Visits

medicine

Ambassador of Brunei Darussalam visits Sidra Medicine

Sidra Medicine recently welcomed Mohamed Bahrin Abu Bakar, the Ambassador of Brunei Darussalam to the State of Qatar and Norfazerne Md Jaafar, the Second Secretary to its hospital.

The Ambassador and Md. Jaafar were welcomed by Mohammed Al Mana, managing director and member of the board of governors at Sidra Medicine;  Prof. Ziyad M. Hijazi, acting chief medical officer and executive chair of pediatric medicine and Hamza Al Kuwari, chief of administrative services.  They were taken on a tour of Sidra Medicine’s specialist pediatric and women’s services wards including the Heart Center. Both parties discussed Sidra Medicine’s role in welcoming patients from Brunei to Qatar and medical tourism. 

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dentist

Even dentist visits go remote during the COVID-19 pandemic

The COVID-19 pandemic has transformed many in-person activities into remote services delivered over the internet. The latest example is the dreaded visit to the dentist.

Dvora Brandstatter used to drive her son Elchanan half an hour to the orthodontist and back every month to make sure his braces were working properly. Now, from the comfort of her home in Bergenfield, New Jersey, she attaches a special scope to her smartphone camera, opens an app and inserts the contraption into the 11-year-old’s mouth. A video of the boy’s choppers is sent to his dentist, who checks progress, diagnoses any issues and sometimes ends the appointment right there.

“As a parent, having fewer appointments is a good thing,” Brandstatter said. “I haven’t seen a downside so far. It’s probably the way everything is moving anyway.”

The app and the scope were created last year by New Jersey-based startup Grin. After the pandemic hit, Chief Executive Officer and dentist Adam Schulhof said the company sped up development of the technology and partnered with manufacturer 3M to quickly distribute it to as many orthodontists as possible. About 5,000 units have shipped out and roughly 1,000 patients have used the system so far, according to Grin.

Schulhof, who uses the system for his own practice, said the coronavirus has spurred huge demand for new procedures that help people reduce the close contact that typically happens when they visit the dentist. The CDC has warned that dental instruments create spray that can contain droplets of water, saliva, blood and other debris, and has advised the use of “teledentistry” as an alternative to in-office care.

When the Grin videos arrive at the dentist’s office, other software from the startup helps practitioners analyze the condition of the teeth and integrates the footage with existing patient management systems. The app also lets patients see what the dentist sees inside their mouth. Not for the faint of heart.

There are already new, internet-focused dental services that Grin is going up against. Companies such as SmileDirectClub mail invisible aligners and braces to consumers. SmileDirectClub shares have more than doubled since the middle of March. Schulfhof said Grin’s offering is aimed at fighting the challenge to conventional dentistry from such direct-to-consumer offerings. “We’re trying to disrupt the disrupters,” he added.

In the short term, the technology will help orthodontists keep their businesses running while many patients avoid the dentist’s office completely, the CEO said. As smartphone capabilities improve and the software develops, Schulhof expects Grin’s scope to use artificial intelligence image analysis to become a more powerful diagnostic tool for dentists.

The CEO also sees the technology gaining traction in general dentistry where insurance companies may back its use. People’s teeth decay at different rates and more regular, remote checks, could be used to identify problems before they require more complicated and expensive treatment at in-person visits every six months, he said.

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health

Outpatient Visits Rebound for Most Specialties to Pre-COVID Levels

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

After taking a nosedive during the initial wave of the COVID-19 pandemic, then rising and plateauing, weekly outpatient visits in the United States have rebounded and now slightly exceed levels seen in late February, according to new data.

Overall visits plunged by almost 60% at the low point in late March and did not start recovering until late June, when visits were still off by 10%. Visits began to rise again — by 2% over the March 1 baseline — around Labor Day.

As of October 4, visits had returned to that March 1 baseline, which was slightly higher than in late February, according to data analyzed by Harvard University, the Commonwealth Fund, and the healthcare technology company Phreesia, which helps medical practices with patient registration, insurance verification, and payments, and has data on 50,000 providers in all 50 states.

The study was published online by the Commonwealth Fund.

In-person visits are still down 6% from the March 1 baseline. Telemedicine visits — which surged in mid-April to account for some 13% to 14% of visits — have subsided to 6% of visits.

Many states reopened businesses and lifted travel restrictions in early September, benefiting medical practices in some areas. But clinicians in some regions are still facing rising COVID-19 cases, as well as “the challenges of keeping patients and clinicians safe while also maintaining revenue,” write the report authors.

Some specialties are still hard hit. For the week starting October 4, visits to pulmonologists were off 20% from March 1. Otolaryngology visits were down 17%, and behavioral health visits were down 14%. Cardiology, allergy/immunology, neurology, gastroenterology, and endocrinology also saw drops of 5% to 10% from March.

Patients were flocking to dermatologists, however. Visits were up 17% over baseline. Primary care was also popular, with a 13% increase over March 1.

At the height of the pandemic shutdown in late March, Medicare beneficiaries stayed away from doctors the most. Visits dipped 63%, compared with 56% for the commercially insured, and 52% for those on Medicaid. Now, Medicare visits are up 3% over baseline, while Medicaid visits are down 1% and commercially insured visits have risen 1% from March.

Interestingly, the over-65 age group did not have the steepest drop in visits when analyzed by age. Children ages 3 to 17 saw the biggest decline at the height of the shutdown. Infants to 5-year-olds have still not returned to pre-pandemic visit levels. Those visits are off by 10% to 18%. The 65-and-older group is up 4% from March.

Larger practices — with more than six clinicians — have seen the biggest rebound, after having had the largest dip in visits, from a decline of 53% in late March to a 14% rise over that baseline. Practices with fewer than five clinicians are still 6% down from the March baseline.

Wide Variation in Telemedicine Use

The researchers reported a massive gap in the percentage of various specialties

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