Delaying Care Is Dangerous: One Patient's Journey

Posted February 16, 2021

When Priscilla Baker called her doctor about a pain in her abdomen, she didn't think twice about how health care has changed during the COVID-19 pandemic. She knew she needed care, and she needed it now.

Baker, a recently retired Middlebury resident, was enjoying the solitude of self-quarantine. Otherwise very active in the community, she appreciated her slower routine “following the thread of the day” by taking daily walks and sewing cloth masks for local organizations. However, increasing abdominal pain prompted a call to her doctor. “I felt really awful,” says Baker. Through a video visit, she connected with her primary care doctor to determine her next steps. “Although she couldn't perform a physical exam and take my vitals, she could see through the video visit I really wasn't feeling well and was clearly dehydrated, so she advised I go to the emergency department.”

Half an hour later, Baker walked into the Emergency Department at UVM Health Network's Porter Medical Center in Middlebury, greeted by staff awaiting her arrival. “My doctor called ahead so they knew I was coming. The admission process was streamlined. Everyone was masked. They immediately took me to a room and started hydrating me, performed a physical exam and took a blood draw,” says Baker.

Baker suspected she was experiencing a diverticulitis flare up, something she was treated for several years ago. She was right, but blood tests and a CT scan revealed another health issue in need of immediate medical attention. Her CT scan found a potentially cancerous mass in her abdomen that needed to be biopsied at the University of Vermont Medical Center. After an ambulance ride to Burlington, Baker was admitted, her infection was treated and she underwent a needle biopsy.

“What's encouraging is that in this entire time she was admitted, we were in the thick of COVID-19 preparations and caring for COVID-19 positive patients, and she still got the care she needed. She didn't lose time,” says Cheung Wong, MD, Director of Gynecologic Oncology & Urogynecology at UVM Medical Center. “I want to remind our patients that we are here to help them. We don't want people to ignore their symptoms and avoid the hospital out of fear for COVID-19. This virus is going to be with us for a while and there are many medical conditions that cannot wait. The earlier you address a health issue, the faster you can get it under control.”

The Doctor Will See You Now

“We have changed how we practice medicine, however that change isn't bad, but in fact good for you,” says Dr. Wong. Safety precautions and protocols, such as universal masking, screening, and enhanced infection-prevention efforts, are in place across UVM Health Network facilities to provide safe, accessible care to the community. Further, to ensure continuity of care, video visits have expanded across most practices to connect patients with their providers.

“COVID-19 has really pushed video visits forward for us,” says Dr. Wong. “While we've previously used video to connect with patients, COVID-19 has forced us to more rapidly adopt this care option and offer it broadly. If we see any bright spots with COVID-19, it has forced us to adapt and move more quickly toward where we want to be.”

In Baker's case, after she was discharged from UVM Medical Center, Dr. Wong needed to speak with her because her biopsy results revealed the mass in her abdomen was in fact cancerous – a recurrence of a cancer she treated 20 years ago. “It's incredibly important for me to be able to see my patient when I share this news with them. I feel more connected to my patients when I use video conferencing. I need to see Priscilla's expression when I deliver her test results and her next steps for care,” says Dr. Wong. “A lot of what we do is recognize the expression and body language from the patient. When you give results to patients it's important to see them and see how they respond to this news.”

Avoiding the trip back to Burlington to learn her test results, Baker was able to connect with Dr. Wong through a video visit. “I think that if we spoke about my care by telephone it would have felt like a disembodied voice that didn't connect with me,” says Baker. “Ordinarily, I would've had to drive back to Burlington to meet with Dr. Wong, but a video visit made my appointment more convenient. Plus, they were able to schedule my follow-up care at Porter and I was so pleased. I have experienced the seamlessness of these two hospitals working together and sharing in my care.”

Across rural Vermont and northern New York, video visits expand care options for patients that otherwise need to travel significant distances or do not have access to transportation. Additionally, noted Dr. Wong, video visits expand the care team to include family members that wouldn't ordinarily be able to join patients at their appointments, even family from out-of-state. “You can securely connect anyone into that meeting, whether they're sitting in the same room or anywhere across the country. This is just another way to be patient-centric and provide care to our patients near and far, when and where they want it."

It's important for patients, like Baker, to seek out the care they need. A small health issue now can become a larger issue later. Dr. Wong echoes the sentiments of other health care providers urging their patients to take care of their health throughout this pandemic: “I want patients to remember we are still providing safe, patient and family-centered care. We don't want people to ignore their symptoms out of fear for COVID-19. Check in with us, we are here to help.”