Sign In Forgot Password

ISSUE 7 VOLUME 1

03/24/2020 02:08:37 PM

Mar24

Dr. Ron Kastner

I would like to write why I'm hopeful. More accurately, how I try to be hopeful. I have my share of worries; a daughter 6000 miles away from home, an 84 year old mother I'm not allowed to host, the daily concern that my wife or I may get exposed by one of our patients, and in turn expose others including our own family.

I'm hopeful because of what I've seen happen in the past and what is transpiring to shape the future. 

Over 30 years ago I began my medical odyssey at NYU Medical School and Bellevue Hospital.  It was there that I learned about an RNA virus (similar to today's Corona menace) which was overwhelming the NYC health system. Entire wards were dedicated to it and in a few years’ time it was predicted to consume entire hospitals. There was the very same logarithmic charts and the race to flatten the curve. The virus then was HIV.

The disease of AIDS unleashed a Tuberculosis epidemic that required us healthcare workers to wear gowns, masks, and gloves, much like today. The public was asked to change their behaviors while medicine raced for a cure. In my day, HIV was a death sentence of the worst kind. The only question was would you die from meningitis, pneumonia, dehydration, or bone marrow failure? It seemed endless and hopeless. Well, today we all know there are no longer HIV wards.  Today, there are many treatments available that can make HIV more manageable than diabetes. (Think how great Magic Johnson is doing). The epidemic that looked so insurmountable is now a historical footnote.

The other source of hope is how I see medicine is transforming before our eyes.

My group is starting to offer drive thru Covid testing and telehealth.  Something that two weeks ago government regulations, administrators and medical legal experts would have restricted. But, with this crisis, those barriers have fallen, and for telehealth, it should stay. Picture a patient with Parkinson's and  Diabetes that needs to be brought by his daughter and aide in a wheelchair every four months to the neurologist and every three months to the endocrinologist. Think of the time and effort on the daughter's behalf. Maybe she needs to miss work that day. Maybe an ambulette needs to be ordered. Think of the exposure to flu and other viruses in the waiting room.

Well now picture having a video conference instead of those visits. Not for every visit.  Some visits require hands on exam. But the majority of those visits; to review lab work, symptoms and adjust medication can be done remotely.  Think of all the time and effort saved for the daughter. Think of the expense reduced by not needing an ambulette. Think of the improved hygiene of keeping an elderly patient out of the office. This week my wife started Telemedicine and I hope to start next week. I think Telemedicine is here to stay and it will be a positive legacy from today's situation.

So look to the past, look to the future. This will one day be a footnote in history and maybe a turning point in patient centered medicine.

Stay healthy and hopeful.

By: Dr. Ron Kastner

Mon, March 30 2020 5 Nisan 5780