The doctor will not see you now.
A cascade of calendar-clearing appointment delays and cancellations is adding to the anxiety gripping older folks as coronavirus cases surge across Massachusetts.
Thousands of scheduled appointments in March and April ― the physicals, blood work, check-ups with specialists, and colonoscopies that are part of the rhythm of life for many seniors ― have been postponed to the indeterminate future by hospitals, doctors’ offices, or patients suddenly loath to venture into a health care facility where germs might lurk.
“Almost everything’s been canceled, except the essential stuff,” said Boston Age Strong Commissioner Emily Shea.
Her agency’s Age Strong Shuttle, which carts older city residents from their homes to medical appointments, has scaled back from nearly 80 rides daily before the virus hit to about 20 now ― mostly to radiation therapy for cancer patients or dialysis for patients with kidney disease.
Although many patients see the wisdom in postponing non-urgent appointments, some of the cancellations have left seniors dealing with uncertainty and even pain.
Tufts Medical Center canceled two appointments this month for Marion Jones, 79, of Hyde Park, a retired administrator for the state Department of Veterans’ Services, including one she was looking forward to at its pain management clinic.
“I was disappointed,” said Jones, who suffers from spinal stenosis caused by fractures in her lower back. “I wanted to check in to make sure whether I needed a [cortisone] shot.”
Tufts, on March 11, became the first Boston hospital to start reducing “discretionary and elective clinical care” to limit the potential for viral infection and free up resources to treat COVID-19. The respiratory disease caused by the globe-trotting coronavirus is potentially deadly for older adults and those with serious underlying medical conditions.
Other health care systems in the area, including Beth Israel Lahey Health, the Partners HealthCare hospitals, and Boston Medical Center followed suit in cutting nonessential care, creating a formidable appointment backlog when the virus abates. All continue to provide emergency care.
“If someone actually needs to be seen, we’ll see them, but we don’t want most patients coming in right now,” said Dr. Hollis Day, chief of geriatrics at Boston Medical Center, the state’s largest safety net hospital. “It’s a little odd at times to walk down hallways that are usually busy and are now empty.”
Hollis said Boston Medical Center is offering patients the option of “televisits" ― telephone consults ― with their health care providers or Boston University medical students in place of appointments. “Not only are we checking on their condition, we’re making sure they have their meds and can get their groceries,” she said. The hospital isn’t deploying video yet, but Hollis said that may be added to the consults in the future.
For now, patients like Jones are bearing up and waiting until they can reschedule their in-person appointments. “You’ve got to have a strong spiritual life at a time like this,” she said. “At some point, this is going to come to an end.”
There is also concern that the spread of coronavirus, fear of infection, and travel restrictions will harm patients with other serious illnesses such as cancer and pulmonary diseases. Some foreign patients with rare cancers that can only be treated with novel immunotherapies already have been blocked from coming to Boston hospitals where the treatments are available, said Dr. Ayguen Sahin, founder of the Cancer Education and Research Institute in Cambridge.
“Cancer is a disease that requires fast treatment and diagnosis,” Sahin said. “If people don’t know if they have cancer, they have to get to the doctors to be diagnosed. My concern is the longer this [public health crisis] goes on, it could affect cancer patients on many levels.”
But many patients weighing the risk of other diseases against the risk of contracting COVID-19 are opting to stay away from hospitals and medical offices for now, often picking up the phone to cancel appointments before their doctors do.
Barrie Levine, 75, a retired lawyer in Wenham, plans to postpone upcoming appointments with her eye doctor to test for cataracts and glaucoma and with her dentist to have her teeth cleaned.
“I’m taking a zero-tolerance policy,” she said. “I’m going to all this effort to isolate from social contact. I told my daughter not to come up [to visit], so you think I’m going to worry about canceling with the dentist?”
There were no objections from Susan Peppercorn,, a career transition coach from Dover, when her primary care physician and cardiologist at Atrius Health canceled her appointments. “The doctors are under stress right now, so anything I could do to lessen their load was the right thing to do,” she said.
For people with more serious conditions, the choice is tougher. Joan Hollister, 87, of Peabody, went to the hospital with severe pain five weeks ago and had a large mass removed from her ovaries. She was scheduled to return for a post-op visit with her surgeon last week, but it was delayed.
“I was very happy because I didn’t want to go in to Brigham and Women’s now,” she said. “I’m fortunate there have been no complications. I hope I’ll be able to go in a month.”
Retired hospital employee Nancy Sholkin, 74, on the other hand, chose to keep her appointment at Newton-Wellesley Hospital this week to be examined for gallstones, which cause abdominal pain. “I was willing to put it off for a while, but then I thought, ‘Who knows how long this will go on?'" she said. “I’m willing to trust in God and take my chances.”
But another Newton resident, Shirley Goldberg, a painter and poet who said she’s over 90, willingly agreed to delay a laparoscopic procedure she’d scheduled for next month.
When the doctor’s office called her to postpone, she said, “I was expecting it, and if I didn’t hear I was going to reschedule myself. This is one of those times when we have to do the right thing for the moment and hope for the best.”
Robert Weisman can be reached at firstname.lastname@example.org.