Care In Crisis - Elizabeth Sharp '01

by Daintry Duffy Zaterka '88

How do you treat a patient with an earache when you can't look inside their ear, or diagnose the cause of a patient's sore throat when you can't feel their glands or see inside their mouth?

When Governor Cuomo issued a stay-at-home order for New Yorkers on March 20, Dr. Elizabeth Sharp discovered that these are just some of the challenges of treating patients from afar. Overnight, her primary care practice in midtown Manhattan switched to telehealth, and soon, she was conducting twenty virtual appointments a day, initially from her office and then from her Tribeca apartment. “I never thought I would have a desk job” she laughs, but like many people, Elizabeth's daily life and work were changed by COVID-19 in unexpected ways.

After Elizabeth graduated from Fay in 2001, she attended Hotchkiss and then Rollins University. She graduated from St. George's Medical School and completed her internal medicine residency with a focus on primary care at Lenox Hill Hospital. She currently works as a primary care physician in internal medicine at Mount Sinai Doctors, an affiliate of Mount Sinai Hospital, where she practices preventive medicine with a patient- centered approach.

From early March, when she was doing COVID-19 testing in the office, to the following weeks, when she treated patients almost entirely through telehealth, Elizabeth has seen rapid changes in medicine. Adapting to telehealth was a learning curve. “As a doctor, you have to get creative because you can't take vital signs or do a thorough physical exam,” she notes. “You are hyper- focused on looking at the patient from the shoulders up.” These limitations sometimes made it difficult to decide whether a patient needed to be evaluated in the hospital. Assessing a patient’s respiratory status, which can be extremely tenuous with COVID-19, is particularly challenging in a quick telehealth visit, especially when meeting and screening a patient for the first time. Convincing patients to leave their homes for necessary lab work has been another obstacle, as many people, especially elderly patients with chronic medical conditions, fear leaving their homes. However, she is quick to point out that these are minor challenges compared to those faced by many in the medical field. “Although I volunteered to go into the hospital, I haven’t been called to go in, and I feel lucky to have a job and be healthy and safe,” she says.

The pandemic changed the kinds of cases Elizabeth was seeing. The evolving guidance on COVID-19 testing meant that she went from testing patients in her office, to recommending that they stay at home or go to the hospital for testing, to now testing in the office again. There has also been a steady increase in patients seeking treatment for mental health conditions: “I've been treating more psychiatric conditions than ever before because of increased stress, depression, anxiety, and insomnia.” In that respect, telehealth was crucial in helping Elizabeth connect with patients. “When patients have experienced worsening depression, anxiety, or stress,” she says, “I've been able to continue treatment through telehealth. It's been gratifying to do follow-up visits and now see that they are happy and doing well.”

Elizabeth lives alone and found the days practicing out of her apartment difficult. Unable to evaluate her patients in person or confer with colleagues sometimes left her wondering if she had made the right decision in telling a patient to stay home rather than going to a hospital for

evaluation. The combination of her high- risk job and the fact that many of her friends left New York City was also socially isolating. “The stress of being isolated and nervous for myself about COVID, combined with working full-time in a stressful environment, was challenging,” she says. She managed it by practicing yoga, meditating, running and biking, cooking, and read- ing instead of watching TV. “I was so overstimulated by looking at screens that by the end of the day, I just felt like I couldn't watch anything else!”

Elizabeth is back in the office seeing patients for routine visits three to four days a week, but telehealth appointments still take up about two-fifths of her schedule. She believes that they are here to stay. “It is beneficial for certain types of follow-up visits and is so convenient,” she notes. “I don’t see telehealth going anywhere in the near future.”

While Elizabeth's experience during COVID-19 has not changed the gratification that she gets from helping her patients, it has deepened her appreciation for seeing them in person. While she is generally focused on pre- ventive care, the increase in acute visits over the past few months has enabled her to appreciate her role in seeing patients through a health cri- sis and back to good health again: “It has been a privilege to be here for my patients during this difficult time.”

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Care In Crisis - Elizabeth Sharp '01

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