Learning how to reopen a medical practice during a pandemic definitely falls under the category of "things that were not taught in medical school." However, this process may feel strikingly similar to opening a practice for the first time. Like that first opening, this is a big step, and a practice will have the most success by relying on a thorough plan.
A reopening plan should focus on three main factors: when and how to open; how to keep staff and patients safe; and how to maintain the health of your business.
When and How to Reopen
The American Medical Association (AMA) recommends that physicians first choose a target date for reopening. With this date in mind, practice leaders can gauge personal protective equipment (PPE) needs. They can also decide whether to order more disinfectants (surface and hand) and clinical supplies beforehand.
Consider not only physical barriers between reception staff and patients but also written protocols. Communicating new standards to your employees — whether to wear masks, how and when you will clean or what to do if someone is sick — should be at the top of your list.
The AMA recommends beginning with a light schedule. There will almost certainly be contingencies that you could not have planned for, so allow extra time to adjust your protocols as these problems arise.
Keeping Staff and Patients Safe
Talk to your staff before they return. See whether they have health concerns, and let them know what the practice is doing to ensure their safety.
If you plan to schedule a lighter patient load, consider staggering staff schedules or even implementing an on-call schedule for both office and clinical staff. Decide who can work from home.
Teach employees to recognize COVID-19 symptoms and to stay home if they experience any themselves. Also let your staff know where they can get a COVID test if they need one. The regularly updated nationwide listing from GoodRx includes both drive-through and clinic locations.
Prioritize visits for the patients with the most urgent health needs. As you begin in-person appointments, consider introducing a telephone triage. This will allow you to check for COVID symptoms, inform the patient of any changes to normal office procedures and ultimately decide whether they might be better served by a telehealth visit. The American College of Obstetricians and Gynecologists (ACOG) has created a Q and A of COVID and OB/GYN healthcare concerns that may help physicians anticipate the kinds of information patients want.
Ensure that the disinfectants you use to clean both your office and your ultrasound equipment are appropriate and adequate to use against COVID.
Keeping Your Practice Safe
Check with your medical malpractice provider to help you answer questions related to practicing during the pandemic. Physicians Practice advises finding out whether you can reduce your coverage while your hours are limited. Also consider making changes to your policy if you recently began using telemedicine (or want to use it to see patients in another state) and whether you can work outside your scope of practice if you choose to do so.
Lastly, remember that while HIPAA regulations have been relaxed during the pandemic, practices still owe it to their patients to keep their records as secure and private as possible. If a practice has resorted to using noncompliant modes of telemedicine (such as FaceTime), these need to be phased out over time and replaced with options that adhere to the regulations.
A COVID-positive person will eventually spend time in your office, and you may not know about it until a week later. That person might be your patient, or they might even work for you. If you have thoroughly planned for how to reopen, it will limit the impact and allow you to take a measured response. You and your employees need to work as a team now more than ever to ensure the health and sustainability of your practice. While it is necessary to communicate from a place of authority, do it with empathy as well.
