How to navigate post-COVID elective landscape
The world turns again as the tristate area opens back up. Governors are handing over the baton détente to their citizens. Dinner parties, weddings and concerts are returning to a new normal.
How has your health faired through the pandemic? Have you put off elective surgery, procedures, seeing your doctors and specialists? Or maybe you are taking care of an elderly parent who needs assistance more than ever. There is a backlog of check-ins, and a logjam of jeremiads. As a doctor of pharmacy and geriatric specialist, I am starting to see a slew of negative health outcomes indirectly related to the pandemic.
I lived through the pandemic with an unusual perspective. Most of my time is spent conducting chart reviews in nursing homes and assisted living centers. When the pandemic hit, nursing homes were strongly impacted, as evidenced by death rates. Medicare data indicates as many as 134,000 COVID-19 deaths were patients and staff of nursing homes.Patients who survived were subject to isolating conditions and not allowed to see their family and friends — unless through a window. The purpose of this policy was to help prevent the spread virus. The inevitable outcome was a sharp uptick in antidepressant and anxiolytic utilization.
Vaccines, developed at a record pace, became a lifeline for our country. The vaccines were administered by pharmacists in Phase 1a and 1b of vaccine distribution.
I was part of this enormous immunization effort focused on long-term care centers. While we have suffered tremendous loss, our resilience and efforts to combat these challenges will be remembered for generations.
The peak of the horridness is behind us, the battle seemingly won in the United States. However, the war on the virus continues, pursued by pharmaceutical companies developing booster shots to catch up with virus mutation. Although life is returning to a new normal, some industries are slower to return than others and rehab centers are a key indicator of concern. It points to the slow return of elective surgeries.
What’s the big deal? Elective procedures are defacto optional, so they can’t be that important, can they? This kind of parochial mindset can affect your health and the health of family and loved ones. Here’s what you can do:
- Don’t take a rain check any longer. Consider elective health procedures and surgeries as a bastion to future impairments and major disability. Mom is 75 and needs a hip replacement because she can barely walk the aisles of a grocery store. Another year, she might need a walker. She could fall and break her back, or worse. Broken bones can worsen into severe infection and sepsis. These tragedies happen daily and are part of my every day at work.
- Visit your specialists for preventative care. When’s the last time you saw your cardiologist or endocrinologist in person? Specialists need follow up appointments to ensure good health outcomes. Cousin Greg needs to follow up with the dermatologist to have that growth removed before it turns into something worse. Go for the mammograms and colonoscopies, get your annual and quarterly check-ins. We are a year and a half behind on taking care of our medical needs. Preventive care is essential to the health of our nation and its citizens. It is the most cost-effective way to prevent bigger problems down the line. Not to mention, if you had COVID, about 25% of patients develop long term symptoms that may require additional medical treatment.
If you or a loved one need elective surgery and will likely be referred to a rehab center for a few weeks post-discharge, you may be concerned about post-pandemic nursing home conditions.
Here are some helpful tips:
- Check the star rating of the facility on medicare.gov/care-compare.
- Check the staffing statistics.
- High staff turnover rates are correlated to worse care
- Request a pharmacist-performed “medical reconciliation” when you transition from one setting to another (home to hospital, hospital to rehab center, rehab center back to home).
- Medical Reconciliation is defined by CMS as a comparison of the medical record to medication list to ensure appropriateness and accuracy of medication and dose 6
- Be aware of potential mistakes during a transition of care (the movement from one care setting to another).
- Medication errors are common during a transition of care.
If healthcare was a chess game, pharmacists are mostly a defensive healthcare piece. We take pride in catching the medication error before it is made. We call to correct the dose, get a lab ordered, prevent a drug interaction. It should be no surprise that a pharmacist is writing this article to you, dear reader, in the hopes you pick up the phone and call the specialists you’ve been putting off. Look, we all gained weight during the pandemic. Shed those extra pounds and get those knees replaced. Maintain your functionality before it is too late. It is time to return to the new normal.
Justin Machia is a consultant pharmacist with Omnicare, a CVS company, serving the New York suburbs.