I’m a primary care doctor, and, in normal times, my favorite part of the job is getting to see my patients regularly. But because of the ongoing COVID-19 pandemic, I’ve had to substantially cut down on in-person visits to help put the brakes on the spread of the coronavirus.
In this time of high medical anxiety, the phones at my clinic have, understandably, been ringing off the hook.
In addition to questions about symptoms that might signal COVID-19, my patients still need to know if the pain in their knee after a fall signals a broken bone or torn ligament that requires treatment; whether their child with a fever needs antibiotics; whether that sudden swelling in their ankles is a sign we should change their medication.
For many such cases, I once would have said, “Come on in, and let’s get you checked out.” But now we’re all pivoting to e-mail, phone calls, and video chats.
Here are some tips to help you know when to call your doctor and how to get the most out of your virtual visit:
If you don’t have a doctor yet, get one. Because of the pandemic, many primary care providers are allowing new patients to establish care via a telemedicine appointment. (Previously, many practices would only return the calls of patients who had already been seen in person at some point.) Your new doctor will probably ask you to come in for an in-person visit when it becomes safe to do so.
Many urgent care centers and walk-in clinics are also offering telemedicine visits; you can call or check out their website to set up an appointment.
Emergencies are still emergencies. Some of the same rules from pre-pandemic days apply: Sudden chest pain, weakness in one side of the face or body, or a sudden thunder-clap headache are all red-alert symptoms that could signal a heart attack or stroke. The same goes for serious difficulty breathing or sudden-onset confusion in a loved one. Call 911 pronto in these cases, to quickly get a trained professional to you who can evaluate you in-person.
Urgent, but not an emergency? Call your primary care provider’s office. Ask yourself if, in pre-pandemic times, these symptoms would have led you to call your doctor in the middle of the night for advice, or at least made you call for a same-day appointment the next morning. Common concerns in this category include high fevers, a new source of pain, or a minor injury. If the answer is yes, or if you aren’t sure, please give your doctor a call right away.
“If you feel as though this is a … situation that can’t wait, that would make you pick up and go to the urgent care or the hospital, you need to be giving me a call,” Dr. Gary LeRoy, an associate professor of family medicine at Wright State University and president of the American Academy of Family Physicians, tells his patients.
Note that you probably won’t immediately reach your primary care provider — most doctors and nurse practitioners work with a team of office staff, including nurses and other clinicians, who can quickly help talk through your issue over the phone and help establish if it’s safe for you to be evaluated via telemedicine.
To get the most out of this triage call, try to summarize what’s going on in one or two sentences. Start with your most urgent symptom first, note how long it’s been going on, and tell that triage clinician what’s changed. For example, you may have experienced headaches for years and find that they usually go away with ibuprofen. But if your headaches have become worse and aren’t responding to your usual medicines, let your team know.
If the triage nurse determines your symptoms sound like an emergency, you might be advised to go to the hospital ER right away. If that’s what they tell you, don’t hesitate — do it. Even during the COVID-19 crisis, the hospital is still the safest place for true emergencies.
Otherwise, if your concern can best be treated via telemedicine, you’ll be scheduled for a phone or video appointment. Whether or not you’ll have a co-pay for that conversation depends on on its length and your health insurance. (To avoid getting unexpected bills, make sure you ask the triage nurse or administrative staff if your call is considered an appointment).
Before the appointment
Prepare for the conversation: Make a list. Even for in-person visits, I always recommend that my patients write down a list of two or three issues they want to address, so they won’t forget anything important. This is especially vital when the visit is via phone or video-chat, where, I’ve noticed, my patients are more likely to lose their train of thought.