After much discussion, our practice decided to stop seeing patients until the crisis is more manageable. The reasons are numerous:
- Seeing patients with fever and respiratory symptoms requires a level of personal protective equipment and isolation which is simply not possible in the typical office setting. Thus, many practices try to keep these patients away.
- However, filtering patients at the door, using a series of questions, proved to be incredibly unreliable. We started by trying to call patients and ask them about fever, cough and body aches. That failed. We tried a series of signs on our front door. That failed. Then, we literally locked our front door and had patients call a special number we reserved so we could ask them questions about possible illness or exposure.
- After three days of this, we realized we were limiting our practice to patients who needed routine follow-ups which could be either postponed or handled over the phone for the next few months.
- Most of these routine follow-ups tended to be elderly and patients with chronic health problems. Getting vulnerable people out of their house, breaking their self-isolation to be exposed to staff and other patients, no matter how carefully they were screened, created a level of unacceptable risk.
- It is the duty of medical offices to set the example: Do not unnecessarily expose those over 60 to infection.
- We also noted that both my partner and I are over 60. Much of our staff is over 60. We are at higher risk ourselves.
- Also, any of us could be infectious without even knowing it. We were putting vulnerable people who trust us at risk.
Meanwhile, another event drove the point further: I was supposed to have a dental appointment this week. The thought of a dentist sticking his face into my mouth made me nervous. I called to cancel and discovered my dentist closed his office except for emergencies. He was setting a standard we needed to follow.
We knew what we had to do. We stopped seeing patients. Every morning, my partner and I come into the office with one staff person. The doors remain locked. We answer the phones and talk to patients. If you call the office, chances are it is a doctor answering the phone. We freely give out our cell numbers and tell patients they may call us after hours. If you call the office when we are not present, you get a recording of explanation and then you get our cell numbers. It means we are still available 24/7.
We want to help our patients through this as much as possible without putting them in danger. We try to manage issues on the phone. Rarely, we may bring them into the office with a lot of precautions. We want to keep people out of the ER.
It is not perfect, but we say: “We are here and will do our best to help you.” The situation is fluid and we constantly reassess our plan. As an aside, it amazes me how many dental assistants I’ve spoken to who are in offices which are still open for routine dental care. They express fear which is very justifiable. Dentists were listed in a New York Times article as being the highest risk profession. It’s hard. We’ve never been in such a situation.