Reshma Khan, MD
As the cases of COVID-19 continue to rise in South Florida, Reshma Khan, MD, a rheumatologist at the Palm Beach Rheumatology and Wellness Center, Jupiter, Fla., is being careful to emphasize social distancing, but not social isolation. Dr. Khan believes that, during this pandemic, it’s more important than ever for rheumatologists to share support and best practices.
The Rheumatologist recently spoke with Dr. Khan to learn how she’s maintaining connections during the pandemic.
Q: How are you and your staff adapting to the sudden changes brought about by the pandemic?
I started a Facebook group called Women Rheumatologists Group (WRG) four years ago, and this past March, the topic of COVID-19 began coming up. Physicians were talking about ways we could prepare for cases, and my staff and I developed a plan to triage and treat patients in the event of an outbreak.
In early March, we began screening patients over the phone. If they had recently traveled outside of the country or taken a cruise, we booked their appointments two to three weeks out, so there wouldn’t be at risk of spreading the disease. I also set up my computers and cameras to do telemedicine, if needed. I’m glad we had precautionary procedures in place because several rheumatologist friends had to close their offices for several weeks due to COVID-19 exposure.
Q: What types of appointments are you conducting?
In March, before the government announced the pandemic, we started conducting 50% of our appointments through telemedicine. The biggest concern was whether insurance companies would appropriately compensate for our time through telemedicine. However, I did what I thought was best for my patients, and now, we see almost everyone virtually. Infusion and injection patients are still making office visits, but their appointments are spread out, and we only see one patient at a time.
Q: What are you telling patients about COVID-19’s potential risks and symptoms? What are their chief concerns?
When I speak to patients, I stress the importance of social distancing and explain [that] if they are on biologics, they may be more susceptible to COVID-19 infection. I also discuss coronavirus symptoms and how prevention is best, [because] there is currently no cure.
One of the biggest concerns is whether they can continue to receive their medications. Hydroxychloroquine, used to treat lupus and rheumatoid arthritis, is in short supply [because] it’s being studied as a potential therapy for COVID-19. Patients who typically receive a 90-day supply can now only receive a 14-day supply from many pharmacies. For some patients, we also received forms from their pharmacy to do prior authorization. It was more work on our end, but at least we’re able to secure a 30-day supply for patients.
Q: How are your patients adapting to telemedicine?
We’ve had a very positive response. Some of our patients live an hour away, so they appreciate virtual visits. It also gives me insight into their daily lives, and I’ve met many family members and pets through these virtual visits. I’m sure, in some cases, we will continue to offer virtual visits, even after the COVID-19 crisis passes.
Q: Why do you think it’s important for rheumatologists to connect with each other during the pandemic?
We all need support from our colleagues right now, because we’re physically and emotionally exhausted. In our Facebook group, we share something good that’s happened every day, offer encouragement and share best practices. For example, one rheumatologist explained how she separates her staff into two teams. Team A works for two weeks in the office and then works from home, alternating with Team B. This way, the office will always be fully staffed even in the event that some staff become ill.
Q: How is the pandemic affecting you and your staff personally?
My staff have been wonderful during this time. They have stepped up, making sure we continue to deliver the best care to our patients to all stay healthy. Most continue to work in the office, except for one with small children, who now works from home. I have a son, 9, and a daughter, 3, and [because] my husband is a pharmacist, both of our jobs are considered essential. We were fortunate to be able to hire an assistant teacher from my son’s school who comes to our home to help him with his lessons and watch both children.
Q: How are you managing staff morale during the pandemic?
We have a weekly staff meeting where we discuss questions and concerns regarding COVID-19. I also stress the importance of self-care and to make time for eating healthy and exercise. We’ve started holding dance parties after our office closes for the day, where we meet in the front office, turn on the music and dance for 10 minutes. It’s been a lot of fun and a great way to de-stress.
Linda Childers is a health writer located in the San Francisco Bay Area.
