HJAR May/Jun 2021

THE PATIENT EXPERIENCE While we have ensured that treatment op- tions remained unchanged, ever-changing guidelines from state and federal health agencies have dramatically impacted the patient experience. Oncology care is a very intrapersonal dis- cipline, and for months at the beginning of the pandemic we had to switch to virtual visits to help keep our patients safe. Thank- fully, due to public healthmeasures, PPE and the vaccine being more widely available, we have been able to safely bring patients back into the clinic for their regular visits. Due to the need for social distancing and strict screening protocols, there have been times, when infection numbers peaked, that visitors have not been allowed to accompany patients for their visits, causing patients to be physically alone through much of their cancer journey. By virtue of the medicine we practice, a portion of our time is spent delivering tough news and navigating dif- ficult conversations. To help patients feel supported in these moments, many prac- tices have utilized telemedicine, Facetime and speakerphone options to include family members in these sensitive patient visits. In addition, where we once were able to physically comfort patients by holding hands or offering a hug, we are now unable to do so unless we are wearing head to toe PPE. This has made very intimate moments feel sterile and lacking authenticity. As vaccinations become more read- ily available, we expect that oncology care will return to “normal,” but it may be a new normal we have yet to experience. As long as oncology care providers can take care of patients in a safe and efficient manner, we can weather this and any other storm that may lie ahead. n HEAD AND NECK SURGERY SCOTT STERN, MD, CHIEF MEDICAL DIRECTOR AND MEDICAL DIRECTOR OF SURGICAL ONCOLOGY The coronavirus pandemic has had a tremendous impact in the field of head and neck surgery. From the earliest reports out of China, we knew that the virus was pre- dominantly located in the upper airway, the space in which we examine and operate on patients on a daily basis. This led to a host of very specific protocols for our patients. For example, our speech pathologist was the only person in the state changing voice prostheses, which allow our patients who have had their voice box re- moved the ability to speak. This required very specific PPE and for our organization to implement significant cleaning protocols for our exam rooms, which we performed rigor- ously. We did not change any of our treat- ment protocols; our staff simply went above and beyond in order tomake sure that all our patients were able to receive top notch care. Many providers had to close temporarily, so we made sure that anyone who needed leading-edge head and neck surgical care would be seen and treated. Almost every case we do is an “aerosol generating proce- dure,” so we had to be extremely careful for ourselves and our patients. We took every precaution necessary, double masking with N-95s under our surgical masks and using eye protection for every case. In any patient with known COVID, we still treated them, but we used PAPR respirators for maximum protection. Even with our continued clinical avail- ability, we did see a trend toward later diag- nosis because of patients’fear of contracting COVID in a medical setting. In spite of this trend, we are fortunate that we have not had a significant change in patient outcomes. Thanks to our dedicated staff, we have been able to offer exemplary care without sacrific- ing treatment protocols. As we generally treat solid tumors, we have encouraged all of our patients to be vaccinated as soon as they are able. I ask every patient about their vaccination status and spend time talking with them about the vaccines and their safety. From the standpoint of our specialty, I an- ticipate that we may continue wearing masks during clinical visits for both our staff and our patients’ protection for the foreseeable future. Scott Stern, MD Stern completed a fellowship in head and neck surgical oncologyatMDAnderson inHouston,Texas,andcompleted a residency at the University of Medical Sciences in Little Rock,Arkansas,where he also earned a medical degree. CANCER IN THE WAKE OF COVID 20 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF ARKANSAS