Should I Schedule an Online or In-Office Visit With My ENT/Allergist?

Should I Schedule an Online or In-Office Visit With My ENT/Allergist?

June 16, 2020

Doctors weigh in on what you need to know

 

As our healthcare system has been overwhelmed by COVID-19 cases, many patients have postponed non-critical treatments, surgeries, or routine appointments.[1] These patients are scared to leave their homes, and so overwhelmed by COVID-19’s impact on their everyday lives that they risk not seeking proper treatment for chronic conditions.

Dr. Maeve O’Connor, MD, founder and physician at Allergy Asthma and Immunology Relief of Charlotte, North Carolina, says, “Some of my patients with chronic allergy symptoms are uncertain about whether or not it’s safe to come into the office, so they delay making appointments.

I encourage patients who suffer from allergies and sinus pain to seek proper care, regardless of whether they have a chronic, recurrent, or acute condition – and there are ways that they can feel comfortable doing so, without leaving home, such as scheduling an online/telehealth appointment.”

Telehealth has become much more integrated into medical care today, and has vastly changed the doctor-patient relationship. Since the COVID-19 crisis began, Dr. O’Connor has seen an increase of up to 50% more telehealth appointments in her practice.

While a large part of allergy and ENT practice involves physical diagnosis – from performing laryngoscopies, biopsies, or immunotherapy (allergy shots), to therapeutic “interventions” like ear cleanings – some common conditions like acute sinusitis can also be diagnosed by symptoms, using telehealth, to start.

For patients who want to be seen, Dr. Mark Mehle, MD, an ENT-Otolaryngologist in Cleveland, Ohio, first offers telehealth appointments to review their symptoms, then makes recommendations based on those symptoms. When feasible, treatments are made with over-the-counter antihistamines, nasal steroids, or by prescription. If a patient has symptoms that cannot be treated remotely, they are advised to book an in-office visit. For example, someone experiencing hearing loss would need to schedule an in-person hearing test or other diagnostics to see what’s blocking the ear canal.

Now that telehealth is covered by Medicare and reimbursed at the same level as in-office visits, physicians encourage patients to use it for initial evaluations and routine care.[2] 

Dr. Alan Goldsobel, an allergist and immunology specialist based in San Jose, California, pre-screens his patients at the time that the appointment is booked. “We screen patients for COVID-19 symptoms including cough, shortness of breath, fever, muscle pain, new loss of taste or smell within 14 days. Patients who fail the screening are considered for more detailed screening or evaluated via telehealth.

When they do come into the office, we take their temperature again. We screen patients extensively, and our staff is tested for symptoms regularly – we just keep refining the process.”

As some states cautiously reopen this month, physicians like Dr. O’Connor are advising patients to strictly follow their state government’s guidelines and not bend the rules. “Patients should not be afraid to seek the proper care they need – which includes reaching out for help if they are feeling isolated or anxious. Most insurance providers cover mental health services now.”[3]

Patients who are concerned about risking infection from an office visit should check with their doctor’s office for safety measures and guidelines. Many healthcare practitioners like Dr. O’Connor, Dr. Mehle, and Dr. Goldsobel are now implementing guidelines from these organizations to ensure that their staff and patients stay safe:

For more on this topic, check out our recently published blog on how ENTs and allergists keep their offices safe.

 

[1] Salesforce, “How Pack Health Scales Fast to Help High-Risk Populations,” 4/24/20, https://www.salesforce.com/blog/2020/04/pack-health-scales-fast-with-health-cloud.html?eid=ss-hls-blog&nc=7010M000000ZX2UQAW&d=7010M000000uW0VQAU

[2] Centers for Medicare & Medicaid Services, “Medicare Telemedicine Health Care Provider Fact Sheet”, 3/17/20, https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

[3] American Psychological Association, Does Your Insurance Cover Mental Health Services?, https://www.apa.org/helpcenter/parity-guide

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