AILSA CHANG, HOST:
Thousands of pediatric practices nationwide are struggling to adjust to a dire new reality - crashing revenues, terrified parents and a shortage of protective equipment. Jenny Gold brings us this story from Berkeley, Calif., of a practice struggling to weather the pandemic.
JENNY GOLD, BYLINE: On a normal day, the well-child waiting room at Berkeley Pediatrics is a flurry of children playing with blocks, infants crying and teenagers furiously tapping on their smartphones. But today there's not a child in sight. Doctors Olivia Lang and Katrina Michel say lately, their practice has been disturbingly quiet.
OLIVIA LANG: This room is usually - we have toys.
KATRINA MICHEL: Oh, full of toys. All of our toys...
LANG: We have books in every room.
MICHEL: That's all gone.
LANG: That's all gone.
GOLD: It started in mid-March, when the Bay Area issued the nation's first shelter-in-place orders. The practice canceled most of their well-child visits. Dr. Michel says in a matter of weeks, they transformed from a bustling practice of seven physicians to barely hanging on.
MICHEL: There is a business side to running a practice. We have to be able to pay our staff, and it's been challenging with this dramatic drop of volume to be able to do that.
GOLD: They laid off six staff members. The physicians took a 40% pay cut. It's crucial that pediatricians like these be able to manage the chronic illnesses, broken bones and infections that would otherwise flood urgent care centers and emergency rooms. Here's Dr. Olivia Lang.
LANG: Just because COVID is around doesn't mean other infectious agents just take a great vacation. If we can do more telehealth, we can calm patients down. If we can do basic care over the phone or even in our office, it will help reduce the strain on the hospital systems.
GOLD: But if practices like this one shutter, it presents a huge problem. And that's a real possibility. Pediatric practices across the country report that their visits are down as much as 90%. Dr. Scott Needle is a member of the disaster preparedness council at the American Academy of Pediatrics.
SCOTT NEEDLE: These practices don't have a tremendous cushion they can fall back on. So if their visits are down for even just a few weeks, they may not have the resources to keep on going.
GOLD: The academy recommends that pediatricians keep doing well-child visits for children under 2 who need vaccines. But some parents are balking at bringing in even the youngest infants. Dr. Needle works as a pediatrician at a clinic in Sacramento.
NEEDLE: We've had parents of infants one week old, two weeks old, who are saying, I don't want to come in; I don't think it's safe. And we've had to tell them, look; there are a lot of things that we need to check that could be much more dangerous than coronavirus at this point.
GOLD: Things like jaundice, weight loss and congenital diseases. Dr. Michel at Berkeley Pediatrics is particularly worried about vaccination.
MICHEL: We don't want to create a pertussis outbreak because we didn't vaccinate all of our babies on time.
GOLD: To help make things safer, they divided the brown-shingled Craftsman that houses the Berkeley practice into two halves - upstairs for well patients, downstairs for sick. They take the temperature of everyone who walks in the door. Providers wear surgical masks, even for well-child visits. But Dr. Olivia Lang worries all those changes mean she's no longer providing the best care.
LANG: Every day I think to myself, wow; that's exactly opposite to what I learned in medical school and what I was trained to do. You know, I'm not supposed to wear a mask and wear weird things to scare my patients, but I'm doing that every day.
GOLD: For now, Michel says she's trying to focus on making it through the next few months as safely and smoothly as possible.
MICHEL: My very sincere hope is that our 78-year-old practice is going to weather the storm just like it's weathered many before, but it's very challenging.
GOLD: She says they're planning for a very bumpy road ahead.
I'm Jenny Gold in Berkeley, Calif.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.
