CareMount Medical is the largest independent multispecialty medical group in New York state, with more than 45 locations in the New York metropolitan area and Hudson Valley. The New York metropolitan area is the epicenter of one of the most intense COVID-19 outbreaks in the country. We asked Scott D. Hayworth, MD, President and CEO of CareMount Medical, to share his perspectives on what his medical group is experiencing and how caregivers are responding to surging demands for testing of possibly infected patients.
Q: What level of demand for COVID-19 testing are you seeing?
A: Tests are still our biggest issue. We’ve asked our doctors to test sparingly because we simply don’t have access to a sufficient quantity of testing kits. Since we started having a test to offer, we have sent off 743 tests, but only have 223 results in, with 28 positives. The turnaround time has been very slow. If patients are stable, they remain at home. If they’re very sick, with trouble breathing, they are sent to the hospital. The hospital closest to our headquarters in Chappaqua, NY, has five people on ventilators who are positive for the virus.
Our clinical volumes are about 50% of what they were and as of last Friday we have gone to non-elective procedures only. Although we’re seeing a lower volume of patients, our physicians and staff are more available to speak to patients over the phone.
As part of our efforts to sustain our volumes and be available to our patients, we are offering virtual office visits with CareMount doctors. Thinking strategically a few years ago, we licensed the Teladoc platform. We are now aggressively ramping up our telemedicine capabilities and will likely convert the bulk of our 10,000 patient encounters to the virtual telemedicine platform. Our 655,000 patients can be at ease knowing that their CareMount physician is available for an in-person appointment online.
Q: Looking forward, what are the financial implications of decreases in volume?
A: We’re watching that very closely. We are making internal decisions about what moves we have to make. I think any help the state and federal government can give us is important. With nearly 3,000 employees and 45 offices, we are the ones on the front line of taking care of patients. Our 500 physician’s admit to roughly nine hospitals throughout the region. We’re an important employer and an important caregiver. I’m sure that any government assistant made available will support hospitals, which they should, but they also need to support physician groups.
Q: How are you managing care provider contacts with possibly infected patients?
A: We talk to patients before they come in, and when they arrive, we ask them to stay in their cars until they’re called in for their appointment, rather than having our patients sit in the waiting room. For the time being, we’re doing well exams in the morning and sick exams in the afternoon. And we’re doing a deep cleansing at night. Telemedicine is becoming a bigger part of our response and plan every day.
We are putting masks on any patient at risk and any patient who is suspected of being positive. We received a delivery of masks last week, which will help. All clinical people are masked all the time now. Providers are using higher performing masks for higher risk situations.
Q: Are you dealing with any physical capacity issues?
A: We consolidated and moved patients to six of our eight urgent care centers to be more efficient. At some point we may decide to reduce the number of offices we have open, but right now, all our offices are open.
Q: What is your advice to other medical groups who are confronting or may soon confront coronavirus in their communities?
A: It’s hard to find the middle right now, but I think everyone has to be careful not to underreact or overreact. We have to remember that as a country, we’re providing care to hundreds of millions of people with all types of medical conditions. We can’t close our doors to patients, because two or three months from now our patients will present with other serious conditions as a result of not receiving care. We want providers to take all the proper precautions and be judicious about the way they practice, but we have to remember that patients have other health conditions besides the virus.
Every leadership team has to figure out how to keep their businesses operating to make sure they take care of the people who need care, whether it is virus-related or not. Leaders have to be honest and authentic and focused on the goal ahead while being supportive of their teams and help them work through a very difficult situation.