Dr. Michael Lefevre is the interim chair of MU’s Department of Family Medicine. He researches best practices in family medicine and public health, and is a physician himself.
Dr. Lefevre spoke about how the field of family medicine is changing during the COVID-19 pandemic to protect staff and patients – and to keep the most vulnerable among us, safe.
This is an excerpt from KBIA’s daily talk show, the Check-In with Janet Saidi, on Monday, April 13. You can hear the full show – here.
Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words. You can view more conversations at missourihealthtalks.org.
Dr. Michael Lafevre: Importantly, anything that we can manage at home, we manage at home. So, that they're [patients] not subjecting themselves to any other clinic environment, and that is true across all of the specialties. It’s certainly embraced in primary care, but also the other specialties are trying to manage, as much as they possibly can, through home video visits – an option, honestly, that wasn't available to us about five to six weeks ago.
And so, that's one of the key things. You mentioned what can be put off? You know, things that are truly elective. For example, some preventive services. “I feel fine. I just need a pap smear,” for example. Well, you can wait three months to have a pap smear, and you're not really putting yourself at risk by doing so.
Some elective screenings like colonoscopy for colon cancer, mammography for breast cancer. We're trying to delay for two or three months to free up space. We're doing all those things to try to protect the people who are quite honestly the most frail and the most at risk for suffering complications.
Janet Saidi: Let's go into video visits and telemedicine. Has that been a fairly smooth implementation?
Dr. Michael Lafevre: I would say smooth and rapid, very rapid. As a matter of fact, it hasn't been that long – literally about six weeks ago, the federal regulations changed in a way that enabled us to take care of patients at home through “tele-” technology.
Prior to that, for example, in a rural area, a patient would have to go into a local doctor's office and go through a particular setup and contact a position locally here, for example, to have a televisit, and now, well, we can do it at home.
We do it with technology that is familiar to many people. Zoom is the technology that we're using here. It works pretty smoothly and doesn't take a lot of ramp up on either the patient side or the provider side.
And the very first week after we moved to this technology, Family Medicine alone did about 950 televisits that way and have continued to expand that. In our clinics today, more than half of the visits that we're doing, on a daily basis, are being done by Zoom – by telemedicine – as opposed to in person.
For people who don't have that technological capability, we have to fall back to the phone without the video. I think that that's less optimal. I think there are things to be learned from the video that we don't get on just a phone visit and otherwise we bring them to clinic, but they fall into the category of people who need to come in.
Production on The Check-In is done by KBIA’s Kristofor Husted with assistance from Zia Kelly, Madison Conti and Hannah France.