As COVID-19 has spread across the U.S., rural clinics have taken precautions to prevent the spread of the virus and minimize exposure for both their staff and patients. Sarah Kirchhoff is the rural doctor for Concordia and its surrounding communities. She grew up in Concordia and returned after residency to become the town’s family physician at Western Missouri Family Healthcare.
In response to the pandemic, Kirchhoff’s clinic has made almost all appointments virtual visits. They ask patients who do need to come into the clinic to call before entering the building. Staff wear masks, goggles and gloves when interacting with patients.
“You have to be a little bit more flexible and a little bit, kind of have to think on your feet a little more, because you don't always necessarily have all of the resources that a big city would have available at your fingertips,” Kirchhoff said of practicing in a rural area. While the changes in response to COVID-19 have been challenging, Kirchhoff said she feels supported by their main hospital in Warrensburg and by her community.
Mary Stanfield holds her dog Casper while on a virtual visit with Sarah Kirchhoff on Tuesday, April 28, 2020 in Concordia. As a precaution, the Western Missouri Family Healthcare has as few people visit the clinic as possible. Instead, patients have virtual visits using a program called Doxy.me. Kirchhoff said converting to telehealth visits hasn’t been a simple process. “We have a little bit of an older population. So trying to teach them how to be able to use a virtual software like that has been a little bit challenging,” Kirchhoff said. “But at the same time, since our patients know us really well, they can always call us if they have issues and they've been really flexible.”
Sarah Kirchhoff presses her stethoscope into Jana Mueller’s back to listen to her lungs during a routine physical on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. Since the state shut down, Kirchhoff has been seeing six to eight patients a day, whether that be in-person, virtually, or over the phone. Before COVID-19, Kirchhoff said she saw 12 to 15 patients a day. Despite these slower days, Kirchhoff said she’s grateful for the support of the hospital system and the entire community. “You're really seeing people pull together and asking people if they need anything,” Kirchhoff said.
From left, Ciaira Cain, a practical nurse, speaks with Sarah Kirchhoff after doing blood tests for a patient on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. When patients come into the clinic for appointments, the clinic staff, which consists of Kirchhoff, Cain, a nurse practitioner and a receptionist, wears masks, goggles and gloves. They also try to schedule appointments so that routine check-ups and procedures are in the morning and patients who are sick come in the afternoon.
From left, Sarah Kirchhoff, Kim Harrington, Jacki Addington and Ciaira Cain laugh about an online video on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. Addington laughed and said that most clinics don’t have as much fun as they do. Later in the day, Kirchhoff treated her staff to smoked meatloaf from Dempsey’s BBQ, one of Concordia’s local restaurants.
Sarah Kirchhoff dictates notes into her phone after a routine physical with a patient on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. Normally, Kirchhoff brings her laptop into the patient’s room and types her notes directly into their chart. In an effort to minimize exposing people to extra surfaces, she has resorted to writing notes on a notepad while in the appointment and adding them to the chart later.
Sarah Kirchhoff pulls up a photo of her three-month-old son, Aiden, to show Glenda Fuchs on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. Fuchs came to the clinic to get a blood test, which the practical nurse at the clinic handles, but Kirchhoff stopped in her room to say hello. “In general people are concerned and being cautious, but not overly panicked,” Kirchhoff said of the atmosphere in Concordia. “If something like this happened 20 or 30 years ago when we didn't have Facebook and Skype and all those different ways that we can connect with people, it would definitely be a very different situation,” Kirchhoff said.
Lights are dim in the waiting room on Tuesday, April 28, 2020 at the Western Missouri Family Healthcare clinic in Concordia. To minimize person-to-person contact, the clinic has moved most of its appointments to virutal visits and has a sign posted on the door instructing people to call the clinic before coming inside the building. Of course, not all in-person visits can be avoided. “Patients still have high blood pressure and patients still have diabetes, even with all of this going on, so we’re really trying to make sure that we're not letting their chronic conditions fall through the cracks,” Kirchhoff said.
The town of Concordia, as seen through the peephole on the back door of the Western Missouri Family Healthcare clinic on Tuesday, April 28, 2020 in Concordia. The clinic is located on Concordia’s Main Street and is a two-minute drive from Sarah Kirchhoff’s home. “In a small town, you just really get to know your patients on a more personal level,” Kirchhoff said. Kirchhoff said one of the funniest parts of practicing medicine in a rural area is seeing patients around town and having people come up to her and ask for medication refills or for medical advice.
