COVID-19: Pandemic pushes medical community in new directions
Courtesy of Summit Medical Group
by Andrew Garda
Whether a patient needs mental-health care, physical therapy, an eye exam or a general wellness checkup, doctors and their staffs have had to change the way they deliver that care during the COVID-19 pandemic.
Patients who have medical needs but are hesitant to venture into medical facilities still need to be seen, something medical professionals have been doing with the aid of things like video platforms that allow them to connect virtually.
Dr. Jack Cappitelli, internal medicine physician and regional medical director of Summit Medical Group for Bergen and Passaic counties, said the group’s hundreds of primary care and specialists can do almost 3,000 virtual calls a day.
“It helped to keep people out of the emergency room, kept people out of urgent-care facilities and kept people calm,” Cappitelli said.
Summit Medical Group is a physician-owned, for-profit, multispecialty medical practice headquartered in Berkeley Heights. They offer 80 plus locations in New Jersey, with multiple offices in Montclair. But Summit has been able to help beyond Montclair and New Jersey, and in return has been able to receive help from out of state as well.
In August 2019, Summit Medical merged with a New York-based urgent care provider called CityMD. When that portion of the organization was overwhelmed by a massive number of COVID-19 patients, in addition to its normal clients, Summit was able to step in and help.
“They had a virtual platform that they were getting inundated [on] and they needed help,” Cappitelli said. “So, when we closed some of our offices during the pandemic, we used our Summit primary care providers to actually provide services to patients going on a virtual platform in New York City and Long Island.”
Governors of many states have eased restrictions on practicing from out of state, to allow help to come virtually.
“So we were helping areas like Elmhurst in Queens and some of the areas of the Bronx that you’ve been reading about that have been devastated by coronavirus,” Cappitelli said.
Summit also has medical centers in Oregon, and was able to provide virtual help there as well. Those providers, in turn, helped patients in New Jersey.
“We use providers from Oregon to provide the nighttime coverage needed [in New Jersey],” Cappitelli said.
So far there is no one way Summit has handled care for its patients, and the group is still working every day to hone what works and what doesn’t. They don’t have one way to reach their patients; they have three, four, or five. That will change, according to Cappitelli, but not quickly or soon, and will vary based on the needs of a discipline.
“It’s very specialty-derived,” he said. “So we’re going to look into each and every specialty in terms of what their experience has been. You know, there are some specialties that have flourished, and we think [remote medicine] is going to be a huge part of the business.”
One example of a practice that has adapted to the times is the optometry practice of Dr. Frank Barnes Jr. and Dr. Tanya Carter in Montclair’s South End.
Barnes and Carter have used Doxy.Me to work with their patients, as well as Zoom or Facetime on occasion.
“So we can see them virtually, see what’s going on,” Barnes said. “We can communicate with them and have a face-to-face conversation that’s live [versus] talking on the phone and not really seeing them, now we’re able to explain and show things. So, that’s been helpful, we’re going to continue that.”
Barnes said virtual visits have been especially helpful with elderly patients who may be concerned about traveling to the office, and might even struggle to do so even without the current pandemic.
“We’ve had some people who just couldn’t get out,” he said. “Some of my patients aren’t very close, from New Brunswick and further, like New York, stuff like that. So, you know, it’s harder for them to get to me.”
And of course there are patients who are sick, either with COVID-19 symptoms or just in general. While the office is following guidelines from the Centers for Disease Control, including the staff wearing masks, disinfecting surfaces after every patient, and limiting the number of people in the office, it is sometimes best for patients not to come into the office at all.
Both Barnes and Cappitelli said that there are just some things that have to be done in person.
“After two, three months of this going on, you need to have your procedures done,” Cappitelli said.
One of the biggest ongoing challenges hasn’t been the technology, but making sure patients continue to take care of their health in basic ways, such as having wellness visits. And there are simply things they cannot do even with today’s technology.
“You need to have your mammograms done. People have thyroid lesions. They have nodules on their chest. They have skin lesions that they’ve delayed treating,” Cappitelli said. “It’s essential that they come in.”
According to research from the Epic Health Research Network — a research platform run by the Epic Systems Software company — they aren’t coming in. A recent report by EHR found that there has been a huge drop — between 86 and 94 percent — in preventative cancer screenings across the United States.
“We’re missing a lot of cancers because people just aren’t coming in for routine screening,” Cappitelli said.
Aside from screenings, things like colonoscopies or managing heart or blood pressure issues need to be done in a doctor’s office. There’s only so much a doctor can do remotely.
That’s why Summit and networks like it are urging their patients to make sure they take care of themselves, and if that means coming in, the medical staff will do what they can to ease a patient’s anxiety, because long term it can have a huge impact.
“We’re open,” Cappitelli continued. “We’re safe. We can take care of everybody’s issues, but until people feel comfortable with going outside of their house, it’s going to limit what we can do, and it’s going to impact our care.”
Looking forward, both Barnes and the Summit Medical Group are searching for ways to continue utilizing the new technology when things return to normal.
While some services will always remain largely in person, others, such as some physical therapy or mental health services, can leverage remote technology very effectively.
“The virtual business will stay there,” Cappitelli said. “I think there’s a great need for virtual visits, and we’re trying to figure it out.”