Patients weigh seeking care for conditions other than COVID-19

A woman smiles in a portrait.
Sarah Schaleger, of St. Paul, says the COVID-19 pandemic has meant she needs to rearrange and delay some of her cancer treatment plans.
Courtesy of Sarah Schaleger

After nearly two decades of avoiding chemotherapy, artist Sarah Schaleger recently learned she needs to start the cancer treatment now. The slow-growing papillary thyroid cancer created tumors on her lungs that are now too big.

Schaleger, who lives in St. Paul, won’t be able to see her Florida-based doctor because of travel limits with COVID-19.

“I’ve been with my doctor for 14 years,” Schaleger said. 

But her doctor worked with Mayo Clinic to make sure she sees another physician soon to decide on a treatment plan. It isn’t ideal, but Schaleger said she is grateful she can move forward now that her chronic illness has reached a critical stage. 

“It’s scary, too, because you are exposing yourself by going to a hospital with other people who may be carrying the virus,” Schaleger said. “I know they’re going to be doing their best to try to screen people.”

Gov. Tim Walz issued the executive order last month to defer elective surgeries and nonessential procedures. The order is in line with recommendations from the Centers for Disease Control and Prevention and has the full support of the Minnesota Hospital Association, according to president and CEO Dr. Rahul Koranne.

He said the decision helps conserve personal protective equipment and COVID-19 tests, which are still in short supply.

“We need to ensure our patients who come in for these procedures are able to be tested, we want to have enough testing for our care teams, nurses and physicians so that we can assure that our staff is supported and patients are safe as well,” he said

The Minnesota Hospital Association hopes an aid package before Congress may help offset nearly $3 billion the state’s hospitals and health systems are expected to lose in the next three months.

Three of the biggest hospital systems across the state broke down the impact of indefinitely delayed elective procedures.

Mayo Clinic says it’s operating at just 30 percent of its capacity in Rochester, Minn., when it’s normally 85 percent full. If this continues, Mayo says it could experience reduced revenue of more than $3 billion this year.

Essentia Health is projecting a 20 to 40 percent decrease in revenue in 2020 due to pandemic-related declines in patient volumes.

M Health Fairview has delayed approximately 4,000 procedures. The result is a $30 million loss in revenue per week.

Overall, the Minnesota Hospital Association says the state is seeing a 55 percent reduction of patient revenues. It’s closer to 70 percent for rural hospitals. 

Hospitals are also furloughing staff. According to the Minnesota Department of Employment and Economic Development, roughly 40,000 Minnesotans in the health care industry have applied for unemployment insurance so far this year. That number was closer to 1,000 for the entire year in both 2018 and 2019. 

Koranne of the Minnesota Hospital Association stresses that hospitals and doctors are still working together to meet each patient’s needs on an individual basis.

“There is no hard and fast rule,” Koranne said.

Hennepin Healthcare emergency medicine director Dr. John Hick said last week people should not hesitate to seek care in certain urgent situations.

“With the declines in our emergency department volumes that we are seeing, we are very concerned that people may be too fearful of COVID-19 to come to the ER when they are having chest pain, to come in when they are concerned they may be having a stroke or other symptoms,” Hick said.