Dr. Melissa Young, an endocrinologist, reflects on her experiences during 2020 as part of the My Year in COVID-19 feature series.
Melissa Young, MD
2020 has been quite the year. Australian and West Coast wildfires, protests, a tight and highly contested election, and, of course, a pandemic have made it a year of much upheaval. Lives have been lost and even more lives have been changed.
I will admit, when the news of COVID-19 first hit, I was among the people who said, “people die of the flu every year, and we don’t shut everything down. This is the same. Yes, unfortunately, the sick and infirm may not survive it, but the rest of us can calm down and carry on”. Boy, was I wrong.
When a 50-year-old woman in a neighboring parish choir got sick and died, I thought “they could be describing me”. When the public health emergency was declared and the quarantine started, we had to make some quick decisions about the practice.
At first, people started canceling appointments. I had still foolishly hoped that things would be over in a couple of weeks—just like they said school would be closed for two weeks. So we just rescheduled them to the next available spots, but as the pandemic grew and the patient volume dwindled, major changes had to be made.
We started offering telemedicine visits as an option for those who didn’t want to come in. Then, as the incidence of coronavirus infections grew, we switched to all virtual visits. There were some patients who embraced it, others who accepted it begrudgingly, and those who somehow felt no interaction was better than an electronic one and rescheduled.
The schedule, which had been practically empty for a few weeks began to fill up again. As the COVID statistics improved, we were able to offer in-person visits again although I still strongly recommend telemedicine for my older patients who have other risk factors for a more complicated infection. We are now almost at full capacity with a mixture of in-person and telemedicine visits. I am worried about the next few months as the incidence starts rising again. I am hopeful that at this point more people are comfortable with telemedicine and we won’t have too many straight-out cancellations.
To complicate things financially, in addition to loss of revenue due to fewer office visits, there have been additional expenses. I have had to purchase personal protective equipment (PPE) for myself and my staff. I have had to buy additional cleaning supplies. Not that we never cleaned things before, but never to this extent. And what’s worse is that the cleaning products are ruining the surfaces of the exam tables, doorknobs, etc. Kills 99.9% of germs and everything else, I guess. I have purchased touchless soap dispensers, hand sanitizer, infrared thermometers, plexiglass barriers. And, of course, there are the usual expenses—salaries, insurance, utilities, rent.
I applied for a Paycheck Protection Program loan in the spring. I also received some of the CARES act grant. I don’t think I would have been able to keep my staff if I did not receive those funds.
Even now, we have not completely recovered from the loss of revenue and I struggle each pay period to keep things afloat. I have even forgone my own paycheck to be able to keep up with bills. We actually did ok at the height of the pandemic because claims from the beginning of the year were being paid. But since claims were down from April through July, the money coming in now is a lot less than usual. It doesn’t help that Medicare recently rejected several thousand dollars’ worth of claims because of a code they chose not to cover.
I recently applied for additional funds through part 3 of the CARES act. As part of the application, I had to compare revenue and expenses of 2019 versus 2020. Let’s just say, it was quite the eye-opener. Prior to that, I had kept being hopeful, saying, “yeah, we’re ok, we’re down a little, but it’ll be ok”. That spreadsheet was like a kick in the head. No, we are not okay. And another bad quarter could be devastating.
Having said that, I remind myself every day that thus far, this pandemic has been a major inconvenience to me, but nothing more. My family is healthy, I am healthy, I still have a job and a business, my husband still has a job. Not every family can say this.
We have had our scares, we have been frustrated by the craziness of virtual education, we worried about not having enough toilet paper or meat. But the kids are “going” to school, we haven’t run out of toilet paper or meat. We have had more family time. We live in a time in history when we can reach out to and “see” family thousands of miles away. When we can purchase food, medicine, clothes, and yes, toilet paper online. We can watch Broadway shows on our computers and movies on our phones.
COVID 19 continues to affect our lives, our work, our world. We must continue to do what we can to stay safe, to stay afloat. For me, I’ll keep doing what I’m doing. Providing care for my patients, employment for my staff, income for my family. In the safest way I know how.