As the number of coronavirus cases in our area multiply daily, health officials have urged anyone experiencing symptoms of the virus—fever, cough, and shortness of breath—to immediately contact their doctor. But what if you have other symptoms, suffer a minor injury, or just need a checkup? Will you still be seen by a physician?
For many patients in and around Charlottesville, the answer is yes—but not in an office. To prevent the spread of COVID-19, many local practices have moved their appointments online, only seeing patients in person when necessary.
Since last month, Albemarle Center for Family Medicine has allowed both new and old patients with non-urgent issues to schedule virtual appointments. Though its staff was apprehensive at first, the appointments have “been going really great,” says office coordinator Stephanie Hall.
After patients schedule an appointment, they receive a text message and an email with a link, which lets them know what their insurance will cover and allows them to pay their co-pay in advance, Hall explains. (Those without insurance pay an out-of-pocket fee of $75.)
At the time of the virtual visit, the provider’s nurse calls first to do an intake. “We check your meds, we check your allergies, we make sure you’re at home,” Hall says. Once the patient is ready, the provider, who is in a private setting at home or at the office, logs in. “It’s almost like FaceTime.”
After discussing patients’ issues, the doctor or nurse practitioner may use the patients’ cameras to perform a limited physical exam, and have them take their own vital signs, if possible, as well as go over their medical history and other important information before giving a recommendation. And like a regular doctor’s visit, all information is documented and confidential.
After the appointment, “we can send in prescriptions if needed, we can order labs and X-rays if needed…[and] we can have them call us back to make a follow-up appointment in the office,” says nurse practitioner Catherine Easter of Charlottesville Gastroenterology Associates, which started using telemedicine with established patients last month.
For other practices around town, telemedicine is nothing new. Since opening in September, Charlottesville Direct Primary Care has allowed its patients to schedule virtual appointments through an app.
“When you join [our practice], you get a prompt on your phone to download the Spruce app,” says co-founder Dr. Lindsey Neal. “So a telemedicine visit for us is literally like press a button, and there we are on the screen.”
Yet despite its conveniences, telemedicine comes with its own challenges, specifically for those without adequate internet or cell phone service.
“Most of the issues that we’ve had have been technical difficulties, because of all the traffic on the internet, particularly during the day,” says Easter. “But it has been very limited as far as problems go.”
Telemedicine can also be challenging for those who are not tech savvy, particularly elderly patients, Hall points out. They may need help from the doctor’s office or a family member in order to set up the video call. And if all else fails, the appointment may need to be done over a regular phone call, or in person.
Connecting with a patient through a screen can be difficult as well, explains Neal.
“There’s a lot of information that a physician can get just from seeing someone” through a video call, she says. “[But] there’s some beauty in the unspoken information that comes from being in the room with someone…We’re also trained to do physical exams. So it’s really hard to make a diagnosis on someone without that added additional information.”
For Hawkins Dale, a patient at Sentara Family Medicine, telemedicine “worked just fine.”
“There was some confusion on their part about the technical requirements,” he says. “But it turned out it was just a regular old Zoom meeting!”
Because Dale’s appointment was for a six-month checkup, he had set it up in advance, and did not have to go through the scheduling process. At the time of his appointment, a nurse connected with him over Zoom, and “took the basic facts,” such as his weight. Afterwards, Dale discussed his health with his doctor, who simply encouraged him to “drink less beer and get more exercise, as she would have done in person,” he says.
With the ease and convenience of his first virtual appointment, Dale plans to continue to use telemedicine for his medical needs.
“Lots of medicine can be delivered remotely,” he says. “Even without the plague, I would much rather do this from my office, rather than having to go to the doctor’s office.”
Dale is one of many patients who have been pleased with their virtual visits, all three medical professionals say.
“[Our patients] are really grateful to know that we’re here for them, but they don’t have to leave their homes to get the help they need for their issues,” says Neal. “They also text message me a lot…[and] are just hungry for reassurance.”
At Albemarle Center for Family Medicine, patients have also given a lot of positive feedback, and are glad to receive treatment without having to potentially expose themselves or others to the virus, says Hall.
“In general, it has been a great avenue for us to be able to reach some of our patients that we would not have been able to otherwise,” adds Easter. “I hope that patients will continue, even after the COVID crisis, to use this platform.”
Correction 4/16: Stephanie Hall is the office coordinator for Albemarle Center for Family Medicine, not Family Medicine of Albemarle.