Here’s What You Need to Know Before Your Surgical Appointment
This interview was updated July 24, 2020 to include new information regarding the COVID-19 testing timeline.
We’re now deep into summer and a lot still seems uncertain. There’s no way to sugarcoat it; COVID-19 cases are skyrocketing nationwide, and safety is still very much a commodity to protect. That’s why we have exhausted every precautionary measure as we open our doors to daily surgical care once again. One thing we can guarantee: we will be transparent and forthright throughout this process.
Our reopening plans began with the work of our preparedness teams. They analyzed the layout of each and every space and determined social distancing patterns for hallways, elevators, waiting rooms, and exam rooms. Hand sanitizer is plentiful corner to corner, floor to floor. Patient volume is limited to avoid traffic jams and overflow, and your care teams and clinicians are equipped with everything needed to follow our protocols for distancing, safety, and hygiene. We are ready for you.
To answer the most pressing questions we went right to the source, Francine Castillo, Director of Practice Operations, to discuss what to expect when you come to the hospital.
Starting with the big question, who’s coming in for appointments?
It’s important to know that things are still changing. But we began seeing patients in our offices daily starting in mid May—patients with more urgent issues who need to come in for procedures, physical exams, testing. And we are keeping volume very limited hour to hour to ensure your safety with strict social distancing measures, staggered appointments, and screenings.
Now that the Governor has lifted the order to allow elective procedures, how does elective surgery factor in?
Yes! So right now what that means is we will be calling you to reschedule your elective procedure if you’ve been waiting, and we encourage you to call us! We are still prioritizing more urgent needs in the coming weeks, but we can get you on the schedule. We can’t promise it will be super soon, but we can talk about it and get the date set. Please know that we will work with you as much as we can! Don’t hesitate to call us.
All of our surgeons have been approved to operate at both the [David H.] Koch Center and Lawrence Hospital, and we’re operating on weekends, so we’re offering you as much availability and flexibility as we can provide safely. We know it’s been hard on our patients waiting to get procedures done, and we’re excited to be able to start those conversations again.
How does your doctor determine what’s urgent?
Right now, the decision is being left up to your physician. Some are of course clear cut, really urgent cases are moved to the front. But say you’re having a vein issue that may be viewed as cosmetic generally, and you’re in a lot of discomfort or pain, that could fall under the urgent category. No matter what though if you’re having an issue, you should call your doctor and get checked out, whether by video or in person. If it’s something that can’t wait, know that you’ll be taken care of.
What happens if you’re in a lot of pain? Say I’m having a vascular issue and I called the office, my message would be relayed to my doctor to determine the next steps?
Yes, they may start with a video visit right away to make sure and check-in as quickly as possible, or they could just say “you need to come in.” And for appointments like follow-ups and check-ins, video visits have been really great. You don’t have to travel and you get face time with your doctor quickly.
I’ll link to our article on video visits here. But if you need to come in for an appointment, what’s the screening process like when you arrive?
Well, first be wearing a mask. You must have a mask on to enter the building. And if for some reason you don’t have one, we will have a mask waiting for you, but still come in wearing a cloth covering. Then you’ll enter one of the designated entrances, likely the Herbert Irving Pavilion or Milstein entrance. Security is there, but you don't have to show your ID anymore, and there are three stations set up with an MA, RN, or NPA at each station. And depending on if there's a line, you go to a station, they take your temperature and also confirm your appointment.
Every patient is still required to enter the hospital by themselves, is that right?
Yes and no. First, that is still the policy in place for non-surgical appointments. If you’re not having surgery, please don’t try to come in with a guest at this time because we can’t let them in, even though we wish we could. And your guest can’t wait downstairs, they’ll be stuck outside and no waiting areas are available. We know it’s hard, but for anything that’s not surgery, only our pediatric patients, or those pre-cleared with special needs are allowed in with one guest. Otherwise, we have escorts available to get you where you need to go.
But, the good news is that if you are having same-day surgery, you are welcome to bring one guest to stay with you through intake and then rejoin you for the discharge process. Additionally, we are now able to allow one visitor per patient in our in-patient units between the hours of 11 am to 3 pm.
That’s great! What will elevators and waiting rooms be like?
Right now our goal is to actually avoid the waiting rooms as much as we can and get you right back to the exam room. So your wait time will likely be very short or less than it was before. But there are escorts at the elevators and in hallways to ensure proper distancing, only permitting 4 to an elevator, and that lines are properly spaced. We have floor decals and elevator decals that make social distancing as simple as possible too.
Part of the preparation was setting up waiting rooms with proper spacing and signage. Chairs are marked for designated seating and the areas are cleaned between every single patient. And we're still doing check-in online and any payments online so you don't have to do any physical transactions. It’s actually very calm, people are very cognizant about spreading out. We’re quick to adapt!
Do you need to get a Covid test before coming in for your appointment?
Yes. That’s the biggest update to policy—Anyone coming in for a procedure or surgery or test must have Covid testing done at least 2 days before and no more than 5 days before their procedure or appointment, not just the patients having surgery. And it must be within that window, more than 5 days prior will not be accepted. You can go to one of our testing locations with an order from your doctor. All you need to do is call the office and they’ll get you set up right away to make an appointment, or call our hotline NYP-EXAM (697-3926) to schedule your appointment at a testing location closest to you. Just remember that you need the order for testing from your physician first!
Where are these locations?
For those getting their Covid test before a procedure, so pre-op only, not the patients coming in for scans or other testing appointments, you can schedule a PCR test in our APEX clinic at Milstein on main campus, or you can schedule a test at any of our other locations: Bronxville, Rockland, Westchester, or Tarrytown.
For patients coming in for any other appointments, you can also use any of our satellite testing locations but must go to a different location in Milstein, one of the two tents set up in front of the ER. And just be aware that no antibody testing will be accepted, no matter what you will still need to get a Covid PCR test.
Now for our pediatric patients, for any type of appointment or procedure, patients go to a testing location in Morgan Stanley Children’s Hospital on 4 North.
We will put all the details for testing locations at the end of this article, but if you wanted to, say, go to an urgent care near your apartment and get a test, would that be accepted?
Yep, it sure would. You would just need to make sure that the test is done within that 72-hour window and that they fax the results to your doctor’s office.
Okay, what if I’ve just finished chemo and radiation and it’s time for my cancer surgery. How different will this experience be?
Right now, you know, these operations are of course following the same approval process I mentioned. But as of June 19th, I’m so happy to say that we can now allow you to bring one guest to stay with you through the intake process. Once you’re here it should be much of the same experience. You’ll get your Covid test a couple days before or the day before, then day-of you’ll start by seeing your nurse practitioner or doctor for an exam, go down to the lab, and get regular tests. All the same pre-op stuff, then go in for your procedure.
Technically, you can still get your Covid test day-of with your pre-op labs but we don’t recommend it. We have had quite a few patients come back with positive tests and then need to reschedule their procedure after coming all the way here at 5am and doing all the pre-op work. It’s not worth the risk.
Is there a process in place to notify family or designated caregiver with updates throughout and after the procedure?
Absolutely, they can expect a phone call. Most of our surgeons are calling right from their cell phones. And then later on, when in inpatient recovery, you will be allowed to have one guest between the hours of 11am and 3pm. For any other times, Ipads are available so your loved ones can speak to your surgeon with you and be in the room, so to speak.
Have office hours changed, are they the same Monday-Friday?
Our office hours are Monday through Friday, and we do have some expanded appointment time during the week, but the big thing to know is that we are operating 7 days a week. And it does seem like the weekends are a little less busy around here. So there’s a tip, if you’re open to it, think about scheduling your procedure on a weekend if you can and it’s available.
Good to know. Is there anything else we need to know?
It’s a good idea to call your physician’s office right before you arrive, from your car or before you enter the building. That way they can let you know whether to come up right away or to hold off a few minutes and avoid wait times at the screening stations or waiting room. The last thing, I ask that you just be flexible with us. Maybe you’re an early bird and normally you like to have all your appointments at 9 am, but right now it may be best for you to come in the afternoon while we are social distancing. Things like that.
We’re doing everything we can to open up more alternatives with expanded hours and locations, so again please give us a call. Let’s talk about what you need!
Great advice. So, most important: wear a mask and only bring a guest if you’re having surgery. And exercise flexibility.
That’s it. You know, all of our patients who come in are very respectful, very understanding, wearing masks. It’s no surprise, everyone gets it. We’re calm, we’re prepared, and we want to make you feel as comfortable as possible while being as safe as possible providing the top notch care you’ve come to expect.
By appointment only, with written order by your physician. Call the hotline NYP-EXAM (697-3926) or your physician’s office to schedule.
APEX Clinic, Milstein Hospital *Adult Pre-op only
173 Fort Washington Ave, Heart Center, Room LL1
New York, NY
Milstein Tents *No Pre-op testing
Tent 1: Symptomatic only
Tent 2: Asymptomatic only
3975 Broadway (167th and Broadway, in front of Adult Emergency Entrance)
Bronxville, Lawrence Hospital
77 Pondfield Road, Suite 1 F2B (located on the first floor)
26 Indian Rock Plaza
15 North Broadway
White Plains, NY
19 Bradhurst Ave, Suite 700
155 White Plains Road
Pediatrics PCR Testing
Morgan Stanley Children’s Hospital, 4 North Periop Area
3959 Broadway (at W 165th street)
New York, NY