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'The lights are on': B.C. doctors encourage cautious public to seek medical care when needed
VANCOUVER -- Many patients are hesitating to see their doctor during the COVID-19 pandemic and medical experts are increasingly concerned that could lead to more serious health issues in the coming weeks — even as B.C.’s doctors are ready, willing and able to handle nearly all the medical issues they did before.
Health officials cancelled all non-urgent surgeries weeks ago and physicians’ offices are asking patients to call in advance, but doctors are still seeing patients via video call and in person, both in family practices and at walk-in clinics.
“Our family physicians are still working, many of our specialty colleagues are actually still seeing consults — by and large virtually, initially, and that’s for the safety of the patient as well as the safety of the physician,” said Dr. Kathleen Ross, president of Doctors of BC. “Primary care is the touchstone for people’s healthcare, and we continue to provide that service although without the touch.”
Ross says while video consults are effective in diagnosing a range of issues, she and others are still seeing patients in-person when required. But they’re still seeing such a reduced workload, many family physicians are reaching out to patients with chronic conditions or those who are frail to make sure they’re OK.
“I don’t want people to neglect any of their medical conditions. If you have a concern and you’re not sure if it’s serious or not, absolutely bother your doctor — that’s what they’re there for,” said Ross, who discovered a patient who’d been reluctant to make an appointment had breast cancer.
While routine exams and procedures like pap smears are being delayed, Ross says pediatric vaccines, injuries and infections are all being dealt with on a priority basis. COVID-19 screening and testing is now done at either an off-site location or in a dedicated area of the clinic away from non-COVID cases, while hospitals are still dealing with the most serious and urgent cases.
“The things that need to get done are still getting done,” said Ross. “The lights are on and somebody’s home.”
Chronic conditions must be addressed
One of Ross’s key concerns is shared by one of UBC’s top experts in chronic and complex health issues: delaying medical treatement and care could lead to more common and serious health issues in the weeks and months ahead.
“Anybody whose treatment becomes destabilized is at risk of health problems or health emergencies, and so chronic conditions and the care of people with chronic conditions is very carefully mapped out to keep them stable, to keep them out of hospital,” explained UBC Pharmacists’ Clinic director Barbara Gobis.
She says those with heart conditions, autoimmune conditions, migraines, asthma and other chronic conditions need to be vigilant about continuing their meds and maintaining a relationship with their care providers. Gobis points out those most at risk of life-threatening COVID-19 complications could be those not getting the medical maintenance they need.
“That’s going to have repercussions down the road because when someone’s treatment gets destabilized, and they have to go to hospital or they’re struggling and their fears and worries go up and that aggravates other conditions, so it’s a cascade,” she explained.
BC’s top doctor echoed Gobis’s concerns at the daily public update on COVID-19.
“I encourage you to continue to work with your health care providers to talk to your physician's office your primary care providers office, or if you don't have a primary care provider to talk to, call 811 if you need,” said Dr. Bonnie Henry. “It's OK for each of us to reach out and you can do it safely, you can do it online in many cases and there are many resources and options for care available for people online now through our community physicians our family physicians and community organizations.”
Putting off conditions and issues that can be dealt with now is best from a work-flow perspectve as well, since doctors already expect a flood of people with post-traumatic stress, anxiety and depression as a result of self-isolation.
“We will see the upstream consequences of people who have decided to stay home and drink beer or use other substances until this is over, so I have deep concerns about what are the upstream consequences if we don’t help patients with their problems now,” said Ross. “It’s going to be overwhelming.”
An urgent need that’ll lead to permanent changes
While Canada was slowly adapting to remote health options before, aside from access to services in remote communities, the pandemic has already jump-started virtual healthcare by throwing physicians into the deep end.
“I think the way we practice medicine will be forever changed with this process,” predicted Ross. “Tele-medicine was ramping up but it’s here — and it’s here to stay.”
Gobis’s clinic deals with the most complex medical cases to refine their pharmaceutical treatment, while helping others determine which long-term medications they do and don’t need any longer, and has transferred all their patients to tele-health.
“The feedback we’ve been getting from our really complex patients is they’re so grateful their care has not been interrupted,” said Gobis.
“They can continue to get support in their journey so they don’t become a statistic on top of the other statistics.”