How coronavirus is delaying cancer care and screening

"When we reopen, it's likely going to be a mix of telemedicine and in-person visits because we'll have to implement social distancing and stagger the number of people in the

waiting room at any given time,” she says. “It's a way of getting people the care they need while we wait to get back to a full capacity that we had before.” DOCTORS GRAPPLE WITH

PRIORITIZING PATIENTS FOR SCREENINGS As routine screenings and care begin to ramp up again, many providers are trying to prioritize the highest-risk patients first — those with a family

history of cancer, for example. However, some doctors say they don't really have a way to identify which patients ought to be brought in earlier than others. "The way our

electronic medical records are set up, I don't have a way to find those patients in the system,” says Gundry, who notes that it's better for high-risk patients to be a squeaky

wheel than patiently wait for a call from the office. “If the patient calls and says, ‘I'm high-risk,’ or the referring provider says they're high-risk, we can get them on the

calendar. But otherwise we have no way of identifying them." For other practices, the biggest challenge isn't fitting in patients or figuring out how to reschedule everyone,

it's staying in business. "If you're not treating COVID patients and you're not performing your usual services, then you're not bringing in any income,” says Carol

Huang, a dermatologist in private practice in Queens and Long Island, New York. “And when you do reopen, your cost of running the business is higher because you have to take precautions.”

Huang's dermatology clinic, which stopped seeing patients on March 21 when New York issued a shelter-in-place order, has purchased plexiglass guards, extra personal protective equipment

and cleaning supplies, and an ultraviolet C light for disinfecting rooms. "Not every provider, especially those that aren't affiliated with a large hospital or academic

institution, is going to be able to weather this financially. It could be one or two years before we can get back to our normal case volume,” she says. “If you're a younger doctor who

hasn't built up savings, or you're operating on thin margins, your patients may not have a clinic to come back to.” That could present a huge problem, experts say, since many

people already have trouble accessing cancer screenings. A 2015 report from the CDC found that, among those who were in the recommended groups for screenings, about 20 percent of women were

not up to date with cervical cancer screening and about 25 percent were not up to date with breast cancer screening. Two in 5 adults were not current with colorectal cancer screening.

"It would be a tragedy to take a step backwards in that way,” Kroshinsky says.