By Pam Hersh
COVID-19 has upended our reality in so many different ways including bringing us a brand new reality television show: Telehealth-2020. Gone are the days of hiding behind the physical invisibility of a telephone when talking to one’s doctor.
Photo-phobics like myself may hate looking hideous on camera, but my doctor considers it a beautiful thing. He can make a much better diagnosis, when he not only can hear me say “I’m fine, I just have this little pain,” but also can see a pained look on my face and the dark circles under my eyes. And in times of COVID, the technologically remote office visit also keeps the patient safe from potential contamination from outsiders – and others safe from a potentially infected patient.
“For primary care physicians, COVID made in-person appointments difficult because of the sheer volume of patient inquiries and all of the new medical office protocols,” said Dr. Sean Naini, part of the Penn Medicine Princeton Medicine network of physicians. “Telemedicine has been lifesaving – literally. Penn Medicine helped us set up the video platform quickly and seamlessly. Furthermore, I found that the patients seemed to adapt well to the video experience, as did the insurers who reimbursed the virtual medical appointments as though they were in person.”
Dr. Naini said that his office at 281 Witherspoon St. in Princeton never closed. His staff stepped up, never complained and kept coming to work. “Equipped with numerous new procedures and protective gear, we kept seeing patients, but telemed allowed us to treat many more patients than normally would have been possible. Also and very importantly, the video appointments helped us keep many people out of the emergency room of the hospital.”
By mid-March, his office was dealing with 20 to 30 people per day with COVID symptoms. “Making the diagnostic call as to who should go to the hospital was stressful and caused me some sleepless nights, but technology allowed us to function competently and efficiently,” he said.
Even though emergency room physicians have trained for the challenges of mass public health events, primary care physicians generally go into their profession because of a desire to provide personalized, holistic care.
With more than two thousand patients in his practice, Dr. Naini said he really values spending time with his patients, listening, observing, and achieving a thorough understanding of the individual in the context of their experiences and family. Such an approach produces, in his opinion, much better long-term health outcomes. The intensely overwhelming COVID situation interrupted that treatment protocol.
“But we did what we had to do. Thankfully, now I am getting back to treating patients the way that makes sense to me,” even though he is doing that talking and listening while wearing scrubs and protective equipment.
Dr. Naini’s desire to be a primary care physician is rooted in his immigrant roots and profound appreciation of family. A native of Iran, Sean came to America at age 12, when his family fled the politically oppressive Iranian regime in 1986.
They escaped with only the clothes on their backs and valuable documents stashed in his mother’s purse. Because everything was left in their house and not a word was said to anyone, “no one knew we were leaving.” His father, mother, Sean and two younger sisters boarded a plane from Tehran to Istanbul, ostensibly for a little visit. Thankfully, his maternal grandmother already had immigrated to the United States and sponsored their entry into the country. One of the more harrowing moments of the escape occurred when his mother lost – and then found – the all important survival bag in a restaurant in Istanbul.
“Even though I left my friends and all of my favorite possessions and didn’t know a single word of English, I was excited about going to America. I truly was obsessed with experiencing the ultimate American dream– consuming a McDonald’s burger, fries and a Coke.”
Sean’s father got very lucky career-wise. Instead of being forced into a menial job, he, with a Ph.D. in biochemistry, reached out to a professional acquaintance at Columbia University. After working as a lab assistant for a couple of weeks, he then was offered a post-doctoral research position. Currently, he is director of a neurology and hereditary disease program at Columbia University where he played a key role in setting up the neurology laboratory that identifies genes associated with neurological disorders including ALS and Huntington’s disease.
Those years of transition from a fresh-off-the-plane Iranian kid to an America teenager taught him how to “deal with adversity and curveballs. … We moved a lot, had very little, but we had each other,” said Dr. Naini, a longtime Montgomery Township resident with a nine-year-old son and a wife who is a nephrologist.
His appreciation of family – and possibly a few McDonald’s burgers – fed his passion for primary care medicine. But during COVID, it has been his “incredible colleagues and the outpouring of heartwarming support from patients” that sustained and nourished him.