Fewer Hospital Admissions For  Common Health Issues 

During the last three months, hospitals have seen a dramatic decline in the number of admissions for such conditions such as heart attacks, strokes, gastrointestinal bleeding, diverticulitis, surgical emergencies such as appendicitis and other infections? Why? Does this mean that the incidence of these conditions actually declined during this time period or is there another reason? With all the stress related to COVID, social distancing and quarantine, it seems unlikely that the incidence of these conditions decreased. It seems more likely that people ignored symptoms because they were scared to go to a hospital emergency department. This may be substantiated by the documented uptick in home deaths. 

So how do we move forward and get people back to thinking about their health? 

There is no doubt that the delivery of medical care will be permanently changed from what it was just a few short months ago. Patients should be prepared for a different type of medical visit. Telehealth will play a big role in this transformation. Telehealth allows for a patient-provider visit through technology without coming to an office. It allows for questions and answers and discussion, but it does not permit a physical examination, a key component of medical care. While certain types of visits lend themselves to telehealth, many do not and patients will still need to come to a medical office for an evaluation. For example, how is the eye doctor going to look in the patient’s eyes without the use of all the current sophisticated equipment or how is a gastroenterologist or cardiologist assess a simple complaint without listening to the heart or examining the abdomen?

Office visits, therefore, will still be required. I can tell you that the flow of the visit will be different from what was done before. Certainly, a waiting room filled with patients and their families is not ideal. There will be no magazines or brochures to read. Likely, patients will wait in their cars and be called or sent a text when an exam room is ready. Accompanying persons will be discouraged or not allowed unless they serve a vital purpose. Masks may be required for patients and personal protective equipment (PPE) will absolutely be required for health care workers. Plexiglass will play a prominent role in offices. Offices will move to become paperless with paper forms being replaced by online forms. Cash will no longer be collected. Yes, cash is a significant vector for viral infections. Exam rooms will need to be sanitized between patients. Patients requiring elective procedures will need to be tested for COVID.

These measures will make offices and hospitals safe for patients and staff. It is critical that patients understand and believe that they will be coming to safe environments for their care. Many people have neglected their health due to concerns about COVID. While reasonable for a time, it is now time to get back taking care of oneself before neglect leads to complications. The medical community is committed to providing safe places to obtain care. COVID or no COVID, people still need medical care and the health care providers in our communities are ready and able to provide this. 

David Bernstein
David Bernstein, MD, is a columnist for Long Island Weekly and chief of gastroenterology, hepatology and nutrition at North Shore University Hospital and Long Island Jewish Medical Center.

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