Gentles, who runs Night Light Pediatric Urgent Care on Hwy. 290 in Cypress, said all of the changes have been part of an effort to ensure the safety of her patients from the coronavirus. Changes have included using a lot more personal protective equipment, enforcing a stricter sanitation regimen, asking patients to wait in their cars between the time they check in and when the doctor is ready to see them and rethinking how and when to conduct appointments by telemedicine.
At the same time, the number of patients Gentles said she has seen throughout the pandemic has been less than 50% of what she normally sees. Because of this, she said she fears some people might be waiting too long to have a problem diagnosed, which could end up making the problem worse.
"People are afraid to come in. Some people come in too late," Gentles said. "People get something on Day No. 1 and come in on Day NO. 7. If we had seen the injury earlier, we could've taken care of it, but by now, it might be septic, and you need to go to an [emergency room]."
Dr. Urmeel Patel, a medical oncologist and hematologist who works out of two Millennium Physicians offices in the Cy-Fair area, told a similar story. In the world of oncology, he said, when it comes to diagnosing a malignancy, any delay can come with severe consequences.
"A delay in diagnosis could potentially result in seeing an uptick in regards to the number of later stage diseases," he said. "That is a concern I have as an oncologist."
Patel said his offices have seen appointment delays, particularly among people whose illnesses were safely being monitored before the coronavirus, some of whom have also switched to telemedicine visits, he said. Telemedicine has both advantages and limitations, depending on each individual case, he said.
Gentles—who has also started providing PCR and antibody tests to individuals ages 0-21—said her office expanded its use of telemedicine over the past two months, but she is now looking to start relying on in-person visits more often once again. For children, in particular, in-person visits can be crucial, she said.
"Young kids just need to be looked at," she said. "A little baby who doesn’t have all [their] shots is more susceptible to common illnesses."
Another side effect, Gentles said, is that she is worried about the long-term financial consequences of the pandemic on her practice as well.
According to the Texas Medical Association, she is not alone. In an online survey of 1,548 Texas physicians conducted by the TMA between May 4-11, 26% said their practice's revenue has decreased by 76%-100%, while 32% said their revenue decreased by 51%-75%. A total of 68% of respondents said their work hours have been reduced, while 62% said their salaries have been reduced.
“Many physician practices work on a fairly tight margin of profit, especially those who see a lot of Medicare, Medicaid, or HMO patients,” TMA President Diana L. Fite said in a May 20 statement released with the survey results. “We have heard from physicians who are charging on their personal charge cards, taking money from their own savings plans and borrowing money just to pay the bills and their office staff. Meanwhile, they have no patients or very few patients to see.”
Gentles and Patel said they are starting to see more patients making appointments again, but Gentles said the increase has been more of a trickle. Both doctors said they understood why patients might be hesitant.
"It is a scary time," Patel said. "But at the same time, I think it’s important to reach out to your physician's office to see what they can do. There are certain things we may be able to take care of without you having to step into the office. If we do have you come into the office to be seen to evaluate what is going on, I think patients can be reassured that we are doing everything we can to prevent the spread of the virus."