Podcast: Getting Medical Care in 2020 during COVID-19
Show-Notes from our fourth podcast:
Getting Medical Care in 2020 during COVID-19, from our new series “Coronavirus: Science and Prevention”
Watch the episode on YouTube and
subscribe to our podcast series on iTunes, Google Podcasts, and Spotify.
Social isolation is great for home, but how do we continue to get medical care as patients and provide medical care as physicians and not fall victim to COVID-19?
The way medicine is practiced has changed radically in the last 6 weeks.
- Visits have shifted towards telemedicine
- Standards of surgical and procedural medicine continue to change
How has our practice, which handles skin cancer treatment and dermatology changed since the start of COVID-19?
Medicare and PPO have relaxed requirements for using and reimbursing telemedicine visits
- Platforms include, but are not limited to, Doxy, Dermio, and Zoom.
How Do We Use Telemedicine?
Cons
- Use of technology can be difficult for elderly patients.
- Lack of ability to do an excellent physical exam
- The video image quality and patient ability
- Store & Forward: patients send photos prior to meeting for physician to review before telemedicine visit
Pros
- Convience for patients
- Safety of Social Distancing
- Patients in outlying areas can be seen by a specialist more easily
- Initial consultations completed through telelmedicine
Adaptations with In-Person Visits
Biopsies, excisions, Mohs surgery, and reconstruction visits can be made shorter through an initial telemedicine consultation. This thereby decreases exposure time of patients, staff, and physicians.
Q&A with SCARS Center Dermatologist, Dr. Mark Juhl
Q) What if a patient is certain about a suspicious lesion? Could you schedule Mohs without having done a biopsy?
A) Traditionally, we would biopsy during the evaluation visit. With the current circumstances, what we can do is take a frozen section of visible tumor the day of your planned Mohs surgery, process it quickly and look at it under the microscope and make the diagnosis prior to beginning Mohs surgery.
Q) Some patients are nervous about coming into doctors offices for treatment. Could you talk about topical treatment for skin cancers?
A) This can be used for superficial skin cancers. When it only invades the topical surface (epidermis), topical chemotherapy creams can be used to treat it for several months and delay an in person visit.
Q) Which treatments can be done entirely through telehealth?
A) The common ones are acne and psorasis. Acne is very common and you don’t need lab work done for diagnosis, as well as psorasis. These can both be easily treated through telederm as long as you aren’t prescribing the more intensive medication like acutane for acne or injections for psorasis.
Q) Which skin lesions can you identify through telehealth?
A) You can diagnose many benign lesions without having to come into the office.
Our prediction? Telemedicine is here to stay.
What We are Doing at SCARS Center
We have drastically reduced the number of in-person visits to our clinic and surgery center and are taking extreme precautions with anyone entering our facility.
All persons entering the clinic, including staff and physicians, are screened for the symptoms of COVID 19. Their temperature is taken and they are asked to sanitize their hands.
All staff are required to wear a mask, which is provided to them. Additionally, all patients are given a mask that they must wear.
Only the patients are allowed in exam rooms so as to maintain as much social distance as possible.
We Fight the Virus on Two Fronts
1.) Fomites
2.) Aerosolization
- Viruses can aerosolize and become airborne in the plume smoke during electrocautery, which is used to control bleeding during a procedure.
- All staff present in the procedure must wear an N-95 mask
- Eyes must be fully enclosed (CAPR alternative -controlled air purifying respir)
- At SCARS Center, we have implemented two air suctioning devices to collect the smoke plumes during this process.
In the surgery center more extreme precautions are being taken.
- All patients with higher risk surgery are tested for COVID with a NP swab. If the test is negative, their treatment is done 4 days after. The patient signs an isolation contract to stay at home until the day of their procedure.
- They are isolated in the same room for the duration of their procedure. A designated care team is assigned to that patient and only they can enter the room.
- Specialized draping is now being used that will isolate the mucous membranes, and airway.
- The surgery center has better ventilation and a higher standard of precautions.
Cases We Cannot Do:
We are not performing any cosmetic procedures. Once there is a two week period of decreasing cases per day, then Phase 1 to recovery guildelines can be instituted.
I don’t think the title of your article matches the content lol. Just kidding, mainly because I had some doubts after reading the article.
mexico pharmacies prescription drugs: cmqpharma.com – mexican pharmacy
mexican drugstore online
http://cmqpharma.com/# п»їbest mexican online pharmacies
mexican mail order pharmacies
buying prescription drugs in mexico online
https://cmqpharma.online/# mexico pharmacies prescription drugs
medicine in mexico pharmacies
india pharmacy mail order: top 10 online pharmacy in india – pharmacy website india
http://foruspharma.com/# mexican pharmacy
canadian drugs online my canadian pharmacy safe online pharmacies in canada
https://indiapharmast.com/# Online medicine home delivery
pharmacy website india: indianpharmacy com – indian pharmacy paypal
safe canadian pharmacy: canadian pharmacy uk delivery – onlinepharmaciescanada com
http://indiapharmast.com/# india pharmacy mail order
Online medicine home delivery best online pharmacy india top 10 pharmacies in india
canada drug pharmacy pharmacy canadian canadian online pharmacy
medication from mexico pharmacy: mexican rx online – buying prescription drugs in mexico
canada pharmacy online: legitimate canadian pharmacy – legit canadian pharmacy
http://foruspharma.com/# pharmacies in mexico that ship to usa
Online medicine home delivery cheapest online pharmacy india buy medicines online in india
mexican border pharmacies shipping to usa: reputable mexican pharmacies online – mexican rx online
world pharmacy india: best online pharmacy india – best india pharmacy
mexican drugstore online: mexico pharmacies prescription drugs – mexico drug stores pharmacies
http://indiapharmast.com/# п»їlegitimate online pharmacies india
india pharmacy mail order indian pharmacies safe india online pharmacy
mexican pharmacy: mexican pharmaceuticals online – reputable mexican pharmacies online
https://canadapharmast.online/# canadapharmacyonline legit
buy medicines online in india reputable indian pharmacies pharmacy website india
buy medicines online in india: best online pharmacy india – buy prescription drugs from india
mexican pharmacy: reputable mexican pharmacies online – reputable mexican pharmacies online
https://canadapharmast.com/# my canadian pharmacy reviews
mexican pharmacy mexican online pharmacies prescription drugs buying from online mexican pharmacy
mexico drug stores pharmacies: mexico drug stores pharmacies – medicine in mexico pharmacies
https://doxycyclinedelivery.pro/# doxycycline tablets online
doxycycline usa pharmacy doxycline best price for prescription doxycycline
can i order clomid pills: cheap clomid price – order generic clomid pills
https://ciprodelivery.pro/# buy ciprofloxacin over the counter
where can i buy amoxicillin over the counter where can you get amoxicillin amoxicillin without a prescription
buy paxlovid online: Paxlovid buy online – paxlovid pharmacy
https://ciprodelivery.pro/# buy cipro online canada
paxlovid for sale: paxlovid pill – paxlovid india
http://amoxildelivery.pro/# amoxicillin 500 mg
http://doxycyclinedelivery.pro/# buy doxycycline 100mg online india
doxycycline online with no prescription where to buy doxycycline in singapore cheap doxycycline tablets
amoxicillin 500 coupon: amoxicillin no prescription – rexall pharmacy amoxicillin 500mg
https://amoxildelivery.pro/# can you purchase amoxicillin online
doxycycline cap 40mg doxycycline 250 mg doxycycline order
https://amoxildelivery.pro/# amoxicillin 500 mg for sale
can i order generic clomid: can i order generic clomid without dr prescription – how to get clomid no prescription
https://ciprodelivery.pro/# ciprofloxacin over the counter
where to get doxycycline in singapore: doxycycline tablets online – doxycycline costs uk
http://amoxildelivery.pro/# can you buy amoxicillin over the counter
ciprofloxacin order online ciprofloxacin over the counter cipro online no prescription in the usa
http://paxloviddelivery.pro/# buy paxlovid online
get clomid online: where buy clomid no prescription – can you buy generic clomid without insurance
http://doxycyclinedelivery.pro/# how much is doxycycline in south africa
purchase amoxicillin 500 mg how to buy amoxicillin online can you purchase amoxicillin online
where can i buy generic clomid without a prescription: can i purchase clomid without prescription – can i get generic clomid without a prescription
http://doxycyclinedelivery.pro/# doxycycline capsules purchase
http://clomiddelivery.pro/# buy clomid tablets
п»їpaxlovid paxlovid buy paxlovid covid
http://ciprodelivery.pro/# antibiotics cipro
doxycycline uk cost: doxycycline price compare – doxycycline hyclate
order amoxicillin online: amoxicillin generic – amoxicillin 750 mg price
http://amoxildelivery.pro/# where can you buy amoxicillin over the counter
how can i get doxycycline over the counter doxcyclene order doxycycline 100mg without prescription
buying cheap clomid: how can i get generic clomid without dr prescription – can i purchase cheap clomid without insurance
https://paxloviddelivery.pro/# paxlovid cost without insurance
http://ciprodelivery.pro/# cipro ciprofloxacin
ciprofloxacin mail online п»їcipro generic buy cipro online without prescription
https://paxloviddelivery.pro/# paxlovid for sale
doxycycline online pharmacy canada: doxycycline 100mg acne – doxycycline cost in mexico
https://paxloviddelivery.pro/# Paxlovid over the counter
can i get generic clomid without insurance can i order generic clomid now where can i buy cheap clomid without insurance
can you buy doxycycline over the counter uk: doxycycline generic brand – buy doxycycline no prescription
http://amoxildelivery.pro/# where to get amoxicillin over the counter
can i get cheap clomid without prescription: cost of clomid now – can i purchase generic clomid pill
https://ciprodelivery.pro/# ciprofloxacin 500 mg tablet price
http://ciprodelivery.pro/# buy cipro cheap
doxycycline nz cost online doxycycline buy vibramycin
https://ciprodelivery.pro/# ciprofloxacin over the counter
doxycycline online paypal: buy doxycycline without prescription – doxycycline canada price
http://ciprodelivery.pro/# ciprofloxacin 500 mg tablet price
how to get cheap clomid pills: how can i get generic clomid price – buy cheap clomid no prescription
https://doxycyclinedelivery.pro/# buy doxycycline for dogs
paxlovid india paxlovid for sale Paxlovid buy online
Thank you for your sharing. I am worried that I lack creative ideas. It is your article that makes me full of hope. Thank you. But, I have a question, can you help me?
buy cipro: ciprofloxacin – ciprofloxacin order online
http://paxloviddelivery.pro/# paxlovid covid
https://amoxildelivery.pro/# order amoxicillin online uk
https://doxycyclinedelivery.pro/# doxycycline 100mg lowest price
doxycycline 100mg capsules cost purchase doxycycline online uk 22 doxycycline
where to buy generic clomid pill: how to get generic clomid pill – cost of generic clomid pill
buy cipro online: cipro 500mg best prices – buy ciprofloxacin over the counter
Thanks for sharing. I read many of your blog posts, cool, your blog is very good.