A week after Gov. Greg Abbott loosened restrictions on non-emergency medical procedures put in place to keep hospitals from being overwhelmed with COVID-19 patients, health care facilities are rescheduling postponed surgeries and urging patients to resume preventive health care appointments.

While concerns about contracting the coronavirus have been the focus when it comes to health care for the past two months, local doctors are reminding patients that if they missed any preventive health care appointments or had surgeries canceled, they should prioritize scheduling with their doctors.  

“People who had a scheduled colonoscopy, mammogram, pap smear, or dermatology screening that got canceled because of the urgency of the crisis, they need to make sure to get that done in the near future,” said Dr. Ruben Mesa, director of UT Health San Antonio MD Anderson Mays Cancer Center. “These are not superficial appointments; these screening tests are crucial to catching health problems early.”

On March 22, Abbott ordered health care facilities to “postpone all surgeries and procedures that are not immediately medically necessary.” Those restrictions were lifted Friday.

The reason behind limiting of non-urgent medical procedures was less about protecting patients from contracting the coronavirus and more about making sure Texas hospitals had enough personal protective equipment for health care workers treating COVID-19 patients, local hospital officials said.

While the Mays Cancer Center never stopped seeing patients already diagnosed with cancer, the facility had 200 appointment cancellations among its 18 clinics due to patients’ concerns about contracting COVID-19 from visiting a health care facility.

“There were appointments and procedures that should have occurred during this time, and what we fear is that people feel like this is an uncertain time; they might rationalize skipping a mammogram this year, which would be a really bad idea,” Mesa said.

Children’s Hospital of San Antonio CEO Chris Daskevich said that the number of procedures at the Children’s Hospital went down by 75 percent while the order was in place, and there is an estimated two-month backlog in necessary procedures, she said, including hernia repairs and inserting ear tubes.

“We had to look at each individual case and coordinate their surgeries relative to how long we could delay it for, and use that timing to make sure” that delaying the procedure wouldn’t impact their quality of life, Daskevich said.

As of Monday, Daskevich said the Children’s Hospital of San Antonio was performing surgeries in its facilities at 50 percent capacity, and physicians have been rescheduling procedures based on how long a patient might be able to go without their condition worsening to the point of potentially causing permanent damage.

Mesa said it’s now a “safe and appropriate time” for health care providers to begin seeing more patients in person, and people with health concerns need to be seen whether they were sick before the pandemic or recently developed a health condition.

“There is a risk in ignoring symptoms and it can result in worse outcomes, and we don’t want that for any of our patients,” Dr. Christina Bird, medical director of the emergency department at University Hospital, said in a prepared statement. “We don’t want folks staying home when they are experiencing symptoms that could be consistent with an emergency such as a heart attack or stroke due to fears of potentially being exposed to coronavirus.”

On April 15, Baptist Health System – one of the San Antonio area’s largest hospital operators – announced plans to furlough less than 3 percent of the system’s 6,600 workers due to revenue lost because non-emergency procedures were not allowed. CEO Matt Stone said the furloughs were necessary to protect the hospital system’s financial future.

“Our expectation is that we [will] return impacted staff to service once we navigate through this unprecedented time and our core business returns to normal,” Stone said in a statement.

To ensure that patients feel safe coming to hospitals, hospitals are completing additional patient screenings via phone and video to verify anyone entering the offices needs to be seen in person. Some offices are checking in patients via text and having them wait in their cars to reduce the amount of time spent in the facility. Staff and patients are also required to wear face masks and other protective equipment, and hospitals are maintaining more stringent cleanliness standards and completing deep cleanings of entire facilities more often than before.

For patients who are worried about leaving the house or whose symptoms don’t require an in-office visit, hospitals and health care providers will continue to provide the telehealth services they ramped up when stay-at-home orders were implemented.

Family physician Dr. Ramon Cancino with UT Health San Antonio said the State’s recent move requiring coverage for telehealth services during the COVID-19 pandemic is the “silver lining” of an otherwise crippling experience for the health care industry.

“At least a third of our patient visits at UT Health are done over video, which is amazing since that was a process that really got turned on at the campus over the course of seven days,” Cancino said. “Prior to COVID-19, we were not doing a lot of telemedicine because of restrictions and concerns over patient safety.”

Local hospitals and care providers plan to continue utilizing online provider platforms to see patients.

“A new normal is coming, and we are about to see that some of the things we learned are possible during this pandemic can be honed to improve access to health care,” Daskevich said. “We now have to keep challenging ourselves to think differently, and to think about what the future will look like and what we can do to ensure the highest level of safety and care for our patients through all methods of serving them.”

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.