JWH eBook - 1

EXPERT PANEL DISCUSSION

Long-Acting Reversible Contraceptive
Issues During the COVID-19 Pandemic
Moderator: Jeffrey P. Levine, MD, MPH1-4
Participants: Cheryl Lambing, MD, FAAFP,5-7 Glenmarie Matthews, MD, MBA,3
Sarah Pickle, MD,8 and Razel Remen, MD9
1

Professor and Director of Women's Health Programs, Rutgers Robert Wood Johnson Medical School,
New Brunswick, New Jersey, USA.
2
Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School,
New Brunswick, New Jersey, USA.
3
Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson
Medical School, New Brunswick, New Jersey, USA.
4
Master Educators' Guild, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
5
Venutra County Health Care Agency, Los Angeles, California, USA.
6
Ventura County Family Medicine Residency, Los Angeles, California, USA.
7
David Geffen School of Medicine UCLA, Los Angeles, California, USA.
8
Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati,
Ohio, USA.
9
Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Dr. Levine: It is my pleasure to moderate this distinguished panel discussion about long-acting reversible contraception (LARC) and its implications
about issues regarding long-acting reversible contraceptives (LARCs) during the COVID-19 pandemic, a very timely and relevant topic especially
given the impact this public health crisis and the
related social distancing strategies have had on our
patient access to onsite, in-person clinical care,
particularly for ambulatory procedures such as
intrauterine devices (IUDs) and contraceptive implant insertions and removals.
Let me kick start the conversation by asking each
of you what you consider to be the most significant
issue regarding LARC access and provision today.
Dr. Lambing: I think this is an opportunity to talk
about LARC access in terms of a journey. Here at the
Ventura County Health Care Agency, I teach a large
residency program and there are 75 of us housed in our
academic clinic. Normally the challenge is having
multiple appointments. Patients schedule, the counseling is completed, and then we are looking ahead to
ª 2020 by Mary Ann Liebert, Inc.

find out when we can schedule the procedure. This
process is not ideal.
Ideally, the patient will come, receive their counseling, make a decision the same day, then we look
around all of our four suites and we find a physician
who has room in their schedule to do the procedure if
the physician completing the counseling cannot do it,
or we move patients to another physician.
Interestingly enough, during the time of the pandemic,
we, as part of a larger health system, fell under federal,
state, and local recommendations and guidelines, which
meant in our institution appointments that were nonessential were stopped. This strategy was intended to reduce the spread of COVID. We closed our operating
rooms and reduced access to all our clinical services.
Before the pandemic, at our institution, we had no
telemedicine and no telehealth options. As for essential
services-you might think, ''Alright, those appointments are for the person who falls down and breaks her
leg or emergency surgeries.'' Yes, but the decision
impacted everything. ''Nonessential meant'' no child
checks if immunization was not required. It meant no
well woman examinations. It precluded contraception,
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JWH eBook

Table of Contents for the Digital Edition of JWH eBook

JWH eBook - Cover1
JWH eBook - Cover2
JWH eBook - A
JWH eBook - B
JWH eBook - C
JWH eBook - D
JWH eBook - 1
JWH eBook - 2
JWH eBook - 3
JWH eBook - 4
JWH eBook - 5
JWH eBook - 6
JWH eBook - 7
JWH eBook - 8
JWH eBook - Cover3
JWH eBook - Cover4
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