As soon as information became available from China and South Korea, I saw the writing on the wall. Based upon the prior SARS and MERS outbreaks, I was very concerned with the potential ramifications.
When the CDC started putting out recommendations to reschedule elective visits, we decided to start rescheduling our patients. Since a significant part of my practice is wellness visits and physicals which are not urgent, I felt the responsibility to reschedule our visits rather than expose myself, my staff, and our patients.
Now we do almost everything over the phone. I’ve also gone to people’s houses to drop off self-swab testing for COVID as well as for acute medical issues other than COVID.
We don’t have PPE other than gloves — I can’t get it. We just have gloves. But it’s more important for my colleagues on the front lines in the ERs, hospitals and ICUs to have PPE at this time to minimize their risk of exposure to COVID19.
My staff is working primarily from home. Right now I’m carrying their salaries. We’ll see how everything plays out with the stimulus bill although my goal is to take care of all my employees during this time. I did find it surprising that if they make under a certain amount, they will make more money on unemployment —
they’ll get about $600 extra per week.
I don’t think insurance will cover losses due to COVID and associated shutdown. As a concierge practice, a percentage of revenue is membership based so the financial impact is more long term based upon the effects of the economy on renewals. Nevertheless, a percentage of the revenue is the executive physicals performed separate from the full concierge memberships and the financial impact of losing that revenue will be significant for my practice as well as other practices which focus on executive physicals.
This is a high-touch practice. We send emails once a week. When reviewing all the information about chloroquine, hydroxychloroquine and azithromycin, we personally reached out to each of our patients to discuss the potential treatment options — limitations of the information — what’s realistic and what’s not. We counseled them on the importance of the restrictions with respect to social distancing, staying at home and shelter-in-place. I do a Facebook Live meeting everyday where I give updates and answer questions.
I’m surprised to look around the U.S. and see so many people in denial or questioning the severity of the situation. I would expect the high schoolers and college students to feel that we are overreacting or not want to follow the recommendations. Telling high-schoolers and college students that they have to stay home and not be with their friends is really hard. For those in their 40s, 50s, and 60s who think it’s all a big overreaction is hard to swallow, especially when you see what is happening in New York City and Italy.
The biggest transition for my practice has been adjusting to not seeing my patients and instead doing telemedicine and phone calls. I like it better than I thought but it’s very different. I use it for follow-up appointments and acute issues, although I miss seeing our patients.