We Stopped Seeing Patients in the Office

After much discussion, our practice decided to stop seeing patients until the crisis is more manageable.  The reasons are numerous:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. It is the duty of medical offices to set the example: Do not unnecessarily expose those over 60 to infection.
  6. 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.
  7. 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.

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Steven Mussey MD

Steven Mussey, M.D. is a physician in Internal Medicine, practicing in the Fredericksburg area for more than twenty years. He grew up in Springfield, Virginia and earned a degree in Physics from The University of Virginia, Phi Beta Kappa. He earned his medical degree at The George Washington University and was inducted into the medical honor society AOA. He is Board Certified in Internal Medicine. He served in the Air Force for four years before entering into private practice. He particularly enjoys geriatric medical care and working with complex patients. For almost a quarter century, he has been practicing with one other Internist. Both doctors enjoy practice in a small, but busy office, and plan on working into their 70s, as long as they can still find their way to the office. Dr. Mussey is also an avid cartoonist and has a weekly cartoon in the local newspaper. He also enjoys cartoon animation and has had several public service cartoons playing regularly on the television cable systems. 

  3 comments for “We Stopped Seeing Patients in the Office

  1. CMat
    March 25, 2020 at 8:53 pm

    My small office in Tennessee is doing the same yet we have primary care offices in the same building and campus still doing routine physicals , “sick visits” and Medicare Wellness exams despite the Governor shutting everything down.We are losing patients to these offices. We are offering telehealth and limited office visits and calling patients at all hours.We can’t get proper PPE. We are sending staff home unable to pay them. We are the hardest working office that I know losing money every day. If there are others out there you are not alone. Doing the right thing is hard but we will get through it,

  2. Harrietta Christodoulos
    March 24, 2020 at 9:18 am

    We are doing something similar for pediatric patients. Only seeing kids under 2 for vaccines, but are thinking of having them get vaccines in their car as drive up or only seeing the Dr if there is an issue…its evolving every day… hopefully these measures will slow the spread…

  3. Sir Lance-a-lot
    March 24, 2020 at 8:59 am

    We’ve gone from having signs on the doors (ignored) to having people stationed at the doors in protective gear to question patients (lied to) to locking the doors, having the patients call, and doing a complete phone triage, then sending them to a dedicated COVID site for an in-car visit with full PPE, and testing if indicated, if they report or show any symptoms at all.

    That leaves whoever’s in the Urgent Care office without much to do (it’s amazing how much less people have begun to care about their sprained ankles), but that’s the way it’ll be for the next few weeks.

    I’m waiting for the stern meeting with the “superiors” asking why my numbers are down…

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