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The post Doctors’ practices face closure after ‘nonessential’ service cancellations appeared first on Virus Reports.
]]>Dr. Keesha Williams-Elliott had to cut her practice at her comprehensive eye care center in the District by 90% as part of a citywide shutdown on elective medical procedures during the coronavirus crisis.
Now on the verge of a reopening, the ophthalmologist worries about being able to resume business as usual.
“Until we get back to operating, my practice is going to suffer because we’re mainly a surgical practice,” Dr. Williams-Elliott said. “As things subside, my hope is that we can get elective care back on and have a backlog of patients that need surgery, cataract surgery and glaucoma surgery … and that we have a whole lot to do in a short period of time.”
Operators of dental offices, eye specialty centers, women’s health facilities and other “nonessential” medical services have had significant reductions in their workloads since stay-at-home orders were implemented two months ago.
As restrictions are eased, they see huge challenges in providing services and maintaining their businesses while changing how they serve patients.
Since mid-March, Dr. Williams-Elliott has furloughed most of her employees, reducing the staff from nine people to just herself and one other worker. She said she is waiting on a loan through the federal Paycheck Protection Program to get her staff back to work.
Her office went from being open five days a week to two days a week for three hours daily — a total of six hours a week.
The eye care center has been open only for patients with urgent cases, including eye pain, trauma, change in vision and any postoperative treatment. Routine appointments had to be rescheduled. Dr. Williams-Elliott estimates she has seen four or five patients per week since mid-March compared with 150 before the coronavirus outbreak.
Dr. Larry Bowers, owner of East Capitol Dental in the District, is operating at about 10% capacity and is seeing patients only for emergencies such as swelling, pain and broken teeth. He had to cut his staff from eight full-time employees to four part-time workers.
“I’m trying to figure out a way to keep my business intact until we’re allowed to reopen and when more patients are comfortable coming back,” Dr. Bowers said. “You don’t really have any idea what demand is going to be when you open up.”
Data shows the U.S. has about 13,000 dermatologists, 18,000 obstetricians and gynecologists, 24,000 ophthalmologists and 110,000 dentists.
Nearly 1.5 million jobs in the health care sector nationwide, or about 9%, were cut from February to April, according to the U.S. Bureau of Labor Statistics, and a large proportion of those job losses were at dental offices.
Dentists who have reopened in other parts of the U.S. are operating at about 25% volume, said Dr. Bowers, citing the American Dental Association.
What’s more, procuring personal protective equipment, which has been prioritized for hospitals, has been almost impossible for Dr. Bowers. He said he is still waiting for 1,000 N95 masks he ordered earlier this month.
In Northern Virginia, Dr. Damon Hou, a physician at Capital Women’s Health, said he has tried to limit in-person appointments for emergencies, even though preventive procedures were allowed, unlike in the District and Maryland.
His practice has largely pivoted to telehealth, keeping the business afloat by relying partially on virtual visits and significant pay cuts for partner physicians.
Through virtual visits, Dr. Hou said, staff members have been counseling patients about birth control, infertility and incontinence. Although wellness exams are allowed in Virginia, some patients have delayed or canceled annual screenings, he said.
“COVID-19 has impacted so many businesses, medical practices especially,” Dr. Hou said. “It’s been tough. … It’s a costly business to run.”
“We just want to make sure we keep the company healthy because we want to stay in practice for our patients,” he said.
Dr. Stephen Suah, of FoxHall Dermatology in the District, said he also is dealing with a smaller staff and a reduced workload.
“Obviously, post COVID-19 world is just a different place. All of us, whether we like or not, have to change and adapt with the realities that we’re given,” Dr. Suah said. “I don’t see us returning back to pre-COVID-19 until there is a vaccine in place. … This is now our new normal.
“To make sure we can still take care of people like we want to and that they deserve, we have to transition. And that might be more me sitting on FaceTime and spreading out visits when patients come in,” he said.
His clinic’s staff asks patients to fill out intake forms electronically to avoid paper exchange and go directly to a procedure room. Patients also are asked to stay in their cars instead of the waiting room until the staff is ready for them.
The clinic’s entrance opens automatically to avoid contact with door handles. Plexiglass has been installed at the front desk, and touch-free hand sanitizers are attached to the walls.
During the weeks the clinic has been closed, Dr. Suah said, he has been seeing 90% of patients via telemedicine. He has handled a few emergencies in person including patients with infections, melanoma or a recent diagnosis of melanoma.
Meanwhile, Dr. Bowers said that in his 39 years at his practice, his dental care clinic has never struggled as much as it has during the COVID-19 pandemic.
“There’s always been a risk in dentistry,” he said, noting that dental work involves close contact with patients. “Now as risky as it gets in terms of COVID stuff.”
Dr. Bowers said dentists always have taken sterilization and personal protection seriously and are modifying procedures to provide the safest possible care during the coronavirus outbreak.
He said he is not sure when people will feel ready to come in for routine exams and estimates it will be at least a year until his clinic is operating as it did before the pandemic.
“The uncertainty is overwhelming,” he said.
Dr. Williams-Elliott said she thinks her eye care center will make it under different, but necessary, operating procedures.
“This has been a very trying time. It was very abrupt,” she said. “It’s a very frightening time. I have five kids, so I’m still exposed to patients on a daily basis. … The potential for me bringing it home, I have to change the way I interact with my own family.”
“As far as businesswise, we were a thriving practice. And I’m not alone in that,” she said. “We’re all trying to figure out what that new normal is going to look like. And it’s uncertain. … But I hope things will work out the best that they can, making modifications, because we still have a lot of patients that we need to serve, and that’s my main goal.”
⦁ This article is based in part on wire service reports.
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]]>The post Dental practices led record health care job losses in April but are already bouncing back this month appeared first on Virus Reports.
]]>Dr. Paul Giotopoulos of Quaker Ridge Dental
Source: Dr. Paul Giotopoulos of Quaker Ridge Dental
The health care sector lost a record 1.4 million jobs in April led by more than half a million job cuts at dentist offices according to the Labor Department, as the coronavirus pandemic kept most non-emergency health care services on hold nationally.
The staggering jobs losses mark a 53% decline in dental practice employment over two months. All but 3% of dental offices nationally were shut down except for emergency appointments last month, according to the American Dental Association, and nearly 9 out of 10 had laid off staff.
Most of the jobs could come back online over the next few weeks. The first week of May saw nearly half of dental practices bringing workers back, according to the ADA.
“This week 28 states have reopened… in those states we’re finding 48% of dentists have fully hired back their staff, which is a considerable jump from two weeks ago,” said Marko Vujicic, the ADA’s chief economist.
Dr. Paul Giotopoulos and his partners in New Rochelle, New York furloughed a dozen employees last month. They’ll be bringing them back next week, with the moratorium on routine dental care scheduled to be lifted on May 15th in the state.
It will be anything but business as usual.
“We’re going to be doing a lot of different things–taking some of the seats out of the waiting room… we’ve put up barriers for the receptionists at the front desk,” as well as doing pre-screening of patients for Covid symptoms, Giotopoulos said.
For many practices, one of the biggest challenges to fully ramping up service is finding enough personal protection equipment for their staff. The other is trying to control the spread of patient aerosols that occur during dental procedures.
“Aerosols are created when we use our drills or ultrasonic tools. If you’re ever had your cleaning done with your hygienist – that creates an aerosol and the aerosol spreads all over the office,” in the air said Giotopoulos.
Dental practices that have resumed service this month are seeing about a quarter of their usual patient volumes, to maintain safe practices. At the same time, they are facing higher costs because of new safety protocols to protect themselves and their patients.
“Protocols like spacing patients out –and even some states are requiring exam rooms to be left vacant, so the aerosols can settle– all these things are going to reduce productivity and increase variable costs for dental offices,” said Vujicic. “That’s not a constraint to reopening, but it’s definitely going to affect profitability and depends on… who bears the cost of that increased PPE expense.”
The ADA has asked Congress to provide tax credits to dental practices in the next round of coronavirus funding, to help cover the increased costs of PPE.
Following the 2008 financial crisis, while other service sectors shed jobs in droves, health care hiring steadily rose. But the sharp spike in unemployment poses a headwind for providers trying resume their practices.
Millions of Americans who have lost their jobs may qualify for health insurance coverage through the Affordable Care Act exchanges or the Medicaid safety net program, which could provide a hedge for doctors and hospitals. But dental coverage is generally separate from insurance for medical care.
“We’re going to be facing a two-fold problem… the disease itself and then now you’ve got people that can’t pay. They don’t have a job,” said Giotopoulos. “I don’t think we really understand the scope of that just yet, and that’s something we’re going to have to work our way through.”
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