Maine Doctors Gear Up For Resuming Office Visits And Scheduling Delayed Procedures

May 1, 2020

Starting Friday, health care providers can resume routine procedures and appointments that they have had to put on hold as the state has tried to stem the spread of the new coronavirus. Many providers say they will not reopen right away, and some, including dentists, say they still aren't allowed to provide treatment other than emergency care.

Now that primary care practices like Martin's Point Health Care can open up additional services, Chief Medical Officer Dr. Jonathan Harvey says they will be able to chip away at the backlog of patients that has grown over the past several weeks.

"We actually counted about 450 of our 90,000 or so patients who needed to be caught up, and so we're in the process right now of outreaching them to set up either video visits or in-person visits once we feel that it's safe for our patients to come back to the office."

That likely won't be until mid-May, says Harvey, as Martin's Point works out the details of its protocols to expand in-person visits. Martin's Point has already instituted some changes, such as screening all patients for COVID-19 symptoms and eliminating the waiting room by bringing patients straight to exam rooms. Moving forward, Harvey expects the system will likely need to provide care in a variety of formats.

'We'll probably do a combination of video visits, office visits, and potentially continue with telephone office visits until we feel it's the right time."

Other providers will open more quickly, but will phase in the amount of patients they see. Optometrist Dr. Sam Pelletier of York Family Eyecare says he plans to reopen Monday.

"We're going to see a half day’s worth of patients, but we're spreading them out over a whole day, so that we're starting slowly. "

Pelletier says he will use Friday to meet with staff to go over the many changes his practice will make in light of the new coronavirus. His waiting room will now be the parking lot. Paperwork will be done online. Staff will be screened daily for symptoms of COVID-19. And everyone, patients included, will need to wear masks.

Pelletier practices in the county with the second-highest number of confirmed cases in the state, and he says he is both nervous and eager to reopen. He just got a loan from the Paycheck Protection Program and needs to make the most of it.

"Once the money hits our account, we have to start paying our employees. And if we had to go another two or three weeks, like we were thinking maybe it would be May 16 before we could open, then we're paying our employees, and we're not working."

Gov. Janet Mills' plan to reopen the economy is coming at the right time for providers like Dr. Pelletier. But others say they have to wait. Dr. Brad Rand is the president of the Maine Dental Association.

"In principle, or in theory, we would be in phase one of reopening, but in practice, we're in the same place we were prior to the announcement. "

During a news briefing Wednesday, the Commissioner of the Department of Economic and Community Development, Heather Johnson, said dentists are allowed to reopen as of May 1, but Rand says they are being directed to a federal Centers for Disease Control document for guidance on how to proceed safely.

"And in that document, it states that all dental care that's not emergency should be postponed," Rand says.

Rand says that is a roadblock that dentists cannot cross. As they wait for more clear direction from the Mills administration, he says they are seeing some patients who had faced minor issues six weeks ago that have now turned into emergencies. He says he just treated one patient who had to postpone an appointment for two fillings because of the COVID-19 restrictions.

"And instead of now having two fillings, he has to have some expensive treatment on one tooth, and he's going to, sadly, has to lose the other tooth. And boy, it just really sunk in that we're starting to see some things materialize that wouldn't otherwise do so."

For other providers, including St. Joseph Hospital in Bangor, supply shortages may prevent a full scale return to elective surgeries. President Mary Prybylo says the hospital is establishing new safety workflows, which include testing patients for COVID-19 before surgery to make sure they will not develop the illness while trying to recover.

"So that testing — and it's more, can we get it done quickly? and are there enough test kits? — are going to be an issue."

Personal protective equipment, or PPE is another issue, says Prybylo.

"In our new world, we're using more PPE than we ever did prior to COVID. Staff didn't walk around with surgical masks on all the time, or even to the extent that N-95s are being worn. So we're going to have to monitor, really on a weekly basis, as to what our supplies are" to determine what services they can provide.

Keeping in mind, she says, that the hospital also needs to maintain a back up supply of PPE in case there's a surge of COVID-19 in the future.

Originally published 5:42 p.m. May 1, 2020