Greetings From Indiana!

This is part of a series looking at different practices of all sizes and locations, and how they are all dealing with issues during this pandemic. 

By Doug Smith, MD

Today, I am sitting in my office at 2:30 pm with little to do other than a feeble attempt to write this synopsis. I am looking out on a courtyard that is part of my office complex view where I can see buds on the ash trees and faintly hear geese honking at one another in some sort of springtime serenade. On a typical day at the office, I would likely be seeing my 14th or 15th patient of the day and surviving with a feeling that I was juggling five balls at once but a skill set that should have only allowed 4. So is the experience of many private practice rheumatologists. A sort of controlled mayhem if you will. But how things can change in a moment.

My practice was founded in 1975 and has served the greater Indianapolis area ever since. Over the years, our size has varied, but we are currently five docs and 1 NP. Like many, we also have an in-office infusion suite, ultrasound, and lab services that we offer our patients. On any typical day, we might have more than 200 patients come through our doors. By contrast, today, I completed five televisits and saw two patients in the office for joint injection. Although this is usually a slow day, even in comparison to the last week or two, it still represents the impact this COVID 19 pandemic has had on our livelihood. We have adapted our office to protect our staff and patients. For the past few weeks, we have a staff member stationed at the front entrance asking patients questions about health and travel as well as checking temperatures. Family members are asked to wait in their cars, leaving the waiting room looking like a ghost town (with nothing to read since all magazines were discarded). Few patients end up making a face to face visit unless they have been deemed to have an “emergent problem.” Our E/M visits are now trending less than 40% of their norm. The docs have had to make a rapid conversion to, which has been surprisingly easier than I had thought, but there is still resistance on the other end, especially from my Mom’s age group (she still uses a flip phone).

I don’t need to go into great detail about the myriad of other changes our excellent administrative staff has implemented in order to keep us afloat. You all have taken similar steps to mitigate infection. Our saving grace has been that our infusion center is largely working at near full capacity. The infusion nurses have gone to extraordinary means to keep our infusion patients masked and separated. To my knowledge, we have had no serious infectious complications during the last two months. In fact, these infusion patients are so grateful that we are open and still treating their arthritic conditions.

I still have a sense of angst when I think about the lost revenue this pandemic has caused. So while I should be able to sit here and enjoy my beautiful courtyard view for a few moments, I think of the work that I should be doing. After all, I am at my office. I guess this is the emotional toll this pandemic has brought upon us. A toll that is hard to measures in dollars and cents. But I am reassured that I have United Rheumatology on my side of this battle, and together, we will get through this mess.

Doug Smith, MD
Rheumatology Associates PC
Indianapolis, Indiana

Stay safe, stay healthy, stay United. 

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