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While telehealth rheumatology visits have been critically important for many patients during the coronavirus pandemic, they can’t fully take the place of in-person care for those with rheumatoid arthritis and other rheumatic conditions.

When you have a chronic rheumatic disease, there can be serious “silent” risks of avoiding medical care. Persistent inflammation that goes unchecked can lead to irreversible joint damage and may impact other parts of your body, like your heart and lungs.

This is why it is so important to:

  • Stay in touch with your rheumatologist and keep your regular checkup schedule. For many people, this means seeing the doctor every three to six months (or more often if needed).
  • Work with your doctor to decide whether your visit should be in person or can be done via telehealth.

If you need to go to the doctor’s office in person, it’s understandable that you may have concerns about your safety, especially after spending months and months staying home as much as possible. But you should know that your rheumatologist’s office is likely taking many precautions to reduce the risk of coronavirus spread.

“It’s imperative for patients with rheumatic disease to keep seeing their rheumatologist in person — and as long as the office is following the proper safety protocols, the risk of potential exposure to COVID-19 is not high, especially compared to the benefits of seeing your doctor,” says Kai Quin, MD, a rheumatologist at Ohio State University’s Wexner Medical Center.

Safety Procedures to Keep Patients Safe

Consider this: Rheumatology offices have now had a full year of experience making accommodations to keep patients (and staff) safe. In addition to strictly following infection prevention guidelines and safety protocols, many rheumatologists, nurses, other health care providers, and office staff are also now fully vaccinated.

Here’s a look at the many steps that rheumatology practices are taking since the start of COVID-19 to keep their patients safe during in-person visits. Specific protocols may vary by doctor’s office.

Personal protective equipment (PPE)

  • Masks, gloves, face shields, and gowns for physicians, nurses, other health care providers, and staff
  • Masks for patients and visitors

Cleaning procedures

  • Hand sanitizing and hand-washing stations
  • Rigorous cleaning and disinfecting of all equipment and high-touch surfaces and objects (such as doorknobs, armrests, handrails, pens) between each patient use
  • Exam rooms fully disinfected between patients
  • No magazines or toys available in waiting rooms or office space

Social distancing

  • Online check-ins
  • Minimize the number of patients in waiting rooms
  • Patients may be asked to sit in their cars to avoid waiting areas
  • Patients must sit at least six feet or more apart (you’ll likely see markings on the floor and furniture rearranged to accommodate this)
  • No walk-ins for labs; bloodwork appointment only
  • Visitor restrictions, which may vary according to the needs of patients

Infusion suites

  • Pre-screening patients prior to appointments and during check-ins
  • Sanitizing suites before and after each use
  • Placing infusion chairs at least six feet apart
  • Requiring nurses to stay at least six feet away from patients when physical contact is not necessary
  • Staggering appointments and having patients wait in the car until the suite is ready
  • Restricting non-essential guests from being in the room with the patient

Screening and testing

  • Screening for coronavirus symptoms among office staff and patients
  • Frequent COVID-19 testing for doctors and staff
  • Temperature checks with “no touch” thermometers for each and every visitor
  • Screening questions (when confirming your appointment and when you arrive at the office), including:
    • Are you experiencing any symptoms of COVID-19 (fever, cough, shortness of breath, chills, muscle pain, headache, sore throat, loss of taste or sense of smell)?
    • Have you or anyone in your household recently tested positive for COVID-19?
    • Have you traveled outside your state?

This resource was made possible with support from AbbVie, Inc.

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ACR Infusion Guidance During COVID-19 Crisis. American College of Rheumatology. https://www.rheumatology.org/Portals/0/Files/ACR-Infusion-Guidance-COVID-19.pdf.

Healthcare Facilities: Managing Operations During the COVID-19 Pandemic. COVID-19. U.S. Centers for Disease Control and Prevention. December 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-hcf.html.

Interview with Howard Blumstein, MD, rheumatologist at Rheumatology Associates of Long Island in New York

Interview with Kai Quin, MD, rheumatologist at Ohio State University’s Wexner Medical Center

Interview with Vincent Domingues, MD, a rheumatologist in Daytona Beach, Florida

Interview with Douglas Roberts, MD, assistant clinical professor of medicine at the University of California Davis Medical School and founder of PainSpot.org

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