Editor’s note: Pediatricians around the country have risen to the challenges posed by the coronavirus disease 2019 pandemic. Some are on the front lines battling the virus; others are connecting with patients while hunkered down at home. They are relying on creativity, ingenuity and tenacity to keep their patients healthy and their practices afloat. Here is one pediatrician’s story.
You could say the stars aligned for Ruben J. Rucoba, M.D., FAAP.
After having a bone marrow transplant 16 years ago, he slowly was gravitating away from seeing patients. Last year, he took a newly created position as director of medical services for PediaTrust, a “super group” made up of 11 pediatric primary care practices and one specialty pediatric practice in the Chicago area. Among his duties was to start a telemedicine program.
He launched the program in December, but it was difficult to get parents on board due to lack of insurance coverage.
Then coronavirus hit.
“For me, telemedicine was going to be the thing of the future anyway, and now it’s just taken off,” he said.
The super group, which includes 70 doctors, made a slew of other changes to make sure they could continue caring for their 70,000 patients during the pandemic.
The overriding concern was to keep kids who might have coronavirus out of the offices so they didn’t expose other patients and staff, and to preserve personal protective equipment (PPE). So patients with severe symptoms were sent to an emergency department.
“We want to do what’s right for patients. We want to do what’s right for our staff, and we want to do what’s right for the general health care system overall,” Dr. Rucoba said.
If children were thought to have strep throat or the flu, offices tried to limit the number of people who came in contact with them in case they had coronavirus. The patient would be put into an exam room immediately, and a nurse would call the parent on a cellphone to get the history. Then, a pediatrician would go in briefly to get vitals and do an exam.
Some offices set up areas in the parking lot, where one staff member donned in PPE would do tests for strep, flu or respiratory syncytial virus.
“Patients actually like that,” Dr. Rucoba said. “They don’t want to come into the office. They don’t mind these setups.”
As the pandemic rages, PediaTrust is thinking about how to catch up with well-child visits that are being put off. One idea is to use telemedicine to conduct most of the visit and then set up something like a flu clinic to get vitals and administer vaccines.
While PediaTrust has adapted quickly, Dr. Rucoba acknowledged the group didn’t have a disaster plan.
“We were flying by the seat of our pants,” he said.
To read other pediatricians’ stories, visit https://www.aappublications.org/news/2020/04/21/covidvignettes042120.
