As frontline medical workers are deluged, other specialists are struggling to stay open.

It is one of many cruel realities of what is a very cruel pandemic—as doctors, nurses and medical technicians are trying to keep up their numbers fighting Covid-19 on the frontlines, their colleagues in clinics and offices away from the battle are fighting to remain open until the pandemic lets up.

To support the frontline workers in need of personal protective equipment, specialists are being asked to postpone elective procedures. At the same time, patients scared of contracting the virus are staying away from primary care physicians, physical therapists and other medical offices and clinics. It has medical practices from small to large scrambling to keep employees on the payroll.

One of the major urgent care clinic companies in Monterey County, Doctors on Duty, has seen a 35-percent decline in patient visits over the last month at its nine locations in Monterey and Santa Cruz counties, says Medical Director Scott Prysi. Last week the company cut staff hours by 30 percent across the board, from receptionists to doctors. The goal is to stay open for now, and be prepared for what Prysi expects to be a surge of patients with delayed issues, as well as an increase in Medi-Cal recipients due to unemployment since shelter-in-place.

“We're hoping our patient hours will get back to normal in one to three months depending on shelter-in-place order,” says Prysi.

PrimeCare Medical Group, part of the Salinas Valley Memorial Healthcare System, is fully staffed for the time being, says physician Peter Oppenheim. He estimates he’s seeing 50 to 60 percent of the patients he normally sees. “Our desire and goal is to keep everybody fully employed. As the numbers go down that’s a decision that gets made above my paygrade,” Oppenheim says.

SVMHS, a private nonprofit healthcare system, made the decision to keep its workforce intact for as long as it can. On April 3 it announced creation of the SVMHS Community and Staff Support Project, redeploying workers to do community service for nonprofits helping at risk populations. Staff members who sign up for “approved education and outreach efforts” will receive regular pay and benefits in exchange for the work, according to a press release.

At Montage Medical Group, part of private nonprofit Montage Health, there have been no cuts in hours or staff yet, says Chief Executive Officer, Mark Carvalho, MD. Instead, they’ve been focusing on efforts to increase the number of patients they see virtually, by phone or by video, a practice every physician and administrator the Weekly reached out to said they are doing. Despite some issues with patients who might have technical issues, overall they are reporting good results using tele-health.

One reason patients are appreciating appointments by phone or video is that it allows them to remain safely at home and still get their questions answered. Doctors report patients who are scared to come into their offices and clinics, or get help in emergency rooms. It’s leading to people putting off care at the risk of further complications and in extreme cases like chest pains, death. The medical professionals stress that they are screening patients with respiratory symptoms by phone or video, so those patients are not coming into offices and clinics. Facilities are also following strict disinfection protocols.

“I’ve been stressing with patients, we are a safe place,” Oppenheim says.