Susan McBride wishes she had a hazmat suit with a “front trap door” for quick breast exposure. That way, she jokes, it wouldn’t have worried her so much when she recently went for her annual mammogram.
As a 14-year breast cancer survivor, McBride, 55, an author from St. Louis, MO, is diligent about going for her regular scans. At first, when her appointment was postponed due to the coronavirus, she was relieved that she wouldn’t have to leave the COVID-free cocoon of her house, especially since she has a 7-year-old daughter.
“I am taking this virus seriously because it is a freaking scary, mutating, killing machine,” she says. “That pediatric inflammatory disease component makes my Mama Bear radar flip-out. I don't want to bring anything home with me when I've done well so far protecting my family.”
Yet she needed the mammogram to give herself peace of mind. So when her doctor’s office reopened, she decided to take the chance.
To stay safe, McBride made one of the first appointments of the day. Once at the breast center, she had her temperature taken; got a sticker on her shirt that designated where she was going and was given a number to check in at the reception desk, where everyone was in appropriate PPE gear.
In addition to her own face mask, she took extra precautions. “I wore my glasses so I wouldn't rub my eyes and carried everything in a tote bag, so I didn't have to leave my shirt and bra behind,” she notes.
The waiting room was set up for only a handful of people and chairs were turned to prevent anyone from sitting closer than six feet. "But," she laughs, "no one else was even there.” McBride kept her bag wedged between her knees, so it wouldn't touch the floor. She also reapplied sanitizer after she touched anything.
When she saw her doctor, they shared an air hug, “because the only people I’ve hugged since mid-March are my husband and daughter,” she says. During the physical exam, her doctor wore gloves, and they both wore masks. "We chatted for a few minutes afterward, across the room from each other."
Once home, McBride “decontaminated,” leaving her shoes outside, dumping clothes in the wash, and showering. “I wiped down my car interior and everything that was in my tote and left it in the garage,” she says. “I felt like I made it!” Yet she didn’t stop worrying until she was symptom-free for five days post appointment.
A Whole New (Hospital) World
For the past three-plus months, people have delayed routine visits, elective surgeries, tests, procedures, and even necessary treatment out of fear of being in proximity to others and going to medical facilities where they may risk coronavirus contamination. But now, as restrictions ease, doctor’s offices, clinics, and hospitals are starting to schedule patients—albeit with new protocols to keep everyone safe.
What does that mean, exactly? For one thing, no more perusing magazines in waiting rooms (they’ve been removed). For another, friends or family members may not be allowed to accompany you for consults or procedures. Bottom line: All changes are meant to keep patients and providers healthy during these unprecedented times, especially in cancer centers or where people are immunocompromised.
“Doctors are seeing fewer patients in an effort to decrease crowding in waiting rooms. Staff will be wearing masks and rooms will be more readily sterilized in between patients than in the past,” explains Stephanie Bernik, M.D., Chief of Breast Surgery at New York’s Mount Sinai West.
Doc offices are also trying to minimize the transfer from one room to the next, so while you may have met in a consultation room before being transferred to the exam room in the past, everything is now done in the exam room.
Dr. Bernik also reassures her patients: “For those needing essential services such as chemotherapy and mammograms, as well as surgery, we have created safe, clean, and dedicated spaces that are completely separate from the areas where Mount Sinai is treating COVID-19 patients.”
A Checklist of Changes
It’s understandable that with so much fear over the virus, people let other health issues slide for several months, says Jacqueline Jones, M.D., a New York ear, nose and throat specialist and head and neck surgeon. But, she stresses, “now is the time to get your health to its best place to keep your immune system healthy as we all reemerge.”
Be reassured, says Dr. Jones, “as physicians, we are trained to provide a high level of cleanliness, so patients should feel comfortable entering their doctor’s offices.”
“Changes will likely continue until there is a widely available vaccine,” says Megan Werdel, Vice President of Grey & Co. Inc. a healthcare compliance consulting firm, who has written COVID preparedness plans for 40 office-based surgery centers. “Elective surgeries may be suspended again if there is another wave of COVID-19.”
Of course, each office will have its own customized protocols, but here’s what you’ll likely see:
Staff will be wearing gloves, masks, and face shields.
There may be partitions between you and any registration staff at check-in.
Face coverings will be required for all patients over the age of two.
Patients may be asked to wait outside or in their cars and will be texted when it’s their turn.
You may have your temperature taken and be asked screening questions.
Adult patients will likely have to see their doc on their own. Minors and those with healthcare powers of attorney should still be allowed one guest.
If a waiting room is utilized, chairs will be removed to facilitate six feet of social distancing. You will no longer see magazines, pillows, or other frequently touched items.
Wait times may increase due to increased cleaning.
Patients undergoing surgery may require COVID testing in advance.
Virtual visits may become more popular.
What You Can Do Now
Remember that you are your own advocate. Before going to your doctor, ask about new procedures. Many hospitals, including Mount Sinai and the Mayo Clinic, have posted videos, checklists and updated information about how to safely go to the doctor in this new normal.
Patients should see visible instructions as to how the office is managing and following CDC guidelines, says Gail Trauco, R.N., an Atlanta, GA, oncology nurse and patient advocate. Speak up—tell the office manager or your doctor—if you notice any non-compliance. “If you receive a poor, inattentive attitude, tell the doctor," says Trauco. "If the doctor does not address your concerns, you may want to find another practice for your care.”
Here are some things you can do to make sure your visit goes smoothly:
Plan ahead. Fill out your intake forms online before your appointment. This will limit your face-to-face contact and time at the office.
Be flexible. As offices reopen and elective procedures are allowed, it will take some time for all canceled appointments to be rescheduled because of the backlog. Note: Many offices are staying open longer or adding additional days to their schedules, says Werdel.
Be patient. Wait times may be longer, but this is because healthcare workers are cleaning everything between visits.
Use touchless payment options when available. Some offices are no longer handling credit or insurance cards and doing all of it online or by scanning an app on your phone.
Be considerate. Do not cancel at the last minute or be a no-show as appointment times will be limited and others need care as well.
Despite all the new safety measures, it's normal to feel anxiety over whether you could catch the coronavirus from your doctor’s office.
Lisa Ellison, a Charlottesville, VA, writer with multiple autoimmune disorders, already had one minor panic attack while shopping in a crowded store during the pandemic and delayed a recommended abdominal ultrasound for almost two months, fearing another one.
Before she finally went in for her screening, “I sanitized my hands three times, put on my mask, and promised not to touch anything—especially my face or phone," she says. When she arrived at 7:30 A.M. for her appointment, she was relieved to discover the hospital was mostly empty.
“Sensing my anxiety, the ultrasound tech shared the hospital’s cleaning procedures, then wiped down the areas I would touch,” says Ellison. “By the end of the appointment, I had relaxed, but I realized it's going to take more than a vaccine to really trust in the safety of the outside world again.”
It’s important to put the risks in perspective, says Dr. Jones. “The risk of getting a COVID-19 infection that will cause significant illness is small, especially as the rate of infection decreases and more of the population develops immunity,” says Dr. Jones. On the other hand, “chronic anxiety can affect the body’s immune system and may make individuals more susceptible to infections. Let’s move through this time with appropriate fears but knowing that we have learned so many lessons and will emerge stronger together.”