An “endless list” of patients with chronic conditions have difficulty being referred to specialists or tests amid the coronavirus outbreak, a family doctor has told Times of  Malta.

They include patients with diabetes, asthma, arthritis, hypertension, cardiac problems, as well as acute cases such as urinary tract infections, back pain, minor injuries, abdominal pains and eye and ear infections.

GP Christiane Ellul says many conditions can wait but not all can wait indefinitely.

“If we indeed flatten the curve of the pandemic, as we would like to, we are still responsible for looking after everyone else for many weeks and months of a crisis situation.”

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Before the outbreak many of her patients had already started medical tests privately.

“Some private clinics have now closed or are running on minimal facilities. Therefore, if I see a patient whom I need to refer I am faced with a dilemma.

“Do I refer to Mater Dei Hospital [many patients are reluctant to go there unless the situation is life threatening] or do I wait until the pandemic ebbs?”

We are human and feel anxious, stressed, worried and helpless

Many services at Mater Dei Hospital have been curtailed with outpatients and theatre lists reduced in preparation for the pandemic.

“Our current work practices have now resorted to telephone or video consultations, but the problem is some patients need an examination urgently while some are reluctant to come to our clinic for fear of transmission,” she said.

Family doctors are facing what she says is “a lack of adequate referral pathways”, a private market that is blocked and Mater Dei Hospital seeing dire emergency cases only.

“These are all the ethical dilemmas we are living with at the moment,” Ellul said.

“We have a good rapport with a lot of our patients, many of whom have been under our care for years. We feel a sense of responsibility towards them especially during this time of national crisis.

“We feel as helpless as they do in trying to help them with limited resources – it’s like going to a gun fight with a sword.”

Ellul appeals to patients not to be afraid to contact their doctor.

“We are still there to offer our help, even if just on the phone, video consultation or messaging,” she said.

“We are willing to offer help to those who need it and try to keep ourselves and our patients safe and healthy, no matter what their illness is. Now and always.”

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