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March 25, 2020

Desperate patients are turning to endocrinologists, dermatologists—and even dentists—for COVID-19 help

Daily Briefing

    Health care providers across the country are being inundated with patient questions about the new coronavirus—but not every provider is trained to handle respiratory infections, and some are struggling to answer patients' questions and calm rising anxieties, Emma Goldberg reports for the New York Times.

    How hospitals are communicating with patients and the community about COVID-19

    Patients seek COVID-19 advice from specialists who lack training in respiratory issues

    Specialists in cardiovascular health, lung care, and obstetrics undergo training that's "highly pertinent to treating the effects of" COVID-19, the disease caused by the coronavirus, Goldberg writes. But these specialists aren't the only ones getting questions from nervous patients.

    Megan Ranney, an emergency physician in Rhode Island, said, "We're hearing a lot of anxieties from specialists who don't know what the right thing to do is for their patients," Ranney said. "Dermatologists, ophthalmologists, we're even hearing from dentists."

    Scott Isaacs, an endocrinologist with 20-plus years of experience, specializes in the care of diabetics, but in the last few weeks, "his phone has been ringing off the hook" with questions about COVID-19, Goldberg writes. Patients have been asking him how to get tested for COVID-19, whether they can stockpile medication, and if he can write letters to their employers to help them get permission to work from home. Diabetics are considered a high-risk group for coronavirus.

    Still, given how new the virus is, Isaacs can't rely on the level of medical expertise he's used to using, Golberg reports. When a pregnant patient who's a nurse asked him if she needed to stay home for her job, Isaacs wasn't sure. Isaacs told the patient, "I really don't have an answer to that."

    According to Goldberg, Isaacs' experience is "shared by many medical specialists who may serve as the primary physicians of patients with particular medical needs."

    Rajeev Jain, a gastroenterologist, has cancelled all non-urgent appointments and is spending a large amount of his time answering calls from patients asking if they should stop taking their immunosuppressive drugs to decrease their risk of getting the new coronavirus. Jain has told them to continue their regular treatment, on the advice of American gastroenterological associations.

    Jain said he's worried his patients could contract other illnesses if they stop taking their medications and end up in the hospital. "That's where a large reservoir of COVID-19 is at the moment," he said. "That's the last thing I want to do."

    Psychiatrists are another group of specialists who are facing coronavirus questions that go beyond the scope of their training, Goldberg reports. Gauri Khurana, who mostly works with college students, said many of his patients are asking whether they could have the virus.

    "I don't think a lot of them have primary care doctors and at this point everyone is terrified, wondering what's going to happen," Khurana said. "I have patients that want to drop out of school, move to Canada. They're grateful for any advice, especially coming from a doctor because there's so much misinformation."

    What specialists are telling their patients

    In terms of what COVID-19-specific information specialists can give their patients, specialists who treat high-risk patients have been told to advise their patients to stay out of the doctor's office and stay safe, Goldberg reports. Both the U.S. Surgeon General and the American College of Surgeons have advised elective procedures be cancelled, while some states have required elective surgeries be postponed. 

    To help its physician members, American Medical Association (AMA), has developed an online resource center and physician's guide for COVID-19, according to AMA President Patrice Harris. Other medical associations said they're working to distribute COVID-19-related resources to their members, Goldberg reports (Goldberg, New York Times, 3/23).

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