OK, to call these recent events “unprecedented” is just obvious. I have been in practice for 35 years and have never seen anything remotely like this. My job as a pediatrician has 2 basic roles:
- Well care–providing immunizations and expectant evaluations like measuring growth for early identification to prevent problems; as well as discussion and “anticipatory guidance” to preview and prepare young families for what comes next in a child’s life.
- Diagnose and treat illness and disease–everything from colds, injuries, rashes, to mental health problems.
And here we are now facing a worldwide health risk phenomenon. I will not address how or why we got to this point. We are here now and have to deal with it. That requires some modification in office procedure and practice style. Most of the functions above will continue apace–well check ups and the large majority of acute complaints can be addressed as they always have been. However, it is obvious that a large percentage of appointments are for cough/fever/ache type illnesses–the very symptoms of COV-19, the “corona” virus. So my office will have to make these adjustments:
- We suggest that most children with cough/fever simply stay home, rest, manage symptoms for comfort. As we all know, most of these sicknesses are caused by viruses (corona included), are “self limited” and will pass on their own. No specific treatment is necessary or, in fact, useful to shorten the course. Supportive care is all that we need or have.
- As always, I encourage my patients to call me for advise. During this situation I will essentially be screening all sick appointments personally. I will help my staff and parents to decide the best approach for each child’s problem on a case by case basis. Absent fever some can be scheduled in the office. Likely we will ask you to notify us of your arrival, wait in your car and our staff will call your cell to bring you up so you can then be promptly ushered into an exam room.
- Along the above, we are going to limit appointment scheduling, seeing fewer patients per hour. Our goal is to limit any waiting room time as much as possible. You arrive and go right into a room. If feasible check in may take place while you sit in the exam room. Limit exposure for everyone as much as possible.
- I urge you not to rush to the ER or urgent care center. Great way to expose your family to all kinds of nasty critters(we’re talking pathogens here, not other patients!) I will try and help you decide if you need to go, and will call ahead for you–again. minimize wait time and exposure where possible.
- In the coming days Coastal Healthcare will have telemedicine capability. Let me state up front: I am old school. Treating over the phone or video is, at best, suboptimal. However, under the present circumstances we simply have to make the best of it. So, again on a case by case basis, and with parents’ agreement, I may opt to treat/prescribe for your child using those electronic encounters only.
Keep in mind: our goal is to help to stop the spread of this dangerous infection. But the good news is evidence from around the world indicates that the vast majority of children are spared serious complications from COV-19. Unlike the flu, corona causes serious problems mostly for older people.
I appreciate everyone’s patience while we make these (presumably) temporary adjustments. Nothing is forever. George Harrison–typically–sang it so wisely and beautifully:
Be safe, friends.