Providing the Best Care: Rheumatologists & Professionals Adapt to COVID-19

“We are seeing some patients in the clinic as urgent consults. I’m also hearing from colleagues that many patients cancel their appointments because they’re worried about leaving the house. One question I am getting from patients is, ‘Do you offer telemedicine?’ Yes, we do,” says Dr. Ranganath, who conducted her first telemedicine appointment on March 19.

“It went much better than I thought it would!” she says. “But this is definitely uncharted territory and creates new ways to conduct medical examinations, where you’re more dependent on technology and listening carefully to your patient. In some ways, it may be good for us, but in other ways, it can be scary.” Video chats make it very difficult or impossible to examine patients with oral ulcers or swollen joints, she notes.

Dr. Ranganath worries about the mental health effects of the pandemic and the disruptions it will have on healthcare providers and staff. She’s also concerned about clinical trials, which are now on hold. “How will we bounce back? If staff are at home and unable to recruit patients, how will we continue?”

Dr. Ranganath tries to take a mental health walk around the area every day. “Or I walk around our house,” she says. “I tell the kids, we have to do a certain number of laps around the house. I have three kids at home, and although they’re a little older, they still expect to be fed, even if I’m working and doing conference calls.”

Suleman Bhana, MD, FACR

Family Life
In New York’s Hudson Valley, Suleman Bhana, MD, FACR, a rheumatologist at Crystal Run Healthcare, says it’s not only a challenging time for healthcare providers at work, but the pandemic has also had a significant impact on their families.

“It’s complete societal disruption,” says Dr. Bhana, who works for a large, multi-specialty group that has taken a proactive, organized approach to the crisis. “We have been aggressively screening any person who enters one of our medical buildings, including patients and anyone who accompanies them. We ask them a series of screening questions for COVID-19, including about travel, symptoms they’ve experienced or direct exposure to a person who has tested positive for coronavirus. If they answer yes to any of them, they’re not allowed in the building.”

His practice has switched to telemedicine for follow-up appointments, but still sees patients for other examinations and laboratory tests. Dr. Bhana also says payers are now reimbursing his clinic’s telemedicine appointments at the same level as regular office visits, which was not the case in the past. He is working at his clinic five days a week to conduct both telemedicine and in-person appointments, and most of his staff is still working in the office. However, he’s changed his usual attire.