Adapting Care During COVID-19: Q&A with Brett Smith, DO

Dr. Smith

The COVID-19 global pandemic has disrupted rheumatology clinics and practices all over the world. In the U.S., many providers have used telemedicine to expand access to care for their patients while managing in-person visits. Brett Smith, DO, who practices at the Blount Memorial Physicians Group, East Tennessee Children’s Hospital, Knoxville, spoke with The Rheumatologist about his patient care experiences during the pandemic and recommendations for the COVID19 vaccine.

TR: What have you learned during the current pandemic?
Dr. Smith: During the pandemic, I have learned how quickly our world can change and how little control we have over many events. These changes create significant stress in our lives and in the lives of our patients. Part of this stress is due to our expectations and where our hope lies. I have continued to learn that our expectations are not how the world operates, and we must continue to have hope in something greater than the brokenness of this world.

In a turbulent year, I continue to learn how much our patients trust us. They are openly asking how to handle their immune suppression, timing of vaccination administration and bringing their anxiety to us.

I’ve also learned it takes not only physical stamina, but continued emotional and mental stamina. It’s one thing to know you are on a rotation in residency for 30 days. It’s entirely different to be working and living in a pandemic with no clear end in sight. Although difficult, this too shall pass.

TR: What are you telling patients about the COVID-19 vaccination, and how are you using the ACR Vaccine Guidance/COVID-19 Guidance?
Dr. Smith: Patients have started to inquire about the vaccine status and what my recommendation will be about the vaccine. My response currently is that vaccines are highly effective for various infectious diseases, and a COVID-19 vaccination is likely to be effective. But I cannot form a formal response until I see the data.

After the vaccines are available, I expect a surge of patient encounters and phone calls to discuss the vaccine. I’m currently advising patients to await the publication of the clinical trial so we can evaluate the data.

The ACR has expressed it may strongly recommend administration of a COVID-19 vaccine once available. I believe this will ease the concerns of patients and rheumatologists alike, knowing the ACR will thoroughly review available data prior to their recommendation for or against vaccine administration.