Social Distancing in a Solo Pediatric Office: What are you doing in your office?

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There is no shortage of instructions from experts, policymakers, and business owners on what to do and what not do to stop the spread of coronavirus. The message is clear on social distancing as one of the remedies. Frequent handwashing, wearing a protective facial mask, sneezing on the inner elbow, and keeping away from others prevent or slow the spread of the virus. People exposed to individuals with coronavirus must self-isolate and stay home for at least two weeks. Where symptoms of fever, cough, and difficulty in breathing occur, those sufferers should seek a medical opinion, starting with calling their physician or other hotlines provided depending on where they live.

In practice, everybody has to use some common sense to avoid the virus as well as maintain a reasonable amount of dynamism, service, and day to day living.

Since every doctor has their own experiences and relationship with patients, what I am doing is probably going to differ from what other pediatricians are doing, but it is worth sharing. When parents call my office for their children to see me, I talk to them directly to determine whether they have symptoms suggestive of coronavirus infection. The majority of them do not, and I believe them since I have known them for several years. Among those who have called, some had an earache. Others had rashes (eczema), sore throat (strep throat), or wheezing. I have also seen in my office children with vomiting and diarrhea.

So what is different now, in the era of coronavirus, than before? Unlike before, when parents walked in with their sick children and stayed in the waiting room with other sick children, our office door is now locked with signs to call us over the phone. To make sure we are in control, we request patients and their families to call the office again when they get to the parking lot. Then we open the office door when they arrive. No longer can there be more than one family in the waiting room. Immediately a family leaves my office, we clean up and instruct the family who has been waiting in the parking lot to come in. Several instructions referencing where to call for a COVID-19 test are also on our front door.

This arrangement has been working very well for our practice. As I said earlier, every practice is different, and every community or patient population is different. However, I wanted to share this idea for the benefit of patients and practitioners in case they find it applicable to them. Being easy and simple does not make it less innovative or resourceful. To be clear, this idea of seeing each family at a time did not occur immediately to me. Like many other practices, businesses, schools, and government institutions, it took some fine-tuning and experimenting to come together. Other offices could emulate or tweak my approach to adapt to their needs. For example, a lawyer or an accountant may adopt a similar approach to consult with their clients.  

My patient capacity has decreased by 60 percent since this coronavirus pandemic started. Where I was seeing an average of twenty patients per day, I now see seven — probably enough to pay my secretary and keep the utilities on. I know there are other options out there, including telemedicine, phone consultations, or going away on an extended vacation. But, for several reasons (not necessarily financial), not everybody is in a place or a mindset to stay physically away from all their patients. In the abundance of time, I now have, I do my homework. 

Good luck, and stay safe. Be sure to check out my latest book.

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