For Amy Bogue, executive director of the Allegro Family Clinic in Columbus, the examples spring easily to mind.
Several elderly patients who had developed urinary tract infections that could have been treated right away with antibiotics. One patient who had suffered a stroke.
Scared of contracting COVID-19 during a visit to the doctor, they waited too long to seek medical help, and their symptoms worsened, though thankfully they received care before it was too late.
“They’re delaying care for fear of COVID, but they’re having way worse side effects because they’re not taking care of the issue at hand,” Bogue said. “So it’s a little concerning.”
The patients Bogue mentioned are far from the only ones delaying needed care because of worries about contracting the coronavirus. She estimated health care clinics in Columbus are 40 to 50 percent less busy as a result of the ongoing pandemic and the fears that have stemmed from it.
It’s become sort of a double-edged sword: While hospitals and clinics suffer financially from fewer patients and the inability to perform nonessential or “elective” surgeries, sick people in need of care are going without it and often ending up in worse shape when they eventually decide to seek medical attention.
“What might be an overnight stay in the hospital turns into a several days’ stay with IV antibiotics, and we are seeing that (with people who delay),” said Mary Kathryn Kight, director of marketing and public relations at OCH Regional Medical Center in Starkville.
Bogue, a registered nurse, knows health care providers are struggling from the lack of business and is working to alleviate concerns her patients have about contracting the virus by visiting Allegro.
“You take an oath to take care of people, and it’s burdensome when you’re unable to do so,” Bogue said.
The bottom line
On March 19, the Mississippi State Department of Health issued a directive to hospitals and health care providers to postpone elective medical procedures until the spread of COVID-19 had diminished, and Gov. Tate Reeves issued an executive order April 10 that delayed all elective surgeries and procedures through Monday.
But Dr. John King of King and Associates Cardiology in Columbus knows that a procedure that is nonessential one day can be an emergency the next.
“We don’t generally have a lot of time to sit on things, even if they are ‘outpatient’ and ‘elective’ procedures,” King said.
Cardiac catheterizations can be used to diagnose and treat heart conditions. Stress testing and echocardiography — an ultrasound for the heart — were temporarily shut down, King said, but his clinic is offering the services again.
“Those are the tests that we use to open the door to other tests if they are abnormal,” King explained. “When you shut that off, you just really don’t know who all might be sick out there if you don’t have that kind of information.”
King said he has performed roughly 80 percent fewer procedures than he did a month ago — a worrying benchmark, he said, given that hospitals make most of their money from such procedures.
“That’s what pays for somebody with multiple medical problems to have a long hospital stay,” King said. “Most (hospitals) help their bottom line dramatically by doing elective procedures.”
Baptist Memorial Hospital-Golden Triangle in Columbus, which typically performs 250 to 300 elective procedures per month, discontinued them in early March to keep beds open for COVID-19 patients.
In an email to The Dispatch on Thursday, Baptist CEO/Administrator Paul Cade credited Columbus Mayor Robert Smith for his decisive action early in the pandemic, which Cade said helped keep the number of cases in the area down.
“I think our mayor did a great job in closing businesses … early, which probably prevented some of the volume that was projected early on,” Cade said. “Our current hospital volume remains low but is starting to pick up. I think we are at a point where we can safely start some elective procedures without fear of becoming overwhelmed.”
In April 2019, OCH performed 481 outpatient procedures (which aren’t necessarily considered “elective”); April 2020 yielded just 95. In a statement emailed to The Dispatch, OCH Administrator and CEO Jim Jackson said the hospital reduced hours for many employees beginning April 20 and has eliminated some of its discretionary expenses.
“The COVID-19 pandemic has created many difficult challenges in the health care industry, both clinically and financially,” Jackson said. “With the suspension of elective/non-emergent procedures, low hospital census, decrease in outpatient encounters in OCH clinics and rehabilitation services, several cost-saving measures have been instituted hospital-wide.”
North Mississippi Medical Center-West Point will resume elective surgeries on Monday, the hospital announced in a press release.
“Rest assured, our facilities, which were safe prior to COVID-19, are even safer today because of our diligence in hand hygiene, masking, screening of all entrants, protective equipment usage, cohorting and distancing of patients who are COVID-19 positive or presumed to be COVID-19 positive, as well as continuous sanitizing of facilities,” Administrator Barry Keel said.
Cade said his hospital remains in decent financial standing. No employees have been furloughed, and Baptist employees who typically work in the outpatient testing department are instead working to screen patients for COVID-19 symptoms at entrances.
“We are proud that we have adjusted employee staffing by moving employees to different positions in the hospital, which has allowed them to keep working and drawing a paycheck to support their families,” Cade told The Dispatch in an email Thursday. “… We anticipate that we will soon be able to resume providing all regular services and do not foresee the need to make any material financial adjustments at this time.”
Other hospitals around the country, though, have had to lay off staff and make other cuts. Some were already in arrears before the pandemic hit: Pickens County Medical Center in Carrollton, Alabama, closed its doors March 6.
“It is really hurting hospitals,” King said of COVID-19. “Thankfully, they’re financially solid here, but there are places all over the country that are in deep, deep trouble.”
Keeping clinics safe
On Wednesday, King saw a patient who likely first had heart problems in March but who put off seeking treatment due in part to the pandemic.
Other patients with active cardiac symptoms have been reluctant to come in for follow-up appointments, King said, even though coming to the clinic poses little danger. Down the road, he said, that could pose a big problem.
“That’s the thing we’re most concerned about: that there’s going to be a big fallout from that in the months to come,” King said.
King’s clinic screens all patients for fever, cough and other symptoms of COVID-19, directing them to get tested for the virus before coming in. Any employees with a fever are told not to come to work.
“This is a pretty safe environment — about as safe as you can make it — and being concerned about coming and getting medical attention is not something people need to be worried about,” King said.
At Allegro, signs outside direct patients with in-person appointments — the clinic also offers assistance by telephone — to call the clinic before entering so a nurse can come out to the car and screen them for fever and other symptoms. Once cleared, they can enter.
That’s just one of the measures the clinic has taken to reassure and educate its patients during the COVID-19 outbreak.
Concerned about the condition of patients with anxiety and depression during the stress-inducing times of the pandemic, Allegro staff members perform “care calls” to check on those patients, asking, “‘Are you OK? Do you need a ride? Do you have food?'” For non-medical needs, Bogue said, the clinic often refers patients to local churches for help.
The clinic is also active on social media, posting information about symptoms and virtual appointments. In Facebook Live videos posted Friday and Monday, respectively, pediatric nurse practitioner Stefanie Christy and pediatrician Dr. Robert Buckley discussed health issues and fielded questions.
Bogue, concerned about low turnout at Allegro and the health of its patients, knows the clinic’s actions aren’t everything, but she hopes they can help to assuage the fears of patients worried that seeking necessary care means being at a high risk of contracting the virus.
“We’re just trying to get the word out and teach people,” she said.
Theo DeRosa reports on Mississippi State sports for The Dispatch. Follow him on Twitter at @Theo_DeRosa.
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Quality, in-depth journalism is essential to a healthy community. The Dispatch brings you the most complete reporting and insightful commentary in the Golden Triangle, but we need your help to continue our efforts. In the past week, our reporters have posted 37 articles to cdispatch.com. Please consider subscribing to our website for only $2.30 per week to help support local journalism and our community.
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Related Photos
The Allegro Family Clinic on Bluecutt Road in Columbus won't let patients enter if they show signs of fever or other symptoms of COVID-19. A sign to the left of the door tells patients to call the clinic and have a nurse come out to their car for screening. Patients have delayed treatment and procedures due to COVID-19 concerns, and that has affected the bottom line at area clinics and hospitals. Photo by: Theo DeRosa/Dispatch Staff
Amy Bogue
Mary Kathryn Kight
John King
Paul Cade
Jim Jackson
Barry Keel
