In this episode we chat with ophthalmologist Dr. Angela Elam from the University of Michigan. Dr. Elam addresses common questions and concerns, and shares her advice for returning to the eye doctor among shifting COVID restrictions.
Returning to the Eye Doctor in 2021
Presented by Ricky Enger
Ricky Enger: Welcome to Hadley Presents. I'm your host, Ricky Enger, inviting you to sit back, relax, and enjoy a conversation with the experts. In this episode, we discuss returning to the eye doctor as COVID restrictions are lifted. And our guest is ophthalmologist Dr. Angela Elam. Welcome to the show.
Dr. Angela Elam: Thank you so much for having me.
Ricky Enger: It is great to have you here because I will tell you that we actually get lots of questions about heading back into the eye doctor. I know that a lot of our staff have similar questions too. So, I figured who better to address those than someone who is kind of dealing with this. And so, before we jump into the questions that we have, why don't you just tell us a bit about who you are and what you do?
Dr. Angela Elam: Well, as you mentioned, I am an ophthalmologist or an eye surgeon who specializes in glaucoma at the University of Michigan. I'm also a health disparities researcher. And so, my particular interest is really around ensuring that people who are at high risk for vision loss, particularly those from disadvantaged communities, are able to access eye care and therefore prevent preventable blindness.
Ricky Enger: That is so incredibly important. I know that a lot of people don't get the care that they need for various reasons. That's probably going to come up at least a couple of times during our discussion here. So, I guess the first question that I have is actually people returning to the doctor as these COVID restrictions are lifting. I know that during the pandemic, people sort of felt like, I can only go in if it's an emergency. I really am hesitant to leave my house. And now things are a little different. Do you see people now, are people more likely to be coming in? And what about those who aren't? What kinds of things would you say to them?
Dr. Angela Elam: During the height of the pandemic, not only were patients choosing not to come in for their safety, but we, as providers were shut down, really. Even patients who wanted to come in, oftentimes we were deferring their care for true emergencies, oftentimes people who needed emergency surgery or things like that. And so, there was a combination of inability for patients to come in, as well as a lack of desire for them to come in. Yes, now things are improving. The restrictions have been decreased and patients are feeling more comfortable as more people are vaccinated and such. So, we are seeing more patients. In fact, my schedule is probably busier than ever. And perhaps some of that may be still catching up to when patients weren't able to come in, but things are certainly no busier than ever.
Ricky Enger: And would you say, if somebody has been putting this off, is it a good idea for people to come in, if they've put things off for a while? I know that some people feel like, well, I don't want to go in and get yelled at by the doctor because I wasn't here for a long time. And now I just feel nervous about coming back in for that and other reasons. So, anything you could say about that?
Dr. Angela Elam: No, there will be no yelling or at least there certainly should be no yelling. Absolutely, you should come in because this is your health. These are your eyes. This is your vision. And so yes, absolutely people need to, as safely as you can come back in because we are here and ready to take care of you and your eyes and ensure that your vision is the best that it can be. We understand that during the height of the pandemic, people may have been nervous to come in and rightfully so, because in many cases, people were grappling with, do I come in to see my eye doctor and risk death from this virus that people were terrified about, including the physicians. The fear was amongst all of us.
But now that we're feeling a little bit safer and I put that in asterisks, a little bit safer, I do think it's time for patients to come in, because I believe that during the shutdown of many clinical activities, people did experience vision loss. They weren't able to get the care that they needed. And all hope is not lost. There's still a chance to intervene and prevent further vision loss. So absolutely. Please get back plugged in with your eyecare provider.
Ricky Enger: So, let's talk a little about logistics then, because it's difficult to imagine walking back into the office and sometimes signage might be difficult for you to see. And so being prepared as to what you need to do as you come in, can really help ease some of that. And I know that every office handles it differently, but I suspect there are going to be some similarities. So, let's, I guess, first talk about masks. Are staff wearing those and are you requiring patients to do that?
Dr. Angela Elam: I imagine the short answer to this is, it depends, but at most medical facilities, academic hospitals, we are still requiring everyone, staff, faculty, patients to wear masks. I imagine that perhaps there are some private practices that are independently owned, and they can make the rules as they see fit. But for many health facilities, there is still a mask requirement in place. And that is for everyone's protection, not just the patient, but our staff and the providers as well. People should be prepared to be asked multiple questions before they even step foot in the door, to perhaps ask about their travel recently or if they've experienced any symptoms.
And so, arriving a little bit early to account for that extra step of going through the questions to ensure everyone's safety, making sure that you have a mask available. I'm sure that if a patient doesn't have a mask available, that they will be offered one. Our operations in many places have changed in order to help with distancing. And so it may be that you have to walk a few more steps in the building, maybe to a different area where you haven't had to go to before, because we are trying to account for social distancing and just making sure that everyone is as safe as possible. So, allow a little more time and bring a little more patience and don't forget your mask.
Ricky Enger: And those logistics can be a little bit confusing sometimes. It helps so much to be prepared. So, what about for someone who is coming in and let's say that they're alone, they don't have a friend or family member with them and they're having difficulties seeing signage. What would you recommend, maybe calling ahead of time or are staff at the office ready and willing to direct people to the right places? How does that work?
Dr. Angela Elam: Absolutely. At the University of Michigan, we try to do a good job of sending out information prior to the appointment so that patients know what to expect when they get here. But if people are visually impaired and not able to read that information for themselves, there's always someone available to chat via phone prior to the exam to explain anything that may take place that day. And then certainly once the patient arrives, we're here to help. Ensuring that you are being taken care of at a place that is willing to help, I guess is important too. I'm certainly speaking from my perspective at the Kellogg Eye Center, but I imagine most places are that way, where we're here to do whatever, we can to help the patient. If you are not at a place where it feels like people are ready to help, then perhaps consider a different eyecare provider.
Ricky Enger: Exactly. For sure. Before the pandemic, and it's sometimes hard to remember what things were like before the pandemic, but at that time it was customary for people to say, I want to bring my spouse. I want to bring my family member with me just because sometimes I don't remember everything. Sometimes they have questions that I didn't think of. What is that like now? Is it okay for people to bring somebody with them?
Dr. Angela Elam: At the height of things, we were pretty strict about just allowing the patient back, except for, in situations where there was just no way that the patient care could be delivered properly without someone there. Now we are allowing, I believe one family member to come back for anyone who wants that. So, that's almost back to normal. Before, it could be whomever you like. If the whole family wants to come, fine. But I think now we're back to allowing at least one person in the room. So, we're back toward normalcy or a new normal, I guess you could say.
Ricky Enger: Yeah. Exactly. And that's so helpful because people, they feel more relaxed having someone there with them. And it's a good thing that we're seeing that now.
Dr. Angela Elam: Yeah. It's important because you may not remember everything the doctor says, you may not feel as comfortable advocating for yourself. I think it's always a great idea to have someone available with you to make sure that we're maximizing your care. Oftentimes when family members weren't allowed in the room, they would FaceTime or call and have them on speaker phone. And I absolutely welcomed that because as a daughter, as a mother, as a family member, period, I want to do whatever I can to make sure that those that I love are healthy. And sometimes that means being in the room, whether it's in-person or via phone. So, I'm glad that people are able to get back to some sense of normalcy and participate in their loved one's care.
Ricky Enger: Sure. And that's a great idea in the instance that somebody can't physically have someone come back, just using FaceTime or anything like that to make sure that somebody is there virtually or otherwise. How about the waiting rooms? I know that when you go into the eye doctor, there's kind of the public waiting room. And then depending on what procedure you're having, there might be additional waiting rooms, too. What is capacity like with those and who can come back, who is not allowed? Are things more or less normal in that respect now?
Dr. Angela Elam: What even is normal these days? We are still doing our best to keep people as physically distanced as possible. And so, in the case of the waiting rooms, we try to keep patients moving as best as possible. And so, when a patient arrives, instead of having them sitting in the main waiting room, we're really trying to do an even better job of staying on top of appointment times and immediately bringing patients back to the exam room to be worked up by the technician. And from there, depending on, like you said, what type of care they're getting that day, moving them to the next place and just really keeping everyone moving so that we're limiting the number of people in any one space at a time. There are times where it's just impossible really to do as good as we want to with the distancing, but we certainly still have protocols in place and are doing our best to keep people as safe as possible.
Ricky Enger: And what about the paperwork, the bane of everybody's existence, even before all of this? But now it's like, oh, am I going to have to touch a pin that somebody else touched just to fill out stuff or sign stuff? How are those things being addressed to keep everybody safe?
Dr. Angela Elam: There's lots of hand sanitizer and wipes and throwing things away. So, in a lot of situations, there may be pens that are single use or pens that are every day, all day bleached and wiped down constantly. So, you can be assured that at most places we are doing everything that we can to make sure that patients are safe. Like I said, lots of cleaning.
Ricky Enger: So, are there other things that people should think about as they're finally returning to the eye doctor? I know that for some people, they may be taking public transportation where they could be close to people who are a carrier of the virus or not vaccinated, or what have you. So even just coming out to the doctor's office can be both a risk to them and they may feel like, should I tell people how I got here, that I was on public transportation or that I took an Uber, and the guy wasn't wearing a mask? That kind of thing. What kinds of things might patients ask like that, and what could you say to just alleviate that concern or any others that people are having?
Dr. Angela Elam: I think people really just have to do their very best. My very best is to have been vaccinated, to wear my mask so that I'm protecting others as well as myself. As a patient, for any appointment that I have, whether it's a doctor's appointment, a hair appointment, I want to be prepared so that my appointment is efficient. I get everything that I need to get done while I'm there and I can get in and get out. And so, again, ensuring that you are vaccinated to protect yourself, wearing your mask to protect yourself and others. Particularly, if it's been a long time since you saw your eyecare provider, writing out a list before you get there of questions that you want to ask or things that you've been concerned about since your last visit, so there's not a lot of downtime and you're able to just fire off your questions and your doctor is able to work with you and make sure that all of your needs are met.
With regards to letting someone know, your transportation mode and all that, I can't think of a situation in which someone would be asked that. I don't even know if people would be asked about their vaccination status. I'm certainly not asking. Oftentimes patients are offering that information because they're so excited and they're so relieved. They're so relieved to have gotten the vaccination. Early on, I would be with patients, and we would celebrate that they were able to get vaccinated. They're like, "Are you vaccinated?" And I'm like, "Are you?" And then we, "Yay!" So do your best. Really, that's all any of us can do is do our best. And as long as we do that, and we're taking care of ourselves and being concerned about the wellbeing of others, I think that's all we can ask.
Ricky Enger: We've covered a lot today, but perhaps we've missed something. Are there any final thoughts that you would mention to people as they're maybe feeling trepidatious, or maybe it's just time for their annual appointment? And they're like, okay, I'm about to go get this done. What should I know? What should I think about? Anything we didn't cover?
Dr. Angela Elam: Well, I would say that the trepidation, the concern, the fear about going back into spaces where other people are, particularly healthcare facilities, where in your mind, that's where COVID is, sick people go to see the doctor. And so, I get that, but I want to encourage people to not sacrifice your preventive health, your vision, by staying away from the eye provider or doctor because of that fear. We know that there are disparities that exist in eyecare, disparities in disease itself, and then also disparities in access to care. And we know that during the COVID-19 pandemic, that some of those disparities in care were highlighted, illuminated, they already existed, but they were kind of brought to the forefront. And so, we don't want to see those disparities worsen.
We know that people based on their insurance type or race and ethnicity, or where they live may receive less eyecare than others. And it just so happens that because of COVID, oftentimes those people have been the hardest hit by COVID and therefore have the greatest amount of fear about returning to the eye doctor. And so, you can see how this is just this never-ending cycle that could potentially worsen disparities in eyecare, in vision loss and blindness. And so, I would just encourage everyone to check back in, check back in with your ophthalmologist, your optometrist, to just make sure that you're in a good place when it comes to your vision and your eye health, because you only get one set of eyes, and we want to partner with you to make sure that we're taking good care of you.
Ricky Enger: Perfect. Thank you so much for that. I really appreciate your taking the time to stop by and have a little chat. And I know this information is going to be helpful for so many people.
Dr. Angela Elam: Thank you for having me. I'm excited, actually. I want to do it again. When could we do it again?
Ricky Enger: We can do it again.
Dr. Angela Elam: Thank you for having me.
Ricky Enger: Thank you. Got something to say? Share your thoughts about this episode of Hadley Presents or make suggestions for future episodes. We'd love to hear from you. Send us an email at firstname.lastname@example.org. That's P-O-D-C-A-S-T@hadley.edu. Or leave us a message at (847) 784-2870. Thanks for listening.