPE and testing supplies and that has certainly changed. I think that if there are symptoms, it certainly is valuable to get a test just so that you can understand if you need to be self-quarantining. People who are asymptomatic don't necessarily need a test, but perhaps they may feel that they're going to visit a grandparent or that somebody is coming in to visit them now that some of the restrictions have been lifted and they want to make sure that they're not a carrier. The challenge is that people can test positive for weeks. So you can have a positive test for four to six or so weeks after even having an asymptomatic affection. So I think the testing issue continues to be a challenge for us to really understand what the test means when we should do it. And I think that as time goes on, we will learn more and more about this. But I would say if anybody has symptoms and is not able to self-isolate that they should get tested.

Host: And then for patients who do have symptoms of COVID-19 such as fever and cough, what is your advice?

Dr. Mintz: So my first recommendation would be to stay home. My first recommendation would be to make sure that you're not going out to the store. You're not, you know, doing routine errands that you self-isolate and you stay home. Certainly there are drive through tests available if you are interested in getting a Covid test, but we're encouraging everybody is that you have any symptoms at all that you stay home. Whereas in the past, if people had mild cold symptoms, we wouldn't be as restrictive. So the best thing that you can do if you are sick, if you have a fever, if you have a runny nose or cough is stay home You certainly can arrange for a drive through tests with your physician, and the other thing that's very, very important is to keep washing your hands and to make sure that others in your household are washing their hands frequently. That's really the mainstay of infection prevention is hand-washing. And so I would recommend to self-isolate and wash your hands very, very often.

Host: So good advice. If you feel sick, stay home, make sure you wash your hands, self-isolate. And if you feel like you need to go get tested, please do so. Dr. Mintz, this has really been informative. Thank you so much for your time.

Dr. Mintz: Thank you so much for having me. It's truly a pleasure.

Host: That's Dr. Holly Mintz for more information, please visit SolutionHealth.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Solution Health podcast from Solution Health. Thanks for listening.