The coronavirus pandemic that took hold this past spring upended normal life for just about everyone, and for many people, that meant delaying health care appointments.
Everything from mammograms and other routine cancer screenings to annual physicals, blood pressure checkups and other non-emergency health care visits got canceled in the early stages of the pandemic. And many folks have still not made their way back to the doctor yet, some six months later.
“In the first few months of the pandemic, hospitals and health care systems were directing patients and families to shelter in place, and there were concerns that local resources and facilities would be overrun by ill patients in need of hospitalization and acute care,” explains Dr. Brian McBeth, a certified physician executive and emergency medicine specialist with O’Connor Hospital in San Jose, California.
Dr. Carrie A. Horn, a hospitalist and chief medical officer and chief of the division of hospital and internal medicine at National Jewish Health in Denver, says that initially, this move to cancel everything “was an acceptable thing to do because the provider offices didn’t have the personal protective equipment or the knowledge of what was going on to feel comfortable bringing people into a public setting.”
Since those earliest days, however, we’ve learned a lot about the virus, and some of the supply chain issues surrounding producing adequate PPE have improved, meaning that many health care offices and hospitals can now get back to a more normal workflow. And now doctors and other health care providers from across the whole health care spectrum are urging patients to reschedule appointments that may have been canceled or postponed over the spring and summer.
“Elective surgery does not mean optional or unimportant,” McBeth notes. “Many times, these are very important to preserve one’s health and quality of life.”
Similarly, routine care shouldn’t be viewed as something that you can ignore. “Routine screenings are preventive or diagnostic,” meaning that they can help you identify an issue early on or keep you from getting sick, says Julie Hilsenbeck, chief nursing officer with Providence Southern California. “They spot the abnormalities that may be early-warning signs of serious conditions and they diagnose irregularities, including tumors and other very serious conditions.”
[SEE: How to Prepare for a Virtual Doctor’s Visit.]
Appointments You Should Reschedule Now
While any routine appointment that has been put off should be rescheduled as soon as possible, there are certain appointments that might take priority. Seek care as soon as you can for the following:
— Urgent and emergency care.
— Diabetes management.
— Cancer screenings.
— Vascular issues.
— Heart disease.
— Dental health.
— Follow-up after urgent or emergency care.
— Blood work and medicine checks.
— Other chronic conditions.
Dr. Richard Seidman, chief medical officer of L.A. Care Health Plan, the largest publicly operated health plan in the U.S., says that “now that we’re months into the pandemic and have improved our ability to control the transmission of the virus with masking, physical or social distancing, and frequent hand washing and cleaning, it’s time to re-focus our efforts to ramp up preventive care and elective procedures.”
Horn agrees that the new knowledge we have about the virus has changed how health care providers work, and you can now feel safe visiting the doctor. “We’ve learned a lot about the virus and about transmission, and we know what we can do to keep people safe when they’re coming in” to the office for an appointment. “We have the masks and gloves and gowns. We know about air turnover, and we know how much time you need to leave between patients to make sure there’s not any virus lingering in the air. We’ve instituted temperature screening,” and other symptom checks to keep a sick patient from potentially infecting others.
Urgent and Emergency Care
It should go without saying that if you’re having a medical emergency, you need to be seen right way. “If you’re having a serious medical crisis, such as a heart attack or a broken bone, you should not avoid an emergency room visit,” Seidman says. “Call 911 if it’s something that’s life threatening. If you take yourself to the emergency room, follow the same precautions that you would for going anywhere else outside your home — wear a mask and keep your distance from others.”
Diabetes Management
For complex conditions like diabetes that affect not only the endocrine system, but also the organs, vascular system, the feet and the eyes, staying on top of the condition by tightly controlling blood sugars and visiting with your doctor or doctors frequently is all part of managing the disease. As such, if you have diabetes and recently skipped a maintenance appointment over fears about the coronavirus, contact your doctor.
Regarding foot care for people with diabetes, “routine maintenance is usually somewhere around every three to four months, depending on the severity of diabetes and some of the secondary complications that are developed with diabetes,” says Brett D. Sachs, a fellow member of the American College of Foot and Ankle Surgeons and a foot and ankle surgeon with Rocky Mountain Foot & Ankle Center in Colorado. Keeping up with those appointments is important.
Cancer Screenings
Mammograms, colonoscopies, PAP smears, skin checks, CT scans of the lungs for former smokers and a variety of other routine cancer screenings are designed to be repeated at a certain frequency, and keeping to that schedule is important.
These screenings “are important mechanisms to promote early detection of cancer, which can often be more easily treated when diagnosed early,” McBeth says.
And Seidman adds that this is a major area of concern for public health officials. “The head of the National Cancer Institute says delays in this type of screening could result in as many as 10,000 more deaths from breast and colorectal cancer in the next 10 years.”
Vascular Issues
It’s important to keep up with routine follow-up care related to blood clots or other vascular issues. The risk of stroke and embolism is elevated in people with conditions such as heart disease and high cholesterol, so you’ll need to keep up with appointments as your doctor recommends.
Heart Disease
If you have high blood pressure, high cholesterol, or other risk factors for heart disease, you should check in with your doctor regularly to make sure your heart is working well. If you’ve already been diagnosed with heart disease, follow your doctor’s orders with routine care to manage the condition and reduce your risk for heart attack, heart failure and other complications.
“Blood pressure checks and other tests, especially for people who are taking medications related to chronic conditions such as diabetes, hypertension and hyperlipidemia are important and should not be delayed,” Seidman says.
Dental Health
“Oral health is important to overall health, so it’s important to keep your dental appointments as well,” Seidman says. He adds that “studies have shown a link between gum disease and heart disease, and people with diabetes can develop gum disease if they don’t receive regular dental care.”
Follow-up After Urgent or Emergency Care
If you’ve had a traumatic injury, surgery or an urgent or emergency health problem, be sure to follow up with your doctor as recommended to make sure that the issue is resolved and you’re healing well.
Blood Work and Medicine Checks
Horn notes that if you’re on any medications, you should keep up with your doctor’s recommended interval for check-ins to make sure you aren’t having any complications. “Even if it’s just getting your blood pressure checked and your lab work done because you’re on blood pressure medicine, for example, that’s super important. We want to make sure that everything’s optimized.”
Routine Immunizations — Especially the Flu Shot
“It’s always important to get a flu shot, but even more so this year to avoid overwhelming hospitals during the upcoming cold and flu season,” which could create a big burden on health care facilities, Seidman notes. The same goes for the pneumonia vaccine for older adults. Avoiding illnesses that are preventable with a vaccine can keep you healthy this cold and flu season.
Other Chronic Conditions
If you have an autoimmune disease, cancer, a genetic condition or any other chronic medical problem, it’s critical that you stay on top of the issue by communicating with your doctor regularly.
This list isn’t exhaustive, and if you have any other condition that requires routine health care, check in with your doctor to get back on track with that maintenance schedule. “Whenever we can address an issue sooner or a problem sooner, it usually means that we can handle it a bit easier,” Sachs says.
Horn agrees. “Delaying care just gives more time for the problem to get worse, and then it’s harder to treat. And maybe we get to the point where we can’t treat it. It’s really important to seek care early and routinely.”
That’s true of everything from ingrown toenails to cancer. “A small scrape on the foot or a small sore is a lot easier to handle than one that’s bigger and is infected,” Sachs explains. When little problems snowball, that can turn into a real health threat that in certain cases could end up being even more dangerous than contracting COVID-19.
[See: Foods That Can Support Your Immunity.]
Tips for Staying Safe at the Doctor’s Office or Hospital
Exactly how many people have put off certain appointments and procedures isn’t entirely known, Hilsenbeck says. But “we do feel this is the case based on our procedure appointments.”
Certainly, it’s understandable that many people are hesitant to go to the hospital or the doctor’s office for care, but she says there are ways to do it safely.
The following tips can help you stay safe when getting the regular and routine care you need to stay in optimal health.
— Washing your hands. Since the very beginning of the outbreak, hand washing has been one of our most useful and available means of preventing the spread of the virus. Wash your hands as much as possible, especially before you touch your face or eat or drink anything. After arriving home from an appointment, be sure to wash your hands thoroughly — at least 20 seconds with warm water and soap — to remove any pathogens you picked up in your journeys.
— Using hand sanitizer. If soap and water isn’t available, use hand sanitizer. Choose one that’s at least 60% alcohol, as this will deactivate the coronavirus and most other pathogens that could make you sick. Many doctor’s offices and hospitals require you to clean your hands with an alcohol-based hand sanitizer when you arrive. That’s for your safety, as well as the safety of other patients and health care professionals you may come into contact with.
— Masking. Most health care clinics and hospitals are requiring that anyone entering the building wear a mask. Reusable masks made of cotton or another light, breathable material are generally thought to work well. Hilsenbeck says it’s important that you choose a mask that fits well, “not a bandana.” Be sure to clean these regularly, and if health care staff at the hospital or clinic instruct you to remove your mask and wear a sterile surgical mask they provide, please comply. It’s out of an abundance of caution that they’re asking you to do such.
— Keeping your distance. Sachs says his office has instituted social distancing policies that keep patients at least 6 feet away from each other at all times, and this is now the norm in most offices and hospital waiting rooms around the country. Some clinics and offices require patients to wait outside the building or in their cars until an exam room is ready, again in an effort to keep people from coming into contact with one another.
— Arriving on time. Many offices are spacing out appointments, so being on time is more important than ever to keep the flow of patients safe and spaced out. And Horn recommends trying to book the first appointment of the day if you’re particularly concerned about your risk. “If you can get the first appointment of the day, you know you’re going into a clean workspace.” Booking an appointment for another time when you know the office is usually slow can also help you keep your distance from others and stay safer.
— Answering symptom questions truthfully. Many doctor’s offices will ask you if you’ve had any symptoms that could be related to COVID-19 in the days leading up to your appointment. Answering honestly is critical to protecting yourself and others who are there to help you. Horn recommends taking your temperature at home before heading into the office if you can, “because they’re definitely going to need to do things differently if you have a fever.”
— Using telemedicine. Where feasible, try telehealth visits as a means of connecting and checking in with your doctor without having to enter a physical space. “This allows for social distancing, but also allows the physician to monitor a patient’s symptoms or any chronic illnesses the patient may have,” Seidman says. As such, telehealth has gotten a huge boost during this pandemic. Not every visit can be conducted remotely. But for those that can, checking in with your doctor from the comfort of home can be a great way to mitigate risk while keeping up with routine health care needs.
— Following procedure. Each doctor’s office and hospital is doing things a little differently and has developed a safety protocol based on local conditions, the logistics of the space they’re moving through and current public health guidelines. Horn recommends contacting your doctor’s office before your appointment to find out what their procedure is so that you’ll be prepared when you arrive. This also ensures that you’re comfortable with how they’ll be working with you. When you get there, heed the advice of staff and follow their procedures, whether that’s having your temperature checked at the door, changing into a clean mask or waiting in the car. These protocols might be a bit inconvenient, but they’re in place to keep you safe. “These simple but important actions effectively prevent spread of COVID-19 and other viruses and bacteria between people, and are critical for patients and providers alike,” McBeth says.
[See: Myths About Coronavirus.]
Planning Ahead
Looking ahead, Seidman notes that the coming flu season could present additional challenges. “We remain concerned about the capacity of the delivery system with the upcoming flu season and need to remain vigilant in our efforts to promote the proper use of masks whenever outside of our households and around others,” he says. “We have no way of knowing how long we’ll be dealing with COVID-19, and putting off routine immunizations, screenings and care can be dangerous.”
Lastly, Hilsenbeck urges you to take care all around and be proactive in staying healthy. “Follow COVID guidelines and stay educated from a reliable source. Continue to eat a healthy diet, exercise and if you’re showing symptoms, notify your doctor immediately and follow instructions.”
She notes that we all have a role to play in bringing this pandemic to heel. “The public has enormous influence on the ability to limit the spread of the virus by following guidelines, not congregating even if others are, and above all, taking care for others as you would want them to take care for you and those you love.”
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