Update

Dear Patients,
It has now been three weeks since we “reopened” our office, and I wanted to provide everyone some feedback. We have significantly changed how we handle the flow of patients through our office to lower the risk of exposure to COVID-19. I am happy to report that I feel the current risk to patients is extremely low. The changes to the workflow can be cumbersome, but when everyone knows what to do, it works beautifully. Here is what we are asking of you:
For all in person appointments:
  • Wear a mask at all times, including covering your nose
  • Call the front desk to “check in” with insurance/credit card info from your car when you arrive in the parking lot.
  • Wait in your car until our Medical Assistant calls you up so that you can go straight back to a sanitized exam room with minimal overlap with other patients.
  • Stop at front desk on the way in only to identify yourself and to self scan your insurance card or credit card if not on file
  • Expect to go straight to the exam room without sitting in the waiting room. Please feel free to wash your hands using the exam room sink.
  • Expect all staff to wash their hands once they are in the room with you.
  • “Check out” should be unnecessary unless you need additional paperwork completed
Should I schedule an in-office or a virtual visit?
We are performing all of the usual activities in the office. This includes routine checkups with EKG’s and lab work. Any visit that would be better performed in person, is now being offered in person. Just call to make an appointment. However, we do continue to recommend Virtual Visits for: anyone who may be actively sick with COVID; anyone who is at high risk for COVID susceptibility; or for a visit for any reason that might be able to be handled over our virtual visit platform. Obviously, the virtual visits are safer and more convenient, and for the moment, covered by insurance. And the virtual visits are working extremely well, even for mental health visits, compared to trying to talk with each other through a facemask. At least on the computer I can see your face! Hours for any type of visit remain 7:30am-7pm M-Th, 7:30am-4:30pm Fri, and 9am-2pm Sat.
Where can I get COVID-19 testing?
We are able to test for the COVID IgG antibodies, which looks for prior infection, by drawing the blood in our office and sending it to Quest Lab using the ELISA test. And we can order the nasal swab COVID PCR RNA test for active infection through one of the walk-thru or drive-thru testing sites, such as at Sibley, GW, or one of the newer sites that have recently become available. Testing for asymptomatic people who either just want to know or for those wanting to socialize or work with others remains somewhat difficult, but can be arranged. Right now we are asking
that you set up a virtual visit if you would like for us to prescribe this test for active infection. Of note, the ability to test for active infection is critical for identifying people very early in their illness, and it appears that this test will be more readily available without a doctors prescription in the next two to three months.
Can I bring the kids to visit Grandma?
That is a difficult question. I know this is not a popular opinion with anyone, but I think you should put it on hold until the medical community can offer some real protection to this virus, with a vaccine or treatment. It is my opinion that this will occur in the first half of 2021, so we should just not risk it. Before then, would I go on a vacation that required air travel and eating in restaurants? Even if you are young and healthy, I don’t think so. There are signs that there may be long term damage from getting sick. and I don’t think it is worth the risk. What if we get a negative test result from the nasal swab just prior to travel? I fully agree that would be incredibly valuable information, and would lower the risk considerably. However, currently the tests are not very accurate, and not everyone in the group will have access to the test. So this last scenario depends on your tolerance for being exposed to any risk.
Thank you again for your continued support during the last few months. I hope you all remain safe and healthy, and have a nice Independence Day.
Bill Condrell

Fourth of July Hours

Our office will be closed on Friday, July 3rd and Saturday, July 4th. If you have any questions, please give us a call at (202) 244-0812.

We are finally opening our office on June 1st! 

I am pleased to be able to resume offering you a clean and disease-free office setting for your primary care! We have put in place a series of procedures and protocols that will keep all of you, and all of us, safe. But I am counting on you to make sure that all of our patients who have COVID-19 symptoms are seen via a Virtual Visit. If you have a fever, or any of the other known symptoms, we will be glad to see you virtually. We will consider arranging for the best available testing, help you manage your illness, and advise you on the need for quarantine. 

 

For all other Primary Care, we are glad to see you either in our office, or continue over our Virtual Visit platform. There will be times when an in-office visit is better, such as for Routine Physical Exams, or when a lab collection is necessary, etc. But whenever possible, at least for the present time, we would love to keep the distance, and provide your care virtually. We may decide during a virtual visit to order lab tests or schedule you for an in-office visit to get a better look, and these can be arranged soon after the virtual visit. Our in office lab is not offering the nasopharyngeal PCR test for active COVID infection (that will be prescribed at a drive through testing center), but we are able to send your blood for COVID Antibody testing to see if you may have developed immunity.

 

When you do schedule a visit in our office, we will let you know more about the “distancing” procedures that we will be asking of you. We are scheduling our visits far enough apart that we hope that when paired with a check-in process that begins at your home, there will be no overlap of patients in the waiting room. Staff will be wearing appropriate personal protective equipment, and we ask that you wear a facemask covering your nose and mouth at all times. And of course, we will be sterilizing each room and all high touch areas after each patient is seen.

 

Reopening our Community

 

Society needs to get back to business and reopen, and we all need to put into place the proper measures to keep ourselves as safe as possible. We are now much more capable of handling this risk than we were at the end of January. We have learned how this disease is transmitted, and of the need for social distancing. And if you become sick with something that resembles COVID, I can help arrange for you to be tested at a drive thru testing center right away. If you all would immediately start recording the names and hopefully contact information for all of the people you become exposed to each day, we can trace and test those folks if you become sick. Unless we are medical researchers, these are likely the only things we can do to help stop this pandemic. 

 

I hope to see you all soon!

 

Bill Condrell

 

How to prepare for a safe visit to Spring Valley Internal Medicine

Here is some important information to know for your upcoming visit: 

 

 

  • Wear a make or face covering

 

Wear a cloth face covering over your nose and mouth. This could be a mask or another covering, such as a scarf or bandana. You will not be seen if you are not wearing a face covering or mask. Please arrive with this on and keep your face covered while you are at the office. 

 

 

  • Arrive alone

 

Visitors or support persons are not allowed in the office unless the support person is deemed medically necessary OR there is a language barrier for the patient themselves. Exceptions need to be approved before your appointment. Please call the office

 

 

  • Keep a social distance

 

Stay at least 6 feet (about 2 arms length) from other people. Do not gather in groups. 

 

 

  • Wash your hands

 

Wash your hands often with soap and water for at least 20 seconds. Avoid touching your eyes, nose, and mouth. Please go ahead and wash your hands upon arrival in the office and when you are leaving.

 

 

  • No walk-in appointments 

 

We are only offering scheduled appointments at this time. Our after hours (4:30-7:00pm) will remain virtual for any of your acute needs. Please call the office to schedule an appointment! (202) 244-0812. 

COVID-19 Update and FAQ’s

Dear Patients,
What is known about COVID-19 continues to change, and I thought it might be useful to send out an update. But for now, please continue to schedule Virtual Visits if you have current symptoms of COVID-19, need testing for active infection, or would like the blood test for antibodies. And as before, please continue to schedule virtual visits for all your general primary care needs. We are scheduling “check-in” visits if your “check up” is overdue to give us a chance to review your care and to provide refills. This visit will not be billed as a “physical”, and I am recommending that you plan to come in for your routine “check up” when we are back in the office.
I am still recommending all of us do our best to avoid exposure to anyone outside of our homes. I want to thank all of you for the opportunity to provide your care virtually even though I think that in-person care would be better. I continue to be hopeful that the office will open soon, but cannot give you a date that any of us will feel safe. I imagine that a lot of us will want to continue to our interactions virtually for a long time, and of course these virtual visits will be fine with me whenever it makes sense. I am hopeful that we will start to see some patients in the office sometime in June, or maybe July.
Stay safe,
Bill Condrell
FAQ’s
What is the difference between the nasal swab (RT-PCR) and the blood test for IgG antibodies?
The nasal swab indicates the presence of virus particles in your nose, and indicates that you are actively sick. A positive result on the nasal swab means the person is likely to be contagious, and should be quarantined even if they are asymptomatic. Ideally, these patients will not leave quarantine until another nasal swab has come back negative. The blood test for IgG antibodies shows us something very different. If the person is generating IgG antibodies (a positive test), their immune system has seen this disease, and has successfully fought back. Antibodies should help prevent reinfection.
Can people who have antibodies get reinfected?
This disease is too new to know the answer. I believe that antibodies to COVID-19 will provide some protection. But there have been reports of patients who became ill with COVID-19, who appeared to recover fully including developing an antibody response, and then later became ill again. This is unusual in that with most other diseases, when someone makes IgG antibodies against that disease, it means that the person has recovered (or been vaccinated) and cannot get reinfected. However, it appears that COVID-19 is different, and antibodies may not prevent reinfection. Researchers are now trying to clarify the degree of immunity associated to COVID-19 antibodies. But a conclusion I feel we can confidently make is that once a person is making antibodies, you will know that they have successfully fought off this disease once, and are very likely to be able to handle a reinfection, should that ever happen.
Is the Quest antibody test accurate?
There has been a rapid growth in companies producing a COVID-19 antibody test, and accuracy is critical to successful reopening of society. Please see the information provided by Quest Diagnostics Lab:
Quest is using a test manufactured by Abbott, who has reported their accuracy through an internal study of 1,200 patients who were tested after 14 days of symptoms which showed Sensitivity of 100%, and Specificity of 99.5%. If these numbers are accurate, a “negative” result would mean that you definitely do not have immunity, and you continue to be vulnerable to this disease. And if you have a “positive” result, you are very likely to have antibodies and some protection. However, because of “false positives”, 8.6% of the people who are “positive” will not have antibodies at all (because there is an 8.6% false positive rate when the prevalence of disease is 5%, and a specificity of 99.5%). Even though these numbers have not been fully evaluated by the FDA due to time constraints, I have confidence that both Quest and Abbott are sufficiently careful about quality to continue to recommend that we use this test to learn about our immunity. LabCorp also does “serology” testing, but have not disclosed their Sensitivity or Specificity data. If new information becomes available on the testing, I will be sure to put it on my website (springvalleyim.com)
For more information, please see these comparisons of the accuracy of the different manufacturers of the antibody tests:
And this is a white paper from Johns Hopkins which thoroughly describes how we should approach Serology testing to help respond to this pandemic:

Big News! We are now able to get you tested for COVID-19 antibodies.

What is an antibody test? 
We hope that when you test positive for COVID-19 IgG antibodies, it means that you are immune to COVID-19 and cannot get reinfected!. While the issue of immunity based on the presence of antibodies has not been proven, it is likely that having antibodies would make you much less vulnerable to reinfection. This is a blood test, and is not intended to see if you have active infection (see below), but intended only to see if you have had a prior infection. Because there is very high demand for this new test, highest priority will be given to those patients who have been sick in the last 2-3 months, and those at high risk for infecting others (healthcare workers, service industry workers, etc.). If you would like to be considered for antibody testing, we are asking that you schedule a virtual visit with one of our providers to arrange for the blood to be drawn at a nearby Quest Lab testing facility. I am told the cost will be covered by your insurance company.
For now, all Primary Care continues through Virtual Visits 
As you are aware, the stay-at-home order is still in place. As a result of this, we will continue to offer Virtual Visits which are covered by your insurance (copays and deductibles may apply). All primary care problems are encouraged to be addressed virtually at this time. We are scheduling Virtual Visits by appointment only Monday through Thursday from 7:30am to 7pm, Friday 7:30am to 4:30pm and Saturday 9am to 2pm. You may contact our office at (202) 244-0812. We anticipate returning to the office for healthy patients sometime between May 15th, and June 1st this year.
Active COVID-19 symptoms and testing
We also want to help manage any COVID-19 symptoms if you are feeling sick now. If you are experiencing upper respiratory or any other COVID-19 type symptoms, please schedule a virtual appointment today, and a provider will discuss your symptoms and management plan with you. If needed, we can arrange for you to be tested for active infection through virus RNA testing at a local testing center.

We are OPEN for Virtual Visits

Dear patients and families,

As you are aware, there is a stay-at-home order in place due to the current COVID-19 crisis. Despite the shutdown, we are open as usual but we are only offering Virtual Visits to limit exposure between patients and staff. All of your concerns may be addressed via Virtual Visits, such as medication refills, chronic disease management, mental health visits, annual wellness visits or any other concerns/new problems. All primary care problems are encouraged to be addressed virtually at this time. Virtual Visits are now covered by all major insurance plans (copays and deductibles may apply). 

Additionally, we can also help manage COVID-19 symptoms. We have been fortunate enough to provide orders to our local COVID-19 centers and have been closely working with them to have our patients tested. We are scheduling Virtual Visits by appointment only Monday through Thursday from 7:30am to 7pm, Friday 7:30am to 4:30pm and Saturday 9am to 2pm.

 

You may call the office to discuss your symptoms and schedule a same day appointment at (202) 244-0812. 

 

Furthermore, to prevent the spread of COVID-19 the following guidelines may help: 

  • Wash your hands often with soap and water, for at least 20 seconds.
  • Avoid contact with people who are sick.
  • Cover coughs and sneezes with a tissue, then throw the tissue in the trash.
  • Avoid touching your eyes, nose, and mouth.
  • Clean and disinfect frequently touched objects and surfaces.

 

We will continue to comply with the orders in place, in the meantime; we are happy to accommodate you for a Virtual Visit. Stay safe and healthy! 

 

Kind regards,

 

William Condrell, M.D. 

(202) 244-0812

www.instagram.com/springvalleyimdc/

Update from Dr. William Condrell

Hello Dear Patients!

 

In order to decrease the risk to all of us from the coronavirus, we have been limiting all our office visits to Virtual Visits, which are now approved by all insurances. The Virtual Visits can be used for essentially all types of care including sick visits, medication refills, mental health visits, Medicare Annual Wellness Visits and much more. While an in-person visit might have been better, we are going to do our best handling all Primary Care through this Virtual Visit method indefinitely. So, please consider setting up one of those visits now. 

 

Though there are some that say we should soon get back to work, please continue to do your part to help eliminate the spread of COVID-19 through the use of social distancing. By this I mean that I recommend staying home, and only going out for very urgent matters such as required grocery store trips. Specifically as of March 26th, I continue to recommend not going to work in an office setting, nor socializing at all. I suspect that this will be my recommendation until after we can be sure the “curve” of new cases has begun to decline. I will update my www.SpringValleyIM.com website as soon as things change.

 

For those of you who are experiencing any upper respiratory symptoms, I am asking that you schedule a Virtual Visit today if possible with one of our providers, rather than going to the ER. Our providers will review your case, and determine if you successfully qualify for COVID-19 testing under current testing rules. If you do meet the standard set by the Dept of Health, we will make arrangements for you at a drive thru testing center right away. As many of you are aware, the COVID-19 testing centers continue to have lots of rules about who can receive coronavirus testing based upon severity and nature of  symptoms. If you do not meet the “criteria” but are suspected of having the disease, we will identify the best next steps, including future testing, the need for quarantine, possible treatment options, and how to handle your exposure to other people. And please know that we are working every day to keep track of all of the available testing centers in the DMV area, and hopefully will find one soon that will test more than just those who meet “criteria”. The first step to COVID-19 testing is scheduling a Virtual Visit with one of our providers. Our Virtual Visits are offered Monday through Thursday 7:30am-7pm, Friday 7:30am-4:30pm and Saturday 9am-2pm. 

 

Update for all Medicare Patients: 

 

Due to the recent COVID-19 outbreak, doctors and other health care providers can use telehealth services to treat COVID-19 AND any other medical concerns from offices and places of residence (homes and nursing homes). As of March 6th, 2020, Medicare now covers Virtual Visits. Please note that coinsurance and deductibles may apply. Also, if you have coverage through a Medicare Advantage Plan, you won’t have to pay out-of-pocket costs for COVID-19 tests.  

 

Medicare has recommended that at this time we schedule Annual Wellness Visits virtually to ensure the health and safety of both our patients and staff. All of our Medicare patients will receive a call from our office to schedule these visits. The Annual Wellness Visit (AWV) is a yearly appointment to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Due to this recent outbreak, it is now an important time for us to schedule these Annual Wellness Visits to ensure optimum health. Keep in mind that the Annual Wellness Visit is not a physical exam and it is separate from what we typically describe as a Physical Exam, which would naturally need to be done in person, and should wait until we are back to our regular office hours. The Annual Wellness Visit includes a health risk assessment/questionnaire which asks about your health status, injury risks, behavioral risk and urgent health needs. It also includes a screening for cognitive impairment, depression and includes health advice/referrals. This can be completed via a Virtual Visits, and Medicare is recommending we do these with our patients annually. Please call the office at (202) 244-0812 to schedule your visit today! 

 

We will continue to post updates as we receive them. Thank you for your patience and understanding through this difficult time.

 

Sincerely, 

 

Bill Condrell

Virtual Visits Only during this COVID-19 Outbreak: No Walk Ins

Effective 3/23/2020, we will temporarily be suspending our walk in visits at our office.  For your safety and the safety of our staff, we ask that you call (202) 244-0812 to schedule a virtual visit.

 

We’re accepting Virtual Visit appointment Monday through Thursday 7:30am-7pm, Friday 7:30am-4:30pm and Saturday 9am-2pm. We will continue to post updates as we make changes to maximize safe social distancing while also continuing to care for all our patients.  If you have any questions or concerns, please call the office.

 

Please note, your insurance treats these virtual visits the same as an in-person office visit and copays are due at time of visit.

 

For the most current updates on what our practice is doing regarding COVID-19, please follow us on social media:

COVID-19

Please read below for common questions you may have in regards to COVID-19.

1. What are the common symptoms for COVID-19?

Common symptoms include a sore throat, cough, shortness of breath, fever over 100.4 degrees F and body aches. Please be aware that some individuals experience only some of these symptoms or none at all.

2. What do I do if I believe I have COVID-19?

Please refrain from going to the ER unless you are experiencing respiratory distress or life threatening symptoms. We need to reserve the ER resources for those who are very sick. If your symptoms are mild, please self-isolate and treat yourself at home. I understand everyone would like to be tested, but as stated above, tests are limited. Leaving your house in search of testing poses unnecessary risk to those around you. It also increases your risk of a COVID-19 infection, in case you do not have it already. Please schedule a virtual visit to hear if we think you need urgent management or an ER visit.

3. What do I do if I have been exposed to someone who has tested positive for COVID-19?

Please self-quarantine for a minimum of 14 days. You may call the CDC/DOH to inquire about testing, but please be aware that unfortunately, you may still not qualify to be tested. During this time, you may also schedule a virtual visit with one of our providers for more assistance.

4. What do I do if I know someone who knows someone who has tested positive?

Distant exposure to a known COVID-19 case puts you at minimal risk for infection. Monitor your symptoms and practice social distancing.

5. What should I be doing to minimize my risk of infection?

  • Please regularly wash your hands for at least 20 seconds and don’t touch anybody while maintaining the recommended 6 foot distance if possible.
  • Try not to touch your face
  • If you do not have access to soap and water, use hand sanitizer with at least 60% alcohol
  • Practice social distancing. Even if you are young and healthy, you put older and immunocompromised individuals at risk by going out for pleasure.

Of note, COVID-19 testing kits remain scarce. We ourselves do not have the capability and means to test for COVID-19 at this time. We will update as soon as local testing centers become available.

 

If you have any further questions, please schedule a Virtual Visit for a
consult by calling (202) 244-0812 or (202) 686-0813. Continue to use the
Patient Portal to send us requests or recommendations. We will try to
continue to update you, as we have access to more information.

Sincerely,
Spring Valley Internal Medicine