Social distancing protocols aside, doctor’s offices are emptier than ever these days. And, according to experts, it’s not all that surprising. According to a new survey from the non-profit Prevent Cancer Foundation (PCF), 43% of American adults have missed routine medical appointments because of COVID-19. The research team also found that 35% of Americans had a cancer screening scheduled in the last few months but skipped it due to pandemic concerns. These results are part of PCF’s “Back on the Books” campaign, urging people to reschedule their healthcare appointments and get the care they need – yes, even during a global pandemic.
Richard C. Wender, M.D., chair of Family Medicine and Community Health at the University of Pennsylvania in Philadelphia and an advisor for this campaign, explains that the fear of COVID-19 is pervasive among patients, and for good reason. “Fear derives in part from feeling like things are out of your control—like there is a hidden risk that you cannot alter or affect,” he explains. This may mean your gut instinct tells you to cancel that mammogram next month. “For many people, going into the health care setting doesn’t feel like a safe place.”
Should I Stay or Should I Go?
So, we know what you’re thinking… isn’t the risk of catching COVID-19 a totally valid fear? Of course, but it’s not the only thing you should be concerned about, says Pavitra Kotini-Shah, M.D., assistant professor in the Department of Emergency Medicine at the University of Illinois College of Medicine in Chicago and an expert with the American Heart Association. “You can’t let the fear be debilitating to a point where it is detrimental to [your] own health,” she says—especially if you’re a person living with a chronic medical condition.
The CDC lists cancer, heart disease, and type 2 diabetes as conditions that put someone at increased risk for severe COVID-19 infection. Dr. Kotini-Shah explains that poor disease management can exacerbate that risk. “Diabetes and hypertension … are already risk factors for severe illness from COVID-19, so it’s even more important that they keep those things in check,” she notes. It’s always imperative to take care of your health, but during this unprecedented time, it’s even more crucial to take your medication on schedule and check in with your doctor when you need to.
Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association based in Boston, has also noticed a trend of people skipping appointments since the pandemic began. “In the early days of the pandemic, this made sense, but now that the duration is longer, we are concerned that people are not getting their necessary care,” he explains. “Telemedicine provides a good alternative, and it is important for people to engage with their healthcare team to maintain good health.”
Telehealth vs. In-Person Care
Of course, telehealth is 100% social-distancing friendly, and you should use it when your doctor gives you the OK to do so—like for routine check-ins or prescription refill appointments. The U.S. Department of Health and Human Services reports seeing a dramatic increase in the demand for telehealth services and is working to make sure you can access those when you need them. They’ve expanded Medicare coverage to include telehealth services for beneficiaries across the country.
But in some instances, virtual care may not be possible. Cancer screenings, for instance, must be conducted in person. “Screening for various cancers will detect an early, curable, asymptomatic cancer in some people and will detect a treatable precursor to developing cancer in some people,” Dr. Wender says, and time is of the essence in catching these issues before they progress. “The window of opportunity for some of these people is relatively short — a few months, not a few years,” he warns. “The longer we delay helping people get back to screening, the greater the suffering and even loss of life will be.”
Dr. Kotini-Shah notes that she has seen patients in the emergency room coming in abnormally sick (with COVID-19 or other illnesses) because they were avoiding care for as long as possible. “Patients have just waited too long, and they’re in a much worse situation as a result,” she says. This fear is understandable but can still lead to dangerous outcomes. “Many patients are still wary of attending their much-needed appointments because they’re worried about putting themselves at risk or worsening their conditions.”
How to Visit the Doctor Safely?
Rather than calling to cancel your upcoming medical appointments, Dr. Gabbay suggests calling your healthcare provider to get information about their safety precautions. “Most healthcare providers have designed systems to allow for physical distancing in the waiting room and appropriate staggering of patients for laboratory tests,” he explains. And if your doctor suggests a telehealth visit, you can trust that that’s the best option for you at this time.
If your community is experiencing a major surge in infections, some healthcare providers may choose to limit their in-person services for a short time. “Always check with the healthcare facility to make sure that cancer screening is available and is safe,” Dr. Wender says. “Just [as] businesses need to shut down while a surge in cases is occurring, health care facilities will need to be more restrictive during these times.”
Once you’ve confirmed the availability and safety of an in-person appointment, your best bet is to come to the doctor’s office prepared. “Make sure you know the basics — options for transportation, where to enter, where to go,” Dr. Wender says. “Wear a mask at all times, covering both your nose and mouth. While you should maintain as much distance as possible from others (at least six feet) during the entire trip, be particularly careful to keep a larger gap between you and people who aren’t wearing a mask or are not covering both their mouth and nose.” (Ideally, your doctor’s office will require masks for everyone.) Avoid public transport if possible so you limit your exposure to strangers.
The CDC recommends using touchless payment if you can and sanitizing your hands if you must hand your credit card to someone else. Talk to your doctor about getting a larger supply of medication so you can limit your visits to the pharmacy to pick it up. Mail delivery of prescriptions is an even safer option.
Luckily, healthcare providers are some of the best-equipped experts to keep you safe during this time. “They know the science,” Dr. Wender notes. “They have guidelines for every procedure, and they follow them.” Dr. Kotini-Shah encourages patients to rest assured they’re in good hands. “Lots of measures are in place to keep people safe,” she says. “Patients should not feel uncomfortable about coming and seeking care.”
The moral of the story: Don’t keep putting off your healthcare appointments indefinitely. “Patients will feel comfortable when they hear and know that there are extreme safety measures in place,” Dr. Kotini-Shah explains. “They should by all means [meet] up with their primary care doctors for their routine visits.” Following public health guidelines is a must during this time, but it’s equally important to seek the long-term care you need.