When the Coronavirus pandemic broke we entered a new era. Life as we knew it – shaking hands and giving bear hugs – changed and we began in March 2020 to do “Telehealth” audio (and video) consultations. It soon became evident that we were able to do good part of what we did in the office visit - sometimes even better - remotely. For example, while in pre-pandemic times we asked patients to routinely bring their medicine bottles with them to office visits, patients would often forget. With Telehealth they just go to their medicine chest and show it to the doctor on video!. Patients are also able to have family members with them at the time of the consultation more easily - since we often do Telehealth late in the evening.  Most importantly patients don’t have to wait in the office and can go about their day till called! 

We have shifted into a new protocol as the pandemic has evolved - we do hybrid consults where we divide the office visit into a “Telehealth part” with the patient at home and a “Physical examination part” done in a subsequent brief office visit. 

We do have the option - as appropriate - to either do the entire office visit in the office as we were doing pre-pandemic or entirely via Telehealth. 

The probability of getting Covid infection (and many others) seems to depend on three things, one is contact with air exhaled by someone or perhaps with contaminated surfaces, another the intensity of such contact (eg., greater indoors than outdoors) and third the duration of time this contact occurs. A mathematical representation of this is as follows: Probability of getting infected = Number of contacts  X  duration of contact. The decreased duration of time spent indoors seems important, so for the "Physical examination part" we have patients wait in their cars instead of the office waiting room and call them in one at a time, so that we have just one patient in the office at a time in addition to everyone wearing masks. We use this routine since even as widespread vaccination appears to have helped, it seems likely that some risk still exists.

The risk of Covid has decreased though sporadic instances do occur and while it is not a concern for most people, persons with serious underlying diseases including cancer may still be at risk. For their safety, we are still trying to keep their exposure risk as low as feasible.

Please share your thoughts.

Dr. Ravi