After a brief return to normality, consulting face-to-face and operating on patients with Category 3 Orthopaedic problems, restrictions are again upon us.
We have reduced most face-to-face contact to minimise risk to all involved. Therefore, I am predominantly performing Telehealth consultations. We use in-person meetings for the majority of initial appointments and many follow-up reviews. A Telehealth consultation is either, a video and audio link to a smartphone or a computer (my preference), or a telephone call. With four months experience in Telehealth, most appointments go well. As well as discussing the critical health issues, a limited “examination” will take place. During the examination, I can look for things such as swelling and bruising, observe how you walk, if required, and assess the movement of a joint.
Telehealth is also our preference for persons who may be at higher risk of contracting COVID. High risk includes elderly patients, people who may have other significant health issues such as diabetes, lung or heart problems, and anyone who may be immunocompromised. Besides, it is often more convenient for people who may have to travel for an hour or more to attend their appointment.
We will decide on a case-by-case basis, whether a face-to-face consultation may be necessary. If we consider surgery is the best option, we will arrange an appointment in my office. At this subsequent consultation, I will perform a complete examination of the joint. It will also facilitate a comprehensive discussion of the operation, the post-operative course, the likely outcome of surgery, and the potential risks involved. A face-to-face appointment is vital for the immediate post-operative check-up. In person appointments may also be required at time-critical points following surgery.
As for surgery, the Government has banned non-urgent Category 2 and Category 3 operations (the Government has not stated the duration of the ban, but I anticipate an announcement on 13 September, when the broader restriction levels are reconsidered). These categories comprise the majority of elective Orthopaedic operations. Any fracture requiring surgery is permitted. Surgery for urgent Category 2 cases are also allowed, but these are quite specific. The Specialty Societies of the Australian Orthopaedic Association (AOA) have position statements with recommendations on what is acceptable. These recommendations are on the AOA website (www.aoa.org.au/covid-19).
Stay safe and healthy.