Is it safe to go to the doctor now? What to do if you’re told to come in for an appointment.

It’s still very important to get standard vaccines and any urgent screenings, tests, or procedures.

That being said, it’s not always easy to tell what is urgent versus elective, especially the longer this pandemic goes on. It depends on your personal and family medical history. And non-urgent issues can become urgent over time.

If your doctor or insurance company is asking you to come for an in-person visit, it’s always worth a discussion about risks and benefits. Here are some tips from Helen’s and Christina’s recent experiences.

1. If insurance is asking for an in-person visit to authorize a medication, ask your doctor if they can provide alternative documentation.

Before approving continued coverage for a specialty drug, insurers will often ask for labs or an office visit at regular increments. However, Helen learned that physicians have some discretion in how to complete the submission. 

At Christina’s hybrid visit last month. They did the imaging in the hospital but met with the specialist via virtual visit to minimize time in the hospital.

For those who don’t know, Helen is Nell’s mother and an unofficial expert in immunology after decades managing Paul’s Common Variable Immunodeficiency (CVID). This month, their insurance asked Paul to come into the clinic in order to authorize continued infusion therapy. However after several calls, Helen learned that a doctor can submit a written letter asserting that Paul still needed infusions. No in-person visit and no labs needed.

2. There’s no harm in asking if the appointment can be postponed for a few weeks or a few months.

One of Christina’s daughters chipped a baby tooth, and she was feeling pressure to bring her into the dentist for an after-hours x-ray. After texting with a friend who is also mom to a special needs child, she felt more comfortable asking the dentist if they could monitor for a couple weeks first. This resulted in a productive conversation on signs that indicated the tooth needed intervention, so she would know when to come in.

If there are no major changes in your health (this will depend on your personal circumstances, but could include things such as unexplained weight loss, new fatigue, changes in your ability to engage in daily activities, or new symptoms that haven’t been reviewed by your care team), there is a good chance you can monitor closely at home. If you’re not currently tracking your symptoms at home, get started today!

3. If it can’t be postponed, ask for a telemedicine visit or a hybrid visit.

Despite the changes that hospitals and doctor’s offices have made to adapt to Covid, it’s still better not to leave your house right now if you don’t have to. There may be more hand sanitizer stations, but Christina’s hospital still doesn’t screen for Covid symptoms upon entry, and that in itself introduces risk. Check with your insurance if you aren’t sure if virtual visits are still covered in your plan.

If in-person testing or lab work is needed, take a hybrid approach and do your tests in-person but schedule the consult with your specialist as a virtual visit. Last month, one of Christina’s daughter’s experienced new pain related to her chronic condition, so they went in for imaging but conducted the consult with the specialist over Zoom.

Hybrid visit success!

4. If you’re still not sure, you can get an additional perspective from another doctor who knows your situation.

A specialty group was asking Christina to come in for diagnostic testing for one of her children, who has a low (5-10%) risk of having an additional chronic condition. She asked her pediatrician (who is part of the same health system) for his opinion. He believed the risk of exposure was greater than the risks associated with the condition (even during Covid) and recommended that they postpone and instead monitor for symptoms at home.

It may be that your entire care team agrees it’s time to come in. But unless it’s an emergency situation, you can probably afford to take a little bit of time to gather all the information and make an informed decision around risks and benefits. 

Note: now that some plans have expanded coverage for telehealth visits, physicians can charge for phone calls as a telehealth visit. But a 10 minute consult with your PCP could be worth it if it gives you confidence that you will be healthiest if you take care of yourself at home for the time being.

And if you do have to go in, read our tips for a safe hospital visit during Covid. Our top piece of advice continues to be: schedule your appointment for the first slot of the morning!