Mapping the Road to Re-opening

Is your dermatology practice open for business? A few months ago, that would have been a simple “yes” or “no” question. Today, it is complicated, and it is likely to be that way for some time. The timeline of COVID-19 closures and plans for re-opening vary, depending on your location. Even if you are allowed to see patients, or expect that to happen soon, it is not business as usual. In order to stay safe and stay profitable, you will need some careful planning and a lot of flexibility. Below are some tips for easing the process.

Be willing to scale back

Do not take an “all or nothing approach” to re-opening. The harsh reality is that you might have nothing left by the time you can resume what was once normal. Depending on your specialty, circumstances, and location, there are many ways to remain partially open and keep some revenue flowing. These include:

• Go virtual. Teledermatology may be your best friend now and for the foreseeable future. You can offer virtual visits in lieu of physical treatment, or as an adjunct. This helps increase revenue streams while decreasing the number of people physically present in your office. The possibilities are virtually limitless, ranging from visual diagnostics for rashes, first aid advice, initial consultations, post-treatment follow up, screening emergency patients, and even planning of cosmetic procedures to be scheduled later.
• Adjust services. Elective procedures might be prohibited, or at least discouraged, for the time being. Even medically necessary procedures may be postponed if nonurgent. This presents a problem for all practices, especially cosmetic dermatology practices. However, if you want to remain open you can temporarily shift to emergency treatment, such as wounds, burns, or severe rashes. In areas hard hit by COVID-19, this approach also helps alleviate some of the burden on emergency rooms and urgent care facilities. When you are ready to accept cosmetic patients again, consider limiting those services to no contact or minimal contact procedures in the first weeks.
• Limit the number of appointments. Perhaps you are ready and able to see your regular patients again. However, the risk of COVID-19 will linger long after the crisis has passed. Experts predict a resurgence in cases if social distancing measures are relaxed too quickly. Consider adjusting your scheduling so fewer people are physically present in your office at any given time.
• Reduce staffing. When you are ready to see patients, of course clinicians will need to be present, as well as someone at the front desk to handle check-ins. What about the bookkeeper and the additional office staff answering phones? Can they continue working remotely? Can clinicians work on alternating days, rather than everyone being present at once?
• Adjust operating hours. Patients might not be eager to schedule appointments. Ill staff members will not be able to work for some time. Thoroughly cleaning public areas each day takes time. For these and other reasons, it might not be practical to resume your regular operating hours. Consider opening for fewer hours, fewer days per week, or both. Test the waters and expand gradually.

Adapt to the new normal

We all yearn for a return to “normal,” but it will not happen soon, if ever. Everything has changed and continues to do so in lightning speed. Your old procedures, protocols, and even office décor are probably no longer applicable. You will need to adjust accordingly, with measures such as:

• Safer reception desk. Face-to-face interactions between patients and the receptionist are probably unavoidable. You can help keep both parties safe by installing plexiglass shields, like those at retail stores.
• Social distancing furniture. Does your waiting room have rows of side-by-side chairs, located where people must walk right by them? It is time for a bit of a remodel. Strive to space chairs six feet apart, and allow that much distance from foot traffic, even if it means putting some furniture in temporary storage.
• COVID-19 screening. Consider checking employee’s temperatures at the beginning of each shift, as well as patients when they enter your office. Also ask about common symptoms. Some practices require staff members to sign waivers stating that they have not experienced symptoms, and that they will report it promptly if they begin to have symptoms.
• Employee issues. Train staff members on the proper way to wear a mask, surface disinfection protocol, handwashing requirements, and other safety measures in accordance with CDC and OSHA guidelines. Be prepared for questions and concerns from people who are afraid to return, or who have problems such as lack of childcare.
• Patient policies. Advise or require patients to wear facemasks and to wash their hands immediately upon entering your office. Implement social distancing standards and limit the amount of people allowed in your office at any given time.
• Go paperless. Remove brochures, magazines, and other reading materials from your reception area. Transform patient handouts, intake forms, appointment reminders, and other paperwork to digital format. The goal is to eliminate (or reduce as much as possible) any items that are handled by multiple people, including pens and paper.

Final thoughts: the importance of communication

The best laid plans are worthless if no one knows about them. Employees will come to work unprepared, patients will bring family members along, and everyone will be confused when you say, “that is no longer allowed.”

Start with your staff. Before you re-open, hold virtual meetings to communicate plans, but it should not be a one-sided discussion. Ask for their suggestions, answer questions, make them feel involved, and be sensitive to their concerns. However, do not count on everyone remembering and following guidelines. Document all new policies and provide all staff members with a (virtual) copy.

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The latest Ekwa Marketing video discusses how social media can help you connect, communicate, and boost your professional reputation.
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Last, but certainly not least, is patient communication. You want to keep people updated about changes in your hours and available services, as well as promoting options such as virtual consultations. Use social media, in-office signage, virtual newsletters, your website, and other marketing channels to get the word out to the public. Your appointment scheduling and confirmation process should include notification about new patient policies such as limited guests or social distancing requirements.

Above all, protect yourself, your team, and your patients. The crisis will pass. Do not rush to re-open sooner than it is safe to do so.