continued on page 36
Urologists add no-contact testing
layer to patient care.
I
n late April, the son of one of
Dr. Howard Korman’
s patients
called his urology office to
describe symptoms of a recurring
condition that in the past had
been treated with medication.
“I dreaded thinking that in the
midst of the COVID situation
I would be taking my almost
92-year-old dad from his home in
Chesterfield all the way to Royal
Oak and have him go inside a
doctor’
s office,
” said his son, who
asked to remain anonymous. “We
knew the doctor would want to
do a urinalysis, and were very
pleasantly surprised to learn that
he could make arrangements for
my dad to be treated without
leaving his house.
”
After a telemedicine videocon-
ference, Dr. Korman included his
patient in what he described as “a
grassroots urine specimen home
pickup method” provided by
Comprehensive Urology, a group
of 50 urologists and advanced
practice providers, of which
Korman is president.
As a urologist, he said most of
his patients require urine testing
to diagnose possible conditions,
some of which, if left untreated,
could be life-threatening. “We
had many patients who were
afraid to come to the office,
”
Korman said. “But the problem
was, how else do we get urine to
check for blood, protein, glucose
or signs of infection?”
In response to the chal-
lenge, Korman, along with
Comprehensive Urology pathol-
ogist Dr. Rajan Dewar and Issam
Atoussi, the group’
s COO, created
a way for patients to provide
urine samples without leaving
their homes and with limited or
no contact with another person.
DROP OFF AND PICK UP
After a urinalysis is ordered,
patients are contacted by Mai
Her, a medical assistant and tech-
nical trainer for Comprehensive
Urology’
s lab who also serves as
the office dispatcher. She then
arranges for a courier to drop off
a urine sample kit on the patient’
s
front porch. “They are so appre-
ciative that they don’
t have to
come into the office when they
don’
t feel well and are concerned
about COVID,
” Her said.
In some cases, the courier
would wait in their car in front
of the patient’
s home until the
specimen was placed outside.
“If they needed more time,
the driver would leave and
the patient would call when
they were ready and I would
arrange for the courier to go
back, usually within 12-24
hours,” Her said.
At the start of the COVID
shutdown, four drivers were
making a total of 40 daily trips
to patients’
homes, with Her
mapping out stops including
those in Novi, West Bloomfield,
Bloomfield Hills, Dearborn, Troy,
Southfield, Oak Park, Grosse
Pointe, Macomb, Birmingham,
Royal Oak and Rochester.
Now about 75% of the group’
s
patients are booking appoint-
ments in their CDC guide-
line-adherent offices with appro-
priate PPE and social distancing.
Home drop offs and pick-
ups are down to about 10 daily,
with only one individual, Dr.
Korman’
s son Jonathan, continu-
ing as a courier, having driven as
far as 200 miles in a day.
“Samples are picked up with-
in 30 minutes of the time they
are placed outside, and I pro-
cess them immediately in the
Comprehensive Urology lab,”
said Jonathan Korman, who is
also working as a laboratory
technician.
“From time to time, I get
to talk to the patients from a
distance, wearing gloves and a
face mask.”
A dipstick analysis is per-
formed on each sample by
an automated machine, with
results immediately sent to the
ordering physician.
“We are also using an inno-
vative kind of urine culture
from Pathnostics using PCR
techniques which analyze the
DNA of the bacteria in the
urine to yield identities and
sensitivities of bacteria much
faster than a conventional
urine culture,” Dr. Korman
said. “This enhances our ideal
of a fast turnaround time for
results.”
STAYING SAFE
Until the COVID-19 outbreak,
Dr. Korman primarily saw
patients in his Royal Oak and
Farmington Hills offices. By
April 1, like others in the health-
care sector, he needed to find
a way to continue to treat his
patients while keeping them —
and his staff — safe. He reduced
in-office appointments to the
10% with emergency needs.
The rest were seen by tele-
medicine. “But analyzing urine
is a critical part of the checkup
for urologists,” Korman said.
“The new program allows us
to add that to our no-contact
34 | JULY 30 • 2020
Front Porch
Medicine
SHELLI LIEBMAN DORFMAN CONTRIBUTING WRITER
Dr. Howard Korman and Issam
Atoussi in the Royal Oak
Comprehensive Urology office.
Health