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A day in the life of an HIV doctor during COVID-19

June 15, 2020

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Dr. Elizabeth Martin says her HIV clinic in Neptune, New Jersey, has been unusually quiet lately.

Elizabeth works as a clinical director in infectious disease at Merck, and she typically volunteers at the HIV clinic once every two weeks. But she says that these days, she is going to the clinic less frequently because the number of patient visits per day has gone from between 40 to 50 to approximately five amid the COVID-19 pandemic.

Although the clinic has reassured its patients that they are taking safety precautions, such as spacing out appointments to avoid close quarters in the waiting room, or requiring everyone to wear masks, patients are still hesitant to come into the office.

That means Elizabeth and her staff at the clinic have to change their “normal” routines to make sure their patients receive the care they need; they are now proactively reaching out to patients to check in and using telemedicine to manage their patients’ conditions.

Elizabeth shares the measures she is taking to ensure her patients receive proper care and why consistent care is so important.

Taking proactive measures to comfort patients during COVID-19

Our patients have heard that the hospital and health care system is completely chaotic and overrun: “Everyone has COVID-19,” and “You’re going to get sick as soon as you step in the door.”

"But the truth is our office is miles away from the hospital and relatively calm."

We reach out to them and explain that’s not the case and ask them to come in. We try to space out the appointments so there’s no one waiting in the waiting room. Our staff all wear masks and we have masks for patients.

Using telehealth to provide holistic care

It’s a lot of reassurance and trying to keep communications open.

We really are able to manage a lot with them over the phone if they don’t want to come in, and many of them don’t need to. We typically see patients every three to four months, but you can extend that out to six months. We are routinely doing that where it seems appropriate, and now it gives us time.

It’s easy enough to call in prescriptions. Access to medication has not been a problem. We can easily prescribe prescriptions that they need, and pharmacies, to my knowledge, have not had difficulty filling them. Many pharmacies are offering delivery services, too.

We don’t just provide HIV care. We also do, for most of our patients, general health maintenance. We manage other conditions, like high blood pressure, cholesterol, heart disease and diabetes.

Telehealth works for some people, but we also have a very marginalized population. Many of them don’t have predictable lifestyles. They don’t have predictable income or housing, or they may not have a smartphone or privacy where they’re living to be able to take a telehealth call. Our staff tries to call patients as often as they can – a phone number might be disconnected one week, and back again the next week.

Hopes for consistent care

I think if we’re going beyond six months without seeing them, then that’s when we’re really going to become concerned.

"I’m hopeful that patients will trust us enough to come into the office."

I hope that as things start to calm down, they will become more comfortable coming in. They really will need their refills and they really will need some assistance – that will probably drive them in.

You have to hope that they will contact you when they need you.