Cover Story
by Casey L. Penn
COVID-19 Alters Practice Patterns:
Physicians and Clinics Adapt
In the July Journal, we shared what some
Arkansas physicians and clinics had experienced
since the threat of coronavirus first
emerged in our state and nation. As many
people went into isolation mode in response to
COVID-19, health care workers continued – as
much as allowed and possible – working on the
front lines.
After a pandemic was declared, some clinics
had to close their doors for a time while others
worked overtime to keep up with increased demand
for patient care. Some struggled to implement
telemedicine for the first time while others
built on established telehealth systems. Circumstances
were as diverse as health care specialties;
however, in all cases, concern was high as physicians
and staff first faced the new and novel virus
and took immediate steps to protect patients
and themselves at a time of elevated risk, lack of
supplies, and many unknowns.
After an initial period of near shut-down,
Arkansas, led by Gov. Asa Hutchinson, began
following White House phase guidelines (see
https://www.whitehouse.gov/openingamerica).
On June 15, 2020, Arkansas entered phase two,
and as the state began to lift some restrictions
while encouraging others, the state’s physicians
and clinics were affected by rules and regulations
on telemedicine, elective procedures, testing
strategies, and more.
As the pandemic continues, so have the
experiences of our members. This month, we
turned to clinics from around the state for a status
check on things like patient response and patient
load, personal protective equipment, telemedicine,
testing, and other continuing concerns
and challenges.
Pandemic-Era Patient Volume
Obstetrician and past AMS President Amy
Cahill, MD, summed up what she has experienced
in relation to patient load since the pandemic
began. “Initially, everything was cut back, but
my volume is back up to where it was,” she said.
“That said, obstetrics is a little different; when orthopedic
surgeons had to stop doing total knees,
we were still doing most of our ‘elective’ surgeries
like hysterectomies. For the most part, when
people need OB care, they can’t put it off until a
pandemic is over.
“I feel like we’re starting to see our referrals
pick back up from family doctors – those lagged
for a bit. It may be that some of this volume is
catching up from what we missed. No mammograms
were done from mid-March to the last
week of May. All those people are now re-entering
the system.”
AMY CAHILL, md
patrick mcgowan, md
photo Courtesy of GastroArkansas.
Patients’ perspectives are perhaps the biggest
change between March and July, she indicated,
“It isn’t that COVID-19 cases are down, but
people are learning to protect themselves and
aren’t as afraid to enter the system.”
Patrick McGowan, MD, practices along
with three physicians at MANA Family Medicine
Springdale. In discussing the change from phase
to phase and patient load specifically, he said,
“As it did for many others, the COVID-19 pandemic
brought a lot of uncertainty to our practice. Our
goal from the onset has been to continue to provide
care to our patients, regardless of their need.
“The phases have not necessarily affected
the way we have practiced. As MANA clinics are
physician-owned, we have had a lot of autonomy
on how our practice has functioned through
this time. Luckily, we have run at full capacity
throughout the pandemic. I think that speaks to
our ability and willingness to adapt as our patients’
needs change. We keep our well and sick
patients distanced from each other, ensuring
their safety. We are also taking measures, as we
have since the start of the pandemic, to keep
our staff safe through usage of masks, telephone
triage, placement of permanent glass barriers,
proper use of PPE, and other means.”
54 • The Journal of the Arkansas Medical Society www.ArkMed.org