As more and more people refrain from leaving their homes in the midst of the COVID-19 pandemic, a wide variety of industries have been forced to adapt — and the world of healthcare is no different.
The Spine and Orthopedic Center in downtown Santa Barbara remains open for business, as they continue to provide patient care in the comfort of the patient’s home via telemedicine.
“Before, you had to go in to see your doctor,” said Dr. Alan Moelleken, orthopedic spine surgery at the center, at 401 E. Carrillo St. “You have to drag yourself up, make an appointment and get there. Especially nowadays, in this pandemic, that could be dangerous.
“By having an appointment from the comfort of your own home, not only is it convenient, but you don’t have to put yourself or others at risk.”
While public perception is that many doctor’s offices are closed and physicians are to be laid off, Dr. Moelleken suspects that patients may be unaware of their options when it comes to appointments.
At the Carrillo Street office, Dr. Moelleken and his staff are offering quick turnarounds for appointments, including in some cases same-day telemedicine appointments. This includes new patients and follow-ups and appointments are possible through any venue for video conferencing, such as FaceTime, Zoom or other options.
Dr. Moelleken admitted there are certain limitations to telemedicine appointments, but oftentimes they can still be very beneficial.
“The doctor is able to see you, real time, talk to you, take a history and do a limited exam,” Dr. Moelleken said. “The exam in telemedicine is not as good as an exam that can be done if you’re there in person, however sometimes it’s good enough, and sometimes it’s much better than nothing at all.”
A big part of most medical evaluations includes family health history, which can still be done by video conferencing. The actual exam is also important, but is not required for every patient.
“For example, let’s say a person tells you about his problems and you know you’re going to recommend an MRI of an area of their body,” Dr. Moelleken said. “Sometimes they really don’t have to go any further. You’re going to need that MRI anyway, so you have enough to get that MRI.”
Patients can still be seen in person if the situation merits, but many of Dr. Moelleken’s patients don’t always have to visit the office to receive care.
“I think this whole pandemic, the silver lining is that it is opening our eyes up to realizing that we can do something that’s extremely convenient for patients and allow a lot of people who don’t have access to care to get care,” he said.
Dr. Moelleken is joined by three other doctors — Dr. Amit Nathani, Dr. Tristan Zhang and Dr. R. Jason Hartman — at the local office, as well as a group of physician’s assistants.
Dr. Moelleken and his office currently see roughly 50 patients each day through telemedicine, including patients with spine problems, orthopedic problems and also chronic pain issues. Dr. Moelleken continues to conduct surgical procedures, which are being limited to patients who are suffering from a neurologic deficit or in severe pain. He conducts the surgeries at the Carrillo Surgery Center in downtown Santa Barbara, with some patients having the ability to have their procedures down as an outpatient. Patients are able to bypass the emergency room and urgent care facilities if needed.
“We’re a virus-free office here, so when patients come in, every patient has their temperature taken, they’re asked a lot of questions to make sure they are not high-risk patients. That protects not only our patients, but also our staff,” he said. “They can rest assured that if they do indeed need to physically be seen that we’re taking every precaution to make it as safe as possible.”
Federal law now requires that all insurance companies allow their insured to use telemedicine. The center accepts a wide array of insurance and payment options, including workers’ compensation, trauma, accident, injuries, PPO insurance, Medicare and CenCal.
“They have to take care of the payment for that,” said Dr. Moelleken. “The patient cannot be stuck with the bill.”
Even though residents are being advised to stay at home, life still continues. People fall, accidents occur and spinal issues are ongoing.
“Orthopedic problems will keep happening, spine problems will keep happening. I think people have to realize that if they have a problem, there is help available,” Dr. Moelleken said.
Before the pandemic, doctors were not allowed to call in pain medicine to a pharmacy — the patient was required to come in to get them. Now, because of ths pandemic, medications must be called in. This makes things more convenient for patients, as Dr. Moelleken explained that things may continue to change moving forward — and at a rapid pace.
“As much as I don’t like to say it and don’t like to hear it, we have a tough road ahead of us,” Dr. Moelleken said.
When the pandemic subsides, Dr. Moelleken envisions that his office will continue to use telemedicine for his patients.
“When you see somebody in pain and they’re calling you from their living room and you realize that you save them a lot of discomfort or pain by not having to drag themselves into the doctor’s office, that’s very gratifying. I think we’ll keep it up after this pandemic is long over.”