In the past week Ive been involved in three different medical appointments, one for my wife and two for myself. Those encounters portend fundamental changes all of us are going to experience moving forward.

Call us when you get to the parking lot, my dentists receptionist told me during a call Wednesday, in advance of a Thursday morning visit. When I did, she instructed me to enter the building.

A hygienist wearing a face mask and rubber gloves met me in the waiting room, holding a form on which there were eight questions she proceeded to ask.

The first was: Do you have a fever, or have you felt hot or feverish recently (14-21 days)?

She also asked if Id had a cough, or flu-like symptoms or shortness of breath. Down near the bottom was this one: Have you traveled in the past 14 days to any regions affected by COVID-19?

More or less, thats like asking if Id traveled anywhere, because the virus has struck just about everywhere, save the Mojave Desert and certain counties in Montana and Wyoming that have far more cows than people.

All the personnel in that dental office wore gloves and masks. And absent from the waiting room were any magazines whatsoever; in the past there were at least 25. The same was true at Vistar Eye Center on Jefferson Street, which I visited Thursday afternoon for a previously scheduled ophthalmologist appointment.

Two feet inside Vistars lobby, an attendant took my temperature as soon as I walked in. She stood behind a clear plastic shield with a cut-out that allowed her to extend her gloved hand, which held a small, no-touch electronic thermometer.

In Dr. Frank Cotters ophthalmology suite, everybody wore masks and gloves (which they changed after washing their hands in between each patient). Each treatment room was disinfected after a patient left it. Disinfecting wipes and lotions were strategically placed in the office, too.

Many of the chairs in Vistars waiting rooms were overturned to prevent patients sitting too closely together. Upright chairs were set apart at 6-foot distances.

Last weekend, Donna tripped and fell on a sidewalk along Grandin Road and injured her left arm. So I drove her to VelocityCare, the Carilion Clinic-owned urgent care center on Electric Road in the Tanglewood area. There, she answered the screening questions from the passenger seat of our SUV before they would let her in the door. (As it turned out, her arm was fractured.)

And those are the minor changes in medical treatment that youre likely to experience soon if you havent already. Its going to be that way for months into the foreseeable future, at the least.

For many appointments, you may not visit your physician at all. Instead, youre likely to wind up talking to them on the phone, or over a digital video link via broadband internet.

It is a whole new world, said Kim Roe, Carilion Clinics vice-president for family and community medicine. (She also oversees VelocityCare.)

Dr. Steve Morgan, a family practice physician and Carilions chief medical information officer, said prior to the pandemic, the health care provider had taken small steps toward telemedicine, mostly in psychiatry.

We were providing around 100 video visits per day, Morgan said. Now, were providing 600 to 700 video visits a day, across a variety of specialties, he said. Previous to the pandemic, Carilion expected it would be two years before they reached that volume of telemedicine visits.

We didnt anticipate it happening over 40 days, Morgan added.

Even primary care, which only a few months ago was nearly all person to person, is now often iPad to iPad or doctor and patient talking on the phone.

A friend of mine, Jeff Krasnow, experienced this firsthand during a recent annual physical with a non-Carilion doctor.

It was predominantly telemedicine, he told me.

What about the blood draw? I asked.

Krasnow said a couple of days before the video consultation with the doctor, he drove to his physicians office parking lot. There, a phlebotomist drew blood from his arm as he stuck it out his drivers-side window.

The pandemic has caused a physical shakeup in health care thats forced practitioners to differentiate between what needs to be brought into the office and what can be done on a digital platform, Roe told me.

Our patients have also seen the benefits of it, Morgan said. Many patients will see it as, this is a more convenient way to interact with [health care] providers.

Of course, telemedicine cant substitute for in- person doctor visits in every case. No doctor can yet put a broken limb in a cast via an iPad or smartphone. For that reason, Donna has an in-person appointment with an orthopedic surgeon Monday.

Roe said Carilion is also sensitive to the fact that not everyone owns technology that will allow video doctor visits. And even when patients do, they may not possess the technological savvy to make it happen.

Besides that, broadband isnt necessarily available in all rural areas Carilions geographic reach extends to Galax and Tazewell County.

And many patients, Roe noted, buy cellphone minutes in blocks. On any given day, they might not have enough phone minutes for a telephonic visit.

So office visits arent going away completely. But those patients can expect to see far fewer waiting-room magazines and far more masks and latex gloves, and to be screened for COVID-19 before they get in the door.

I think its important for your readers to know that, if they feel like they need services, theres a safe place for us to provide care to them, Roe said.

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CASEY: The brave new world of post-pandemic medicine - Roanoke Times