Today, settled into his San Diego-based family medicine practice, Dr. Burgess’ patients face a very different enemy: the COVID-19 pandemic. While keeping them safe is his number one priority, ensuring that they still come in for routine care is a message he finds himself repeating.
“Patients are worried, understandably so,” says Dr. Burgess. “These are times like none other, and I appreciate how vigilant our community is being on staying home and healthy. However, people shouldn’t be afraid to visit their doctor or get the care they need. Hospitals and medical practices are safe, and failing to come in can bring disastrous results.”
Dr. Burgess saw this firsthand, when a new mom missed a series of wellness visits for her newborn daughter. Concerned she would get COVID-19, the mother didn’t make an appointment with Dr. Burgess until her child was 10 months old.
In that time period, six important immunizations weren’t administered, including Hep B (hepatitis B), RV (rotavirus), DTaP (diphtheria, tetanus and pertussis), Hib (Haemophilus influenza type b), PCV13 (pneumococcal conjugate) and IPV (polio).
The child also missed important growth and wellness assessments, such as measuring her head circumference, weight and height, and ensuring she meets healthy developmental markers.
“I didn’t judge her — she clearly was a very loving, concerned mom,” says Dr. Burgess. “She really was doing what she thought was right for her child. But in this case, missing those wellness appointments was more dangerous than bringing the child into our practice.”
Flexibility through a pandemic
In the case of the mother and her baby, Dr. Burgess was able to create an abbreviated wellness schedule that allowed them to catch up on care. Thankfully, since the pandemic kept her family sequestered, the baby had a very low risk of contracting anything covered by the missed immunizations. But the situation prompted Dr. Burgess to work hard to get his message out: get the care you need, when you need it.
A part of his message is that caregivers, like himself, can adapt their care to the limitations created by COVID-19. Some of her visits could have been done virtually, giving Dr. Burgess the opportunity to advise the mother on nursing, the baby’s weight gain or recommendations on supplements, such as vitamin D.
Virtual visits became a lifeline for another patient, who also needed routine baby care around the time of the pandemic. This mother was eager to stay up to date with her son’s checkups and shots, but found herself stuck out of state when COVID-19 made air travel unsafe.
“The family decided to stay put on the East Coast,” says Dr. Burgess. “They were due for their 12-month immunizations, so they called me to find out what they should do. We were able to schedule a virtual visit, and together we came up with a plan to keep the baby’s care on track.”
According to the Advisory Committee on Immunization Practices (ACIP), the 12-month immunizations have a three-month grace period. Dr. Burgess recommended that the family come in before the baby’s 15-month birthday — and if they were still out of state, make arrangements with a local health agency to ensure the baby was immunized.
Virtual visits came in handy shortly after, when the parents noticed a rash on the baby’s chest. “Since the baby was due for his chickenpox shot, the parents were rightfully worried that he had contracted it,” says Dr. Burgess. “We talked through his symptoms, and they sent me pictures — and I was able to diagnose him with a benign virus that causes a rash. Thanks to technology, they were able to get the peace of mind they needed, from 3,000 miles away.”
In-person visits, safe from COVID-19
Virtual visits aren’t the only way that Dr. Burgess and doctors across Sharp HealthCare are working hard to keep patients safe. When in-person visits are necessary, a series of CDC-approved precautions create a safe space for anyone needing personal care.
To start, every patient who visits Dr. Burgess is screened over the phone. Anyone with suspicious symptoms is advised to stay home or get tested, depending on his assessment. If a patient isn’t showing symptoms, they are screened a second time when they arrive at Dr. Burgess’ office. This ensures that no one with COVID-19 symptoms enters the building.
Once inside, patients never wait to be admitted, so the waiting room is always empty. Everyone, from patients to caregivers, is required to wear a mask, and office staff follow thorough cleaning guidelines for commonly touched areas, such as counters and door handles.
With necessary exceptions, such as seniors or children, patients are asked to come to their appointments alone. This limits the overall number of people in the office at one time. But Dr. Burgess stays flexible on this rule, depending on the patient’s or family’s needs.
“For the new dads out there, it’s important for them to hear what the mother is hearing,” says Dr. Burgess. “For the man or woman with low mobility, a caregiver needs to help them see me. We want to stay safe, but safe within reason.”
At this time of uncertainty, it seems Dr. Burgess and his fellow caregivers will do anything to make access to care easy. For patients with limited technological experience, it could mean jumping on a phone call. For patients with high blood pressure, it could mean working with them on securing an at-home monitor. Whatever it may be, he’s up for it.
“Because of this pandemic,” he says, “we’re finding new ways to do everything, from shopping to working to checking in with relatives. Health care is no different. It may not be ideal, but we are making the best of it. And if our new practices ensure that all my patients are getting the care they need, that’s good enough for me.”