As you might expect, a lot of people have been avoiding the doctor’s office due to fear of being exposed to COVID-19. Some people have even delayed or just done without care for medical problems that are considered urgent or even emergencies. There are some obvious reasons why this might be dangerous but also some reasons that you might not have thought about. Let’s talk about why delaying medical care is not a good idea, and how to see your doctor more safely.
Just how big of a problem is this?
There was a random survey done the last week of June 2020, which showed that approximately 41% of adults in the U.S. had delayed or avoided medical care due to concerns about COVID-19. This included 12% of adults who had avoided urgent or emergency care. I can only imagine how that number has grown in the last 3 months!
These results correlate with hospital reports of lower numbers of hospital admissions and emergency room visits for heart attack and stroke since the start of the pandemic. Heart attacks don’t just stop happening.
Hospitals have also been seeing more patients presenting very late with a ruptured appendix, when they previously might have come to the emergency room sooner, before their appendix ruptured.
Why should you see a doctor?
Many serious medical conditions can be successfully treated if they are treated quickly, but can cause devastating consequences, even death, if treatment is delayed. This includes heart attacks, strokes, diabetic crises, appendicitis, and many others. You have to weigh the risks in this situation. What good is it if you avoid COVID exposure, but die from your heart attack?
What about routine follow up of chronic medical problems?
The people who are at most risk from COVID-19 are also the same people who need more routine care from their doctor. If you have high blood pressure, diabetes, and other risk factors that put you at higher risk for complications from the coronavirus, these risk factors also make it more important for you to maintain your routine care with your primary care physician. Your doctor needs to continue to monitor your blood pressure and blood sugar in order to keep you healthy and decrease your risk for complications from your underlying disease, such as heart attack and stroke.
What about cancer testing or screening?
Cancer screening is designed to find cancer when it is small and curable in patients who have no symptoms. This screening is important to reduce the cancer burden in the U.S. Cancer screening is recommended for breast, colon, cervical, and lung cancers. When the pandemic started, many groups such as cancer societies and medical associations recommended that cancer screenings be delayed. This made sense at the time, to limit exposure of patients to each other in waiting rooms and not to use healthcare resources for cancer screenings.
Now that this pandemic has been going on for more than six months, and is expected to continue for several more months, we need to rethink this idea of delayed screening.
Short-term delays in cancer screening may make sense for patients at average risk for cancer, but not for those patients at higher risk. Patients who are at a higher risk for cancer, based on their family history or genetic factors, should not even have short-term delays in screening. The risk is too high.
Even for those at average risk, we are now past the “short-term” time period. Cancer does not wait for the pandemic to be over. Another concern is that if a person delays cancer screening, they may just forget about it and not get the screening done at all. Screening is important.
Even more important than routine screening is cancer testing if you have concerning symptoms.
If you have discovered a lump in your breast, or have swollen lymph nodes, or other symptoms that might indicate cancer, testing should not be delayed! You should see your doctor right away to have these symptoms evaluated.
If we do not discover cancers while they are small and easily treatable, we will likely have a significant increase over the next year or two in people coming in with late-stage cancer that is both harder to treat and harder to beat.
What can be done to make these visits safer?
The good news is that a lot has already been done! Hospitals and medical offices have changed protocols so that they are more focused on protecting patients from coronavirus. They have implemented physical distancing within the office, and are maintaining strict sanitation procedures.
Many offices are having patients check in by phone and wait in their car rather than the waiting room until their appointment time, when they receive a call or text to come in for the appointment. Some primary care offices are breaking their weekly schedule into “sick” days and “well”; days, so that patients coming in for routine appointments are much less likely to be exposed to any infectious disease.
Many primary care offices are now doing telemedicine appointments for some follow up visits that don’t require a complete exam. You can have your appointment by phone or video call with your doctor, and quite a lot can be done to maintain your health in this way. Check with your family doctor; I’ll bet they are doing telemedicine appointments.
You can also help in this effort by wearing a mask to all appointments, and notifying your doctor’s office in advance or cancelling routine appointments if you have signs of infection.
When measures are in place to reduce exposure to the coronavirus, screenings and routine appointments can be done safely and absolutely should be done.
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Dr. Anita Bennett MD – Health Tip Content Editor