man on laptop talking to doctor
Thyroid Health in the time of COVID-19 – a Q&A With Dr. Igor Priven

With the COVID-19 outbreak dominating today’s news cycle, we sat down with TVC Medical Director Igor Priven, MD to discuss how the pandemic is affecting the thyroid community (both patients and providers), including how care is being delivered not just for COVID patients, but for patients of other diseases as well.


Q: Dr. Priven, we know you’re a thyroid disease expert and not an epidemiologist, but nevertheless, as an experienced physician, what is your overall view of the recent COVID-19 outbreak?

A:   As you said, I’m not an epidemiologist or infectious disease expert, but an endocrinologist, who specializes in diseases and disorders of the body’s endocrine system. However, as a practicing physician, I’ve watched the COVID-19 outbreak evolve from epidemic to pandemic, and am staying aware of new developments as they unfold. All I can say is that the rate at which the virus has spread has certainly been alarming, and should be taken seriously by patients and providers alike. I think the most basic measures that we need to take as a society have been outlined by organizations such as the CDC and WHO, such as focusing on prevention and preparedness. For patients that means things like hand washing, maintaining a safe distance from others, and avoiding touching your face. For providers, it means focusing on detection, testing, isolation, and proper treatment protocols. The good news is that these messages have been out there for many weeks now, so people are certainly aware and are taking action.


Q: Since your focus for the past twenty years has been on endocrine disorders, particularly diabetes and thyroid disease, what would your message/advice be at this time to thyroid patients in light of recent developments, in terms of special precautions to maintain optimal thyroid health?

A:  Patients with thyroid conditions do not generally belong to a high risk group for severe illness from coronavirus unless they are elderly or have other conditions such as chronic lung disease, asthma, serious heart conditions, advanced liver or kidney disease, advanced cancer or uncontrolled diabetes.  However, at this time there is a high chance that people taking thyroid medications may stop taking them or take them inconsistently because of limited access to their doctors, potential pharmacy supply interruption, or people’s general shift in focus to coronavirus related issues.  I can’t stress enough the importance of keeping up with the daily taking of thyroid medications, under any circumstances. People are already stressed out, and if they start developing various symptoms as a result of missing their thyroid medications, it may add to the level of stress and anxiety.  We at the Thyroid Virtual Clinic are available at all times to address our patients’ thyroid needs, answer their questions, make sure they have enough medications, and if needed,  have a blood test done at their home using our dry blood test kit, making it unnecessary to leave their house to go to a laboratory or their primary doctor’s office.


Q: The delivery of just about every product or service has been disrupted by the COVID-19 outbreak, including health care delivery. One of the main tools that is being deployed around the world is care delivery via telemedicine. TVC seems to be at the forefront this trend. Was this what you had in mind when you initially came up with the idea for TVC?

A: Absolutely. After treating thyroid patients in my brick-and-mortar clinics for over fifteen years, I came to the realization that the overwhelming majority of thyroid conditions can be managed rather easily with the right treatment regimen, resulting in a very high quality of life for these patients. I noticed that this treatment regimen had become rather routine, and even mundane, for many of my patients, and that such a regimen could be maintained rather effectively via telemedicine. As a result, not only could I provide the same high quality of life to these patients, but also the added convenience factor which is inherent in the telemedicine model.


Q: What makes thyroid disease so conducive to being treated via telemedicine? Is the standard of care really the same as what one would receive from a traditional “brick-and-mortar” medical clinic?

A: The standard of care is absolutely the same for 99% of thyroid conditions. Your typical thyroid patient suffers from a chronic condition, the most common being hypothyroidism, or underactive thyroid, which is managed via regular blood testing and an appropriate dose of medication. There is no need for a patient to be in the same room as his or her doctor to discuss bloodwork results, or to communicate how he or she is feeling, etc. Even conditions such as thyroid nodules can me managed remotely, as the only in-person modality of care that is required is a thyroid ultrasound, which can be done at any local imaging center. But there is no need to then travel to your doctor’s office to discuss the results, as this conversation can be held via a telemedicine encounter. This, in a nutshell, is the entire value proposition that telemedicine offers: the same standard of care as an in-person visit, but without the need to take time off from work, travel, sit in a waiting room, etc. This is why telemedicine is absolutely exploding in popularity right now.


Q: Where do you see the future of health care delivery, and particularly telemedicine, ten years from now?

A: Telemedicine was already one of the hottest trends in healthcare before the COVID-19 pandemic, but has now been pushed into the spotlight as both patients and providers are beginning to really understand its value. I only expect this trend to continue and even accelerate from here, and I believe that most health care experts would agree. I’ve read estimates that as many as 75% of all patient-physician encounters could be delivered via telemedicine at some point in the future. Of course this can never reach 100%. I mean if you were to break your arm, you’d still need to go to the ER for an Xray and cast. But for many conditions, particularly chronic ones such as thyroid disease or diabetes, telemedicine is an obvious solution, as it can deliver the care that patients require in a more convenient way and in most cases at a lower cost than the traditional model of hospital/doctor’s office/urgent care center. I’d imagine that in ten years from now you’d be hard pressed to find anyone who hasn’t either received care via telemedicine, or is acutely aware that it exists. The future of the industry is extremely bright.