Dear Fellow Bay State residents,

It’s been a little more than a month since COVID-19 led Gov. Charilie Baker to issue a stay-at-home advisory. In that short period of time you have likely made sacrifices to help stop the spread of the virus and we’re beginning to see the pay off. And although hospitals and medical offices have had to urgently adapt, health systems across Massachusetts are still standing and ready to take care of you.

We’d like to take this opportunity to thank you for your sacrifices and implore you to please, check in with your primary care provider and continue getting medical care. Even if you don’t have symptoms of COVID -19, and especially if you’re one of the estimated 4 million Bay Staters who have at least one chronic illness, we’d really like to hear from you.

There has been a lot of coverage of how hospitals are increasing capacity to care for sick COVID-19 patients, and at least locally, our preparations have been successful. Thankfully we have enough beds and ventilators to go around and by current estimates, we may be just on the back side of the initial surge. What worries us though is that there has been a 50% drop in primary care visits over the last six weeks. Simultaneously we’ve seen a 70% reduction in new cancer diagnoses, and notable declines in strokes and heart attacks. This drop does not indicate a miraculous curing of cancer or cardiovascular disease. Instead it raises the possibility of a more ominous threat looming in the not-too-distant future, a wave of very sick patients whose conditions might have been much less severe, or even prevented altogether, with timely access to primary care.

Your primary care office is still here for you and one could argue we’re better equipped than ever to keep you healthy and at home. Historically, in order to prevent you from being admitted to the hospital we asked you to come into our office regularly so we could adjust your medication, check your vital signs and provide counseling. Since the pandemic struck, however, we’ve made changes to allow you to more easily receive primary care from a distance.

Telemedicine is now offered widely, and your primary care physician (PCP), along with a team of nurse practitioners, physician assistants, medical pharmacists, social workers, nurses and population health specialists can talk to you by phone or video. The software is secure and designed to protect your privacy, and will be as convenient as talking to family or friends over Facetime. No parking, no traffic, no crowded waiting rooms, no lines. In addition, if together we decide that you do need to come into the office for an in-person assessment, we have safe and careful ways to be sure you are not put at risk during an office visit.

So, if you’re reading this and wondering if you should call your doctor, we’ve put together a simple check list to help.

• How often did you see or speak with your PCP before COVID? Has it been at least that long?

• Do you have a diagnosis of heart failure, diabetes, depression, anxiety, hypertension, asthma, lung disease, chronic kidney disease, chronic liver disease, chronic heart disease, HIV or other chronic illness?

• Are you having issues with housing, food security or feeling safe at home?

• Are you running low on medications, having trouble paying for your medications, or do you have so many you can’t remember how or when to take them?

• Do you have a new health problem or symptom that is not improving?

• Are you having intrusive thoughts of anxiety or fear, or feeling down or hopeless, in our current circumstances?

• Are you looking at this list and still not sure if you should call your doctor?

If the answer to any of these questions is yes or maybe, you should check in with your primary care provider’s office!

Finally, don’t be surprised if your PCP calls you to set up a visit. For your safety we’re reviewing our patient lists and trying to reach out to people we think are at high risk for hospitalization. If you get that call, please make some time for us, we’re calling because we care and we want to make sure you’re staying healthy.

Primary care teams exist to keep you out of the hospital. COVID-19 did not magically eliminate diabetes, heart disease, hypertension, depression, asthma or COPD, but it did make it easy for many of us to neglect those conditions for a while. It would be a tragedy if we survived the global COVID-19 pandemic only to be overrun by a wave of familiar and treatable illness. We’re here for you. Call us.

James A. Heckman, MD, is assistant medical director, Healthcare Associates; medical director, High Risk Care Management, Healthcare Associates; and instructor in medicine, Harvard Medical School

The undersigned have reviewed the content of this letter and wish to formally offer their support

Atrius Health

Philip Ciampa, MD, MPH

Chief Innovation Engineer

Atrius Health

-

Jane F Fogg, MD, MPH

Chair of Internal Medicine

Atrius Health

Daniel H. Slater, MD

Chairman, Pediatrics | Medical Director, MassHealth ACO

Baystate Health

Elizabeth Boyle, MD

Vice President, Primary Care and Clinical Integration

Department of Medicine

Division of General Internal Medicine

Baystate Medical Practices

Beth Israel Deaconess Medical Center

Marc L. Cohen, MD

Medical Director, Healthcare Associates

Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center

Assistant Professor of Medicine, Harvard Medical School

James Heffernan, MD, MPH

Primary Care Section Chief

Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center

Associate Professor of Medicine, Harvard Medical School

-

Ateev Mehrotra, MD, MPH

Hospitalist

Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center

Associate Professor of Health Care Policy and Medicine, Harvard Medical School

-

Eileen Reynolds, MD

Chief of Division of General Internal Medicine and Primary Care

Vice-Chair of Education, Department of Medicine

Beth Israel Deaconess Medical Center

Associate Professor of Medicine, Harvard Medical School

-

Beth Israel Lahey Health Primary Care

Elizabeth H. Johnson, MD, MS, FACP

Chief Medical Officer

Boston Medical Center 

Katherine Gergen Barnett, MD

Vice Chair of Primary Care Innovation and Transformation

Program Director Family Medicine Residency

Boston Medical Center

Boston University Medical School

Jason Worcester, MD

Medical Director, Adult Primary Care Practice

Assistant Professor of Medicine, Boston University School of Medicine

Shapiro Ambulatory Care Center/Crosstown Center – Boston Medical Center

-

Brigham and Women’s Hospital

David Westfall Bates, MD

Chief of General Internal Medicine

Brigham and Women’s Hospital

Medical Director of Clinical and Quality Analysis, Partners Healthcare

Professor of Medicine, Harvard Medical School

Professor of Health Policy and Management, Harvard School of Public Health

-

Cambridge Health Alliance

Jessamyn Blau, MD

Medical Director, Broadway Care Center

Medical Director, Outpatient COVID Care

Cambridge Health Alliance

Lora Council, MD, MPH

Senior Medical Director Primary Care

Cambridge Health Alliance

-

Lara Hall, MD

Staff Physician /Clinical Lead Respiratory Clinic

Community Care Cooperative

Julita Mir, MD

Chief Medical Officer

Harvard Medical School Center for Primary Care

Russell S. Phillips, MD

Director, Center for Primary Care

William Applebaum Professor of Medicine

Professor of Global Health and Social Medicine

Harvard Medical School

Gordon Schiff, MD

Quality and Safety Director, Center for Primary Care

Associate Professor of Medicine

Harvard Medical School

Associate Director, Brigham and Women’s Hospital Center for Patient Safety Research

-

Massachusetts General Hospital

Michelle M. L’Heureux, MD, FACP

Director of Primary Care

Division of General Internal Medicine

Massachusetts General Hospital/ Massachusetts General Physicians Organization

-

Newton Wellesley Hospital

Mohini Daya, MD

Internal Medicine and Pediatrics

Medical Director of Primary Care

Newton Wellesley Medical Group

Tufts Medical Center

Wayne Altman, MD, FAAFP

Professor of Family Medicine and Jaharis Family Chair of Family Medicine

Department of Family Medicine

Tufts University School of Medicine

Karen M Freund, MD, MPH

Sara Murray Jordan Professor of Medicine,

Tufts University School of Medicine

Vice Chair of Medicine

Tufts Medical Center

-

Benjamin A. Kruskal, MD, PhD, FAAP, FIDSA

Medical Director

New England Quality Care Alliance

The undersigned have reviewed the content of this letter and wish to formally offer their support

 

Atrius Health

Philip Ciampa, MD, MPH

Chief Innovation Engineer

Atrius Health

 

Jane F Fogg, MD, MPH

Chair of Internal Medicine

Atrius Health

 

Daniel H. Slater, MD

Chairman, Pediatrics | Medical Director, MassHealth ACO

 

Baystate Health

Elizabeth Boyle, MD

Vice President, Primary Care and Clinical Integration

Department of Medicine
Division of General Internal Medicine

Baystate Medical Practices

 

Beth Israel Deaconess Medical Center

Marc L. Cohen, MD

Medical Director, Healthcare Associates
Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center
Assistant Professor of Medicine, Harvard Medical School

 

James Heffernan, MD, MPH

Primary Care Section Chief

Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center

            Associate Professor of Medicine, Harvard Medical School

 

Ateev Mehrotra, MD, MPH

Hospitalist

Division of General Internal Medicine and Primary Care

Beth Israel Deaconess Medical Center

Associate Professor of Health Care Policy and Medicine, Harvard Medical School

 

Eileen Reynolds, MD

Chief of Division of General Internal Medicine and Primary Care

Vice-Chair of Education, Department of Medicine

Beth Israel Deaconess Medical Center

Associate Professor of Medicine, Harvard Medical School

 

Beth Israel Lahey Health Primary Care

 

            Elizabeth H. Johnson, MD, MS, FACP

Chief Medical Officer

 

 

Boston Medical Center

 

Katherine Gergen Barnett, MD
Vice Chair of Primary Care Innovation and Transformation
Program Director Family Medicine Residency
Boston Medical Center
Boston University Medical School

 

Jason Worcester, MD

Medical Director, Adult Primary Care Practice

Assistant Professor of Medicine, Boston University School of Medicine

Shapiro Ambulatory Care Center/Crosstown Center – Boston Medical Center

 

Brigham and Women’s Hospital

David Westfall Bates, MD

Chief of General Internal Medicine

Brigham and Women’s Hospital

Medical Director of Clinical and Quality Analysis, Partners Healthcare

Professor of Medicine, Harvard Medical School

Professor of Health Policy and Management, Harvard School of Public Health

 

Cambridge Health Alliance

Jessamyn Blau, MD

Medical Director, Broadway Care Center

Medical Director, Outpatient COVID Care

Cambridge Health Alliance

 

Lora Council, MD, MPH

Senior Medical Director Primary Care

Cambridge Health Alliance

 

Lara Hall, MD 

Staff Physician /Clinical Lead Respiratory Clinic

 

Community Care Cooperative

Julita Mir, MD

Chief Medical Officer

 

Harvard Medical School Center for Primary Care

Russell S. Phillips, MD 

Director, Center for Primary Care

William Applebaum Professor of Medicine

Professor of Global Health and Social Medicine

Harvard Medical School

 

Gordon Schiff, MD

Quality and Safety Director, Center for Primary Care

Associate Professor of Medicine

Harvard Medical School

Associate Director, Brigham and Women’s Hospital Center for Patient Safety Research

 

 

Massachusetts General Hospital

Michelle M. L’Heureux, MD, FACP

Director of Primary Care

Division of General Internal Medicine

Massachusetts General Hospital/ Massachusetts General Physicians Organization

 

Newton Wellesley Hospital

Mohini Daya, MD

Internal Medicine and Pediatrics

Medical Director of Primary Care

Newton Wellesley Medical Group

 

 Tufts Medical Center

Wayne Altman, MD, FAAFP

Professor of Family Medicine and Jaharis Family Chair of Family Medicine

Department of Family Medicine

Tufts University School of Medicine

 

Karen M Freund, MD, MPH

Sara Murray Jordan Professor of Medicine,

Tufts University School of Medicine

Vice Chair of Medicine

Tufts Medical Center

 

Benjamin A. Kruskal, MD, PhD, FAAP, FIDSA

Medical Director

New England Quality Care Alliance