April 25th, 2020 Pillar PC Update on COVID-19

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Email highlights:
-Our communities are opening back up. Infection numbers will likely climb. Let’s protect our at-risk neighbors by remaining diligent with personal hygiene while we help business owners put food on their own table.
-COVID-19 symptoms need to be taken seriously. Call me before coming in.
-COVID-19 antibody testing is available. Call for an appointment.
-Wear a mask and wash your hands for all office visits. Paper forms are out. Online forms are in.
-This week’s focus: Antibody testing, telemedicine visits, and sick visits in the afternoons.
-May: Telemedicine all day, well visits resume in the mornings, and sick visits in the afternoons.
-There is no ‘I’ in TEAM.

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Dear Pillar PC Family,

With Governor Lee starting to reopen the state in the coming days and weeks, I have developed an office protocol to help us get back to normal operations while trying to lessen the transmission of COVID-19 infection. This email will share that information with you.

Before I jump into that discussion, I also want to share some details relative to the reopening of our communities.

First, as always, the best way to prevent the spread of any infection is to take wise precautions. Good hand hygiene and avoiding touching your face are two of the most protective measures you can take. I would continue to advise wearing a mask in public for the near future and you will be asked to wear a mask at any office visit. I also recommend that you continue to practice good social distancing when in public by keeping separated as much as is appropriate for the situation. We now know that the highest risk individuals are those over the age of 50 and those with certain chronic health conditions. If we continue to be diligent in our own activities, we can help mitigate the risk to those who will suffer COVID-19.

We will see an increase in the spread of the infection as the community opens back up. We should be prepared for that. Thankfully, the majority of those infected in our community to date have done very well and, as a percentage, few have died. Additionally, the shut down has had an enormous impact on our community and many are suffering as a result. In Knox County, we have had more suicides during this time than COVID-19 deaths. Let us all strive to help our neighbors on both fronts. Wash your hands and wear your masks to keep our over 50 population safer while restarting our thriving economy to prevent homelessness, hunger, and depression. I believe we can do both if we choose well and act selflessly.

Second, we want to identify and isolate new cases of COVID-19 as quickly as possible. If you have a fever (temperature greater than 100.4 F), sore throat, cough, shortness of breath, diarrhea, or loss of sense of smell, please contact me or the office. These symptoms are suggestive of COVID-19 and should be taken seriously.

Once we discuss your symptoms and it is decided you need to be evaluated or tested, you will be scheduled at 4-5pm that day. Aggregating all the COVID-19 suspected cases at one time limits the number of times I must don and doff my protective gear which conserves our supplies and limits the risk of contamination and spread. All testing and evaluation will continue to be on the back porch. Please call us from the parking lot and you’ll be directed to the next steps.

Testing is also available around the region and from many community centers. Knox County testing locations can be found here: https://covid.knoxcountytn.gov/covid-test-sites.html

Third, antibody testing for prior COVID-19 infection is available starting Monday. It has been released from several of our national lab vendors which offers a reliability that should be trustworthy. Any patient who would like to be tested is welcome to schedule an appointment and have it done. I do not know the price yet but like all Pillar PC labs it will be a pass-through price at my cost. I expect it to be around $50 but really do not know how much it will be.

Lastly, I am asking all patients to schedule an appointment for any visit to the office. This will help us spread out our patients to limit their exposure to each other while here. Please call to schedule all labs, office visits, and injections. You do not need to schedule a pickup of your medications.

I am asking all patients to come wearing their own mask. A cloth mask is fine. I have a limited supply of surgical masks but will share as I am able. Also, all patients will be asked to wash their hands in the lobby restroom upon entering the office. Again, these two very simple precautions have shown to be remarkably powerful in reducing the spread of infections.

Prior to each visit, via text or email, we will be sending out the patient agenda form. This is the form you usually fill out upon arriving that helps us highlight the topics you want to discuss at the visit. It is very easy to fill out on your phone or laptop and can be found here: https://intakeq.com/new/6ShNv5. It saves automatically so you don’t have to worry about how to send it back to us. This cuts down on our interactions with clipboards, pens, and papers which are common fomites.

Reopening schedule:
Starting Monday April 27th, we will reopen the practice on a more routine schedule. The focus of this week will be COVID-19 antibody testing and telemedicine visits throughout the day with acute care visits in the afternoon. I will continue to aggregate sick visits to the afternoons and COVID-19 nasal swab collection to the late afternoon as previously mentioned.

Starting Monday May 4th, we will reopen the practice to in person well visits in addition to what has been mentioned above. I will continue to offer telemedicine and encourage its use. The telemedicine platform is useful for many types of visits including things like nutrition follow ups, management of high blood pressure when the patient has a home BP cuff with readings, and follow up of anxiety, depression, ADD/ADHD, and sleep apnea. These can be done by phone or video conference.

Well visits will be restricted to the morning clinic hours and sick visits to the afternoon clinic hours until further notice. With the ability to do telemedicine throughout the day, I hope to be able to serve all the needs of my patients and their timing issues. However, by aggregating people coming in for well visits like babies, children, adult physicals, and follow ups to the morning hours I hope to reduce their exposure to patients suffering fevers and respiratory symptoms.

Final Thoughts:
At this juncture, so many want to look back and criticize the decisions we made saying that they were too strict and now have proven an overreaction. Others wish to point to the future opening as a sure sign of spreading the infection and a guarantee that more lives will be lost. All choices are made with imperfect knowledge and I’ve always found it hard to predict the future but even more difficult to change the past. It really comes down to decided what we are going to do today. Maybe we should take Queen Anna of Arendelle’s words to heart and just ‘do the next right thing.’ Putting others before ourselves, we can find a way through this.

‘So if there is any encouragement in Christ, any comfort from love, any participation in the Spirit, any affection and sympathy, complete my joy by being of the same mind, having the same love, being in full accord and of one mind. Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others. who, though he was in the form of God, did not count equality with God a thing to be grasped, Have this mind among yourselves, which is yours in Christ Jesus, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. ‘
Philippians 2:1-8 (https://my.bible.com/bible/59/PHP.2.1-8)

Please feel free to reach out to me with any questions you have during this uncertain time.

Mark B McColl, MD
Internal Medicine and Pediatrics
Mark 2:17

Pillar Primary Care, PLLC
“Healthcare without hassles, built for you.”
10437 Hardin Valley Rd
Knoxville, TN 37932
Phone: 865-244-1800
Fax: 865-444-6002
www.pillarpc.com

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