Get to Know Our Doctors: Meet Three Irving Medical Center Doctors From the Front Lines of the Pandemic
A version of this article appeared in the Columbia Neighbors Newsletter Summer 2020 edition.
Dr. Ariel Pablos-Méndez, Dr. Ana Cepin, and Dr. David Buchholz have been working on the front lines of the COVID-19 pandemic at Columbia University Irving Medical Center. Read about their experiences, the ways they've adapted at work, and what they're doing to get through it.
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Dr. Ariel Pablos-Méndez is a professor of Medicine at Columbia University Irving Medical Center where he worked on multidrug-resistant tuberculosis while still a fellow. He also has worked as director of knowledge management at the WHO and managing director for international health at The Rockefeller Foundation. In 2011, Dr. Pablos was appointed by President Barack Obama (CC’83) to lead USAID’s Bureau for Global Health.
Q: How have you responded to the COVID-19 pandemic?
A: I volunteer in the fever and cough clinic established to relieve pressure on the emergency room. I have collaborated with Columbia colleagues to start a new serology clinic to test for antibodies, starting with health workers who may have had COVID-19 last month. Given my background in health policy and global health, I have also devoted time to various strategic discussions on the best response to COVID-19
Q: How have you adapted to provide your patients with the best care?
A: With the regular clinic closed, I have been doing lots of telemedicine. By sheer coincidence, [NewYork-Presbyterian (NYP) hospital] had switched to a new electronic health record, EPIC, just in January with good training and transitions in February. This platform enables far greater communication among various members of our team and other specialties with our patients — and we can now do encounters by phone or video!
Q: Do you believe that the worst is behind us?
A: We may not be out of the crisis just yet and must remain vigilant of any resurgence of COVID-19. I understand the urgency to reopen the economy but we must keep elderly people and those with diseases like diabetes, emphysema or heart disease isolated at home — as a group they account for 98% of all fatalities. Zoonotic viruses will keep coming at us and there will be many analyses on the lessons learned from COVID which will need to be shared to make Upper Manhattan more resilient next time.
Q: What lessons have you learned regarding public health and crisis management?
A: Leadership, preparedness, data, trust and good communications are all essential.
Q: How are you aiding efforts to end the outbreak?
A: I have been busy having strategic discussions with a business roundtable and members of Congress to accelerate the introduction of serology testing and the optimistic possibility of herd immunity, combined with home isolation, to end the outbreak. You may read my op-ed in The Hill or watch my interview with Newsy News.
Q: Have you read any good books or watched any inspiring shows during quarantine?
A: My wife and I did enjoy the Global Citizen’s all-star musical celebration, Together at Home.”
Q: What advice would you offer other frontline healthcare workers?
A: First, my sincere thanks to everyone and especially to the folks working in the ICU. I am proud to belong to a profession that cares for others regardless of personal risk and steps up without hesitation when called upon to face a crisis striking panic at the heart of the world. My advice? Stay safe and keep it up!
Q: What advice would you offer residents in Upper Manhattan?
A: We all have a role to play and the community has been exemplary in Upper Manhattan and all of New York, including Gov. Andrew Cuomo. Stay safe, keep a safe distance, help others, and above all make sure elderly and sick patients stay isolated. We’ll get through this together!
Dr. Ana Cepin is an assistant professor of Obstetrics and Gynecology as well as medical director of the NY-Presbyterian/Ambulatory Care Network Family Planning Practice at Columbia University Irving Medical Center, where she has worked since 2003. Dr. Cepin also serves on the board of Planned Parenthood of Greater New York and is passionate about improving women’s health and empowering women to achieve their goals.
Q: How has your day to day changed since the beginning of the COVID-19 crisis?
A: Things are certainly different. Our clinical practices have been transformed in order to continue to provide access and care while keeping patients and staff safe. Most of our visits are virtual and when we are at work we are socially distanced. As human beings we are naturally social and like to interact with others. We are less able to do that now.
Q: How have you adapted to provide your patients with the best care?
A: We are doing many virtual visits with our patients. Patients have a level of access that they may not have had before. They can arrange to be "seen" quickly from the comfort of their home. If patients have a need that requires an in-person exam, then we are able to provide that as well.
Q: Do you believe that the worst is behind us?
A: Unfortunately, I do not believe that the worst is behind us. The incidence of COVID infections may be decreasing, but I still worry about a possible resurgence. This pandemic has also negatively impacted our society and economy. The repercussions will be felt for a very long time.
Q: What lessons have you learned regarding public health and crisis management?
A: We have all learned that the basic principles of public health still matter. There is renewed interest and respect for science and medicine. I hope we can continue that moving forward. In terms of crisis management, I have been impressed with the power of effective communication from our leaders. Our University and hospital leaders have allowed us to cope with all the changes and uncertainty by communicating honestly with us.
Q: After the crisis what will you do to help ensure that Columbia plays a greater role in promoting health and wellness in communities in Upper Manhattan?
A: It has been devastating to see the impact that COVID has had on our community. So many of my friends, family and neighbors have fallen ill due to coronavirus. Our community has a higher prevalence because many residents of Upper Manhattan are essential workers or are unable to socially distance. Once infected they may be more at risk for complications due to underlying conditions. As a physician practicing in Upper Manhattan, I will continue to provide education and preventive care to keep my patients as healthy as possible. As an institution, we will also need to play a role in the rebuilding of our community and society so that it's more equitable with fewer disparities.
Q: Have you read any good books or watched any inspiring shows during quarantine?
A: I am re-reading The Great Influenza by John Barry. I was a history of science major in college, so this stuff is fascinating to me. It's very interesting to see all the parallels between the Influenza outbreak of 1918 and our current pandemic.
Q: What advice may you offer other frontline healthcare workers?
A: This crisis has taken a mental and emotional toll on all of us. For many it has also offered an opportunity to evaluate what is truly important. Take time to take care of yourselves and your family. You will only be able to provide care to others if you've taken care of yourself first.
Q: What advice may you offer residents in Upper Manhattan?
A: First, I'd like to thank my neighbors who have been on the frontlines–the grocery store clerks, the taxi drivers, the healthcare workers, etc. As a lifelong resident of Upper Manhattan, I have seen our community handle adversity before. We will come out better and stronger.
Dr. David Buchholz, MD is the senior founding medical director, primary care, assistant professor of Pediatrics. He leads strategic development for an expanded primary care program that will offer patients greater access to health care services across the New York metropolitan area, with the goal of improving clinical care.
Q: How has your day-to-day changed since the beginning of the COVID-19 crisis?
A: There is little similarity in my life at home or work since the onset of the pandemic. I had two main themes before the crisis — grow primary care at Columbia and NewYork-Presbyterian for the benefit of the people of NYC and Westchester County and care for pediatric patients at [ColumbiaDoctors Midtown]. Since the start of the crisis, I have partnered with our teams to open fever and cough clinics and implement telemedicine in our faculty practice organization (FPO) internal medicine practices. Pediatrics temporarily consolidated its services into W 86th Street, and I’m caring for pediatric patients in our fever and cough clinic on Columbia’s Morningside campus and doing telemedicine visits to see Columbia and NYP employees with a current, or a history of, confirmed or suspected COVID-like symptoms.
Q: How have you adapted to provide your patients with the best care?
A: Nearly all care has been converted to telemedicine. My pediatric partners are seeing healthy children in person for well-child visits up to 13 months of age at W. 86th Street and nearly everything else is cared for through telemedicine. Children with respiratory illnesses were seen at the fever and cough clinic, but are now seen in a borrowed pediatric neurology space next door. By using different spaces, we were able to keep healthy and sick kids separated.
Q: Do you believe that the worst is behind us?
A: I’d like to say yes, but that might be wishful thinking. It all depends on better understanding the prevalence of SARS-CoV-2 in our neighborhoods and how we manage our restart. As a pediatrician, I have never met a vaccine that I didn’t love. Let’s hope for the rapid development and deployment of a safe and effective vaccine to really get us back to “normal.”
Q: What lessons have you learned regarding public health and crisis management?
A: Primary care is the front door to public health and population management, and we will need to continue to increase its footprint so that we are better positioned to respond to the next crisis. We also need to rethink our physical ambulatory practice design and workflows to ensure that we are keeping our patients, staff, and faculty safe from contagious illnesses whether there is an active pandemic or the infrequent case of measles in the community. Everyone has stepped up during this pandemic and has done an awesome job responding. Let’s take this opportunity to really make a difference in how we do our work, so the next pandemic doesn’t strain us as much.
Q: After the crisis what will you do to help ensure that Columbia plays a greater role in promoting health and wellness in communities in Upper Manhattan?
A: Many of our communities in Upper Manhattan have been disproportionately impacted by COVID-19. We need to work together to reduce the disparities that made our communities more vulnerable to the pandemic. Primary care plays a significant role in promoting health and wellness, and I will continue my efforts to expand and promote population health and primary care with embedded behavioral health and dental medicine to assist with this effort.
Q: Have you read any good books or watched any inspiring shows during quarantine?
A: To be honest, I come home exhausted and have just enough energy left to support my family. I have done a few things, though, that make me laugh including finally watching the first season of The Marvelous Mrs. Maisel.
Q: What advice would you offer other frontline healthcare workers?
A: Our adrenalin has kept us going, and I suspect that we will likely crash on the other side of the curve as we return to a more normal state. When we can, we need to refocus on our own physical and mental health. We will do that differently, but I know that we have the support and resources of Columbia and NYP to help if we need them.
Q: What advice would you offer residents in Upper Manhattan?
A: Stay strong, stay safe, and continue to follow New York State and City Department of Health guidance for social distancing and mask wearing as we get through this pandemic.