Doctors offices around the Austin area are starting to rethink how they do their daily work and change the way they interact with patients. Many of them are starting to employ telemedicine — in which you see a doctor virtually — or prescreen patients before they come into the office.


On Friday, when Gov. Greg Abbott declared a state of emergency, he paved the way for state agencies to use telemedicine, and the Texas Medical Board also allowed for the medical community to use telemedicine, including the use of phone only, to see patients. (In an emergency, such as chest pains you think might be a heart attack, patients should call 911 or call their doctor to see if they should go to the emergency room.)


Ryan says if patients are having trouble getting through, a provider will call them by phone first and walk them through what’s needed for a video appointment.


Central Family Practice sent an email to its patients on Monday announcing that it will use "remote office visits" for all initial contact. That means staff will call patients using a HIPAA-compliant telemedicine program. All patients need is a smartphone or computer with a camera.


If patients need to be seen at the office, some screenings will happen with a healthcare provider coming out to their car in the parking lot. If a patient suspects they have COVID-19, the illness caused by the coronavirus, Central Family is following CDC guidelines. They’ll test for flu and strep at the car to rule those out before testing for the coronavirus. While they have a few coronavirus tests, they don’t want to use them before they’ve ruled other things out.


If a patient needs something that requires them to go inside the office, such as heart monitoring for chest pains or stitches, the patient will be screened for the coronavirus before they can come into the office.


Women’s health nurse practitioner Connie Ryan, who owns Central Family Practice, says she began preparing for this scenario two weeks ago, getting a telemedicine program in place and the office up to speed on procedures.


"Patients are very happy," Ryan says. "We’ve only gotten positive feedback."


Ascension Texas has been encouraging Central Texans to use its online telemedicine program, which doesn’t require insurance. Download the app at ascension.org/onlinecare, and use the code HOME for a discounted $20 visit.


Dr. Johnny Franco of A More Beautiful You has been encouraging his patients to use telemedicine, which he has used for years, for initial visits as well as follow-up visits.


If a patient has something that needs to be done in person, such as removing drains or sutures, his office is allowing them to check into the office and then wait in their cars rather than the waiting room. Staff will text them when it’s time to go back to the treatment room.


Franco says they are trying to limit the number of people in the office at one time from 50 people on a typical day before the pandemic to 10 people or fewer now.


"We can’t just shut down like Nordstroms or something like that," Franco says. "Care needs to continue in some form or fashion."


In the office, they continue to clean rooms and all the bedding and garments between patients, and they’ve also become more aware of cleaning screens — such as the iPads they use.


And, of course, there’s no more handshaking, only elbow bumping.


He has had several doctors’ offices contact him about how he conducts telemedicine because of the coronovirus.


"It’s the wave of the future," he says. "We’ve been forced into action a lot faster right now."


He sees this as a way to expand care to more people who might not have access to it right now.


The Austin school district also has sent out messages to its students about how they can get access to telemedicine through its partner Virtual Care for Kids.


At Thriveworks Counseling, therapists have moved to teleconference or telephone sessions for all clients who want it. Some of clinicians are now offering sessions only remotely, says Debbie Roberson, owner of Thriveworks’ North Austin, Bastrop, Pflugerville, Cedar Park and South Austin locations.


Austin Regional Clinic has some limited video consultation capabilities, though it is trying to increase that option. It will call patients in advance if their visit is one that can be done by telemedicine.


ARC has changed some of the ways patients are treated. An email with details was sent to patients on Wednesday.


First, ARC has set up tents outside its buildings or screening areas by the entrances or inside the buildings, but not in the office. Patients are greeted there instead of inside.


All patients and visitors will be screened.


If you have a fever or other symptoms of a viral illness, you will check in at the staging area and then be asked to wait in your car until it is time for the doctor to see you. The staff will text you to come in and you will be given a mask.


If you don’t have those symptoms or a sick family member, you will be able to check in as usual and wait in the regular waiting room, which only will have people who have passed the screening measures.



At Cardiothoracic and Vascular Surgeons, where patients are vulnerable to life-threatening symptoms caused by the coronavirus because of their heart and lung conditions, the office is calling patients in advance to prescreen them as well as delaying nonessential appointments. Beginning Tuesday, the office will have a staging area separate from the waiting area to screen patients before their visits.


UT Health Austin, the group practice designed and managed by the faculty and staff of the University of Texas Dell Medical School, is asking patients who have a fever, cough, shortness of breath or have come in close contact with a person diagnosed with or suspected to have the coronavirus to call 833-882-2737 before their appointments.


When they come to the Health Transformation Building, they are being screened before they can enter, which will take additional time.


They also are asking patients to bring another person with them only if they have physical disabilities or if the patient is a child.


If you have a regularly scheduled appointment at any doctor’s office, check their website or your email for messages or call ahead to make sure you understand what the visitor policy might be and what screening you might need.


At Texas Children’s Pediatrics and urgent care locations, screenings are taking place before entry into the office. Families are asked not to bring siblings or other visitors with them, just a parent or caregiver.


At Texas Children’s Specialty Care Austin, no siblings or other visitors younger than 18 will be allowed.