Covid: What You Need to Know Before Your Surgical Appointment


This interview was updated on April 1, 2021, to include the latest information regarding visitor policy and vaccination.

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Soon every adult in the U.S. will be eligible to get vaccinated, a huge milestone in this pandemic. But that doesn’t mean we should be letting our guards down. Covid cases are on the rise again so let’s all continue to do our part to stay safe and keep our community safe. 

The importance of Covid safety does not mean other medical care should take a backseat. Get the care you need when you need it. We are ready to take care of you. 

Due to the number of Covid-19 hospitalizations, in-patient procedures have been reduced by 50 percent, but out-patient procedures remain the same. Vaccines are now available to New Yorkers over the age of 30. Starting April 6th, anyone over age 16 will be eligible. [Full list of eligibility requirements by distribution phase]

Rest assured that we will continue to be transparent and forthright throughout this process. Have a question? Give your doctor’s office a call. Don’t hesitate to send us a direct message on Facebook or Twitter with any general questions. 

We interviewed Francine Castillo, Director of Practice Operations, to discuss everything you need to know about appointments, surgery, Covid-19 testing, and vaccination.

Appointments and Scheduling

Let’s start with the biggest update—what does 50 percent for in-patient cases mean?

The take-home message right now is really that everything is in flux. We still have a lot of Covid patients at the hospital. So everyone, every surgeon and division, has to limit in-patient cases to 50 percent only. That means any procedure where you have to sleep over. Most groups are prioritizing patients by diagnosis, so for example, cancer patients are going in and cysts are being pushed out because in most cases cysts can wait four weeks.  But this is really a touch and go thing.

For those who need in-patient surgery but it isn’t as urgent, say a cyst, when can they expect to be scheduled?

Before, we wouldn’t let them leave without a surgery date, but now the process has changed. We don’t want to promise you something and then have to cancel or delay your procedure. So for cases like a cyst we tell them “We have you on standby, be ready.” For the more serious procedures like cancer, they will absolutely leave with a date.

And for those who don’t need surgery done immediately, what that means is you’re in a queue. Each division has a rolling list that gets updated and edited based on diagnosis, doctor feedback, testing, etc. For us, this is about keeping you as safe as possible, not bringing you in unnecessarily. Know that we will never delay anything that is urgent, and we still have the capability to add you to the schedule two days before if it is urgent.

Is there anything else we should know about this evolving process?

Really, we just ask for patience. We’re constantly having to reschedule Covid tests because if their procedure gets moved, their pre-op Covid test also has to be moved. So there are many moving parts. And most importantly, I say this in bold—if you are a surgery patient or a surgical candidate and you aren’t fully vaccinated, stay home. You can’t go out.

We had a patient who was pushed on the calendar a few times but kept testing negative which is important. Then had a holiday gathering and when they went in for pre-op testing got a positive test. We had to cancel the procedure. Naturally, they were really upset, and they weren’t out at restaurants, someone exposed them at home.

If you are a surgical candidate, it’s best you stay home three weeks before your surgery date. And if you’re vaccinated, please don’t think you can go back to “normal.” You have to get a pre-op Covid test whether you’re vaccinated or not. Follow guidelines, wear your mask, and wash your hands. We don’t want the heartbreak of having to cancel your surgery a day before because you tested positive. And then you’re waiting a minimum of two weeks after that, queuing back up at that point.

Are there any changes to non-surgical appointments?

We’re still on a relatively normal schedule and able to accommodate all appointments: non-surgical procedures, physical exams, testing. But we are keeping volume very limited hour to hour to ensure your safety with strict social distancing measures, staggered appointments, and screenings. So, expect that you may have to wait a couple of extra weeks to get your elective out-patient procedure, for example, but we will get you on the schedule.

Have office hours changed, are they the same Monday-Friday?

Our office hours are Monday through Friday, and we do have some expanded appointment time during the week, but the big thing to know is that we are operating 7 days a week. We are doing everything we can to get you seen, treated, and cared for as soon as possible.

Are there any cases or situations that you would recommend a patient hold off on coming in to receive care?

No! Our surgeons can attest to this, and I think Dr. Chabot has mentioned it, but we’re seeing more severe cases than we should at times because people have put off care. You know, we are here to take care of you safely. Even if you have an issue that you’re pretty sure isn’t urgent—say you’re having a vein issue that may be viewed as cosmetic generally but you have some discomfort, don’t put it off. Call your doctor and get checked out, whether by video or in person. If you’re most comfortable doing that first appointment at home, great, all of our doctors are doing virtual care. And know that the actual procedure may take a little extra time, but don’t delay getting that process started.

I’ll link to our article on video visits here. But if you need to come in for an appointment, any changes to the screening process when you arrive?

Well, first be wearing a mask. You must have a mask on to enter the building. Then you’ll enter one of the designated entrances, likely the Herbert Irving Pavilion or Milstein entrance. Security is there, but you don't have to show your ID anymore, and there are three stations set up with an MA, RN, or NPA at each station. And depending on if there's a line, you go to a station, they take your temperature and also confirm your appointment. 

As of today, patients can now bring someone with them to an appointment, is that right?

Yes! For non-surgical appointments we can now allow you to bring one support person. The same goes for same-day surgery, you are welcome to bring one guest to stay with you through intake and then rejoin you for the discharge process. We still cannot have any visitors in the PACU [Post Anesthesia Care Unit] while you’re waking up, but your visitor can rejoin afterward.

Additionally, we are now able to allow one visitor per patient in our in-patient units between the hours of 10 am to 6 pm, and 2 caregivers or support persons for pediatric patients in in-patient units. [Read more about the visitor policy here]

What are elevators and waiting rooms like?

Our goal is to actually avoid the waiting rooms as much as we can and get you right back to the exam room. So your wait time will likely be very short or less than it was in the past. But it’s the same drill—limit of four to an elevator, lines must be properly spaced six feet apart. We have escorts, floor decals, and elevator decals that make social distancing as simple as possible.

Waiting rooms have designated seating and signage, and the areas are cleaned between every single patient. We're still doing check-in online and any payments online so you don't have to do any physical transactions. Make sure you have created a myConnect account with our online medical records system, I promise it makes all of this easier for you. And once you’re here, it’s actually very calm.

Is there anything else we need to know?

It’s a good idea to call your physician’s office right before you arrive, from your car, or before you enter the building. That way they can let you know whether to come up right away or to hold off a few minutes and avoid wait times at the screening stations or waiting room. The last thing, I ask that you just be flexible with us. Maybe you’re an early bird and normally you like to have all your appointments at 9 am, but right now it may be best for you to come in the afternoon while we are social distancing. Things like that.

Covid Testing

Let’s review Covid testing policy for appointments—what’s the current policy?

This is the most important thing to get right—Anyone coming in for a procedure or surgery or test must have Covid PCR testing done within 72 hours of their procedure or appointment, not just the patients having surgery. That goes for anyone who is vaccinated as well! Even if you are fully vaccinated, you need to have a Covid PCR test. And it must be within that 72-hour window, 4 or 5 days prior will not be accepted.

Once again, rapid tests do not qualify as clearance for procedures, it must be a PCR test. You can go to one of our testing locations with an order from your doctor. All you need to do is call the office and they’ll get you set up right away to make an appointment, but know that you cannot just walk in.

Where are these locations?

For those getting their Covid PCR test before a procedure—so pre-op only, not the patients coming in for scans or other testing appointments—you can schedule a PCR test in our APEX clinic at Milstein on main campus, or you can schedule a test at any of our other locations: Bronxville, Rockland, Westchester, or Tarrytown.

For patients coming in for any other appointments, you can also use any of our satellite testing locations but must go to a different location in Milstein, one of the two tents set up in front of the ER. And again, be aware that no antibody or rapid testing will be accepted, no matter what you will still need to get a Covid PCR test.

Now for our pediatric patients, for any type of appointment or procedure, patients go to a testing location in Morgan Stanley Children’s Hospital on 4 North.

We will put all the details for testing locations at the end of this article, but if you wanted to, say, go to an urgent care near your apartment and get a test, would that be accepted?

Yes, but I just want to reiterate that if you come in with a rapid test result we will have to cancel your appointment. This happens more often you’d think. So, please be mindful if you choose to get your test elsewhere. Really, my best advice is to just come to us for the PCR test because other testing sites like urgent care centers often cannot guarantee a PCR test result within 72 hours, and if you come to Columbia that issue will be completely avoided.

Hospital Experience

Okay, what if I’ve just finished chemo and radiation and it’s time for my cancer surgery—I’m on the schedule. How different will this experience be?

Right now, you know, the only difference is the limit on visitors. You can bring one guest to stay with you through the intake process and they will be screened upon entry. Once you’re here it should be much of the same experience. You’ll get your Covid test a couple days before or the day before, then day-of you’ll start by seeing your nurse practitioner or doctor for an exam, go down to the lab, and get regular tests. All the same pre-op stuff, then go in for your procedure.

Technically, you can still get your Covid test day-of with your pre-op labs but we don’t recommend it. We have had quite a few patients come back with positive tests and then need to reschedule their procedure after coming all the way here at 5am and doing all the pre-op work. It’s not worth the risk.

Is there a process in place to notify family or designated caregiver with updates throughout and after the procedure?

Absolutely, they can expect a phone call. Most of our surgeons are calling right from their cell phones. And then later on, when in inpatient recovery, you will be allowed to have one guest for up to four hours between 10 am and 6 pm. For any other times, Ipads are available so your loved ones can speak to your surgeon with you and be in the room, so to speak.

Covid Vaccination

Talk to us about vaccine access—who can get vaccinated and where is it available?

As you know, we are vaccinating New Yorkers at The Armory on campus. All vaccinations are by appointment only and done in compliance with New York State guidelines for phased distribution, so as of today, those 30 and older are eligible.

I mentioned the importance of making sure you have a Columbia Connect account. It’s where all your medical information lives, where you can do video appointments, see prescriptions, message your doctor, make appointments, and most importantly for this conversation, how you can schedule your Covid vaccine.

Details for vaccinations at The Armory will be listed at the bottom of the page. Visit the New York state Covid-19 Vaccine Finder page for the most up-to-date information on appointments at vaccination sites nearest you.

Is it possible to get vaccinated while in the office for an appointment?

Great question. Right now, the answer is no. Only specified locations listed on the Vaccine Finder can distribute the vaccine. But you can expect an email from Connect when you become eligible. Personally, I really recommend checking our vaccine website often: vaccinetogetherny.org for the most relevant information. You can log in to your Connect profile there and schedule Covid vaccination at the Armory if you are eligible.

How limited are appointments at Columbia?

I wish I could answer this question. Appointment availability changes daily depending on how many doses are available. So again, please keep checking vaccinetogetherny.org for information, resources, and appointment scheduling. My understanding is that some days could have a lot of availability and others none. And appointments are becoming easier and easier to get at sites all over the city.

Any closing thoughts?

We want you to know that we’re doing everything we can to open up more alternatives with expanded hours and now our surgeons are seeing patients all over the tri-state area. We have offices upstate, in New Jersey, and other boroughs of the city. We’re doing Covid testing and vaccination on campus. So don’t hesitate to give us a call. Let’s talk about what you need!

Covid-19 PCR Testing Locations

By appointment only, with written order from your physician.

APEX Clinic, Milstein Hospital *Adult Pre-op only

173 Fort Washington Ave, Heart Center, Room LL1
New York, NY

Milstein Tents *No Pre-op testing

Tent 1: Symptomatic only
Tent 2: Asymptomatic only
3975 Broadway (167th and Broadway, in front of Adult Emergency Entrance)
Hours:
Mon-Sun, 7am-7pm

Bronxville, Lawrence Hospital

77 Pondfield Road, Suite 1 F2B (located on the first floor)
Bronxville, NY
(914) 961-8500
Hours:
Mon-Fri, 9:30am-6pm
Sat 8am-12pm

Orange/Rockland County

26 Indian Rock Plaza
Suffern, NY
(845) 368-0100

Westchester/Putnam County

15 North Broadway
White Plains, NY
and
19 Bradhurst Ave, Suite 700
Hawthorne, NY
(844) 311-1234

Tarrytown

155 White Plains Road
Tarrytown, NY
(646) 317-3256

Pediatrics PCR Testing

Morgan Stanley Children’s Hospital, 4 North Periop Area
3959 Broadway (at W 165th street)
New York, NY
(646) 317-4311
Hours:
Mon-Fri, 8:30am-5pm

Covid-19 Vaccinations

By Appointment Only

The Armory Track
216 Fort Washington Ave
New York, NY
(646) 697-VACC

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Appointment availability changes daily with vaccine supplies. Eligibility of patients for vaccination is determined by state guidelines. We make appointments available to eligible patients as soon as we know vaccine doses are available. Check here for updates and information.

NYC Covid Vaccine Finder Here

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