Updated on June 25, 2020 & Sept 10, 2020.
Reopening a medical practice during the COVID-19 pandemic requires physicians, their staff, and their patients to cooperate, to adapt, and to be flexible and responsive to changes. This article describes practical steps for reopening your medical practice during COVID-19. Changing conditions need to be kept in mind at all times.
The conditions and requirements for reopening a medical practice vary within the state, counties, and even cities and will change over time. We recommend you to consult your local public health department prior to reopening your medical practice. Be aware of changing conditions. When stay-at-home orders are being lifted, this does not mean they cannot be reinstated.
Here is a list of the public health departments of the counties in the San Francisco Bay Area:
Before reopening your practice, update your financial and staffing plan. This includes anticipated patient volume, changes in hours, and the use of telehealth. Work with your staff and ask for their flexibility to adjust for changes in patient volume and working hours. Always be aware of changing conditions.
Flexibility is the key to stability.John Wooden
Review your existing safety protocols and make adjustments for increased safety to protection against COVID-19. Communicate and train your staff on the updated safety protocols.
List your current supply on hand and your potential supply needs. Plan your consumption of PPE by taking into consideration any supply chain limitations (order quantity limitations, longer delivery lead-times), and potential future surges. Follow these Strategies to Optimize the Supply of PPE and Equipment.
The single biggest problem in communication is the illusion that it has taken place.George Bernard Shaw
Throughout the process of reopening your practices, provide ongoing and clear guidance to patients and staff. Keep them informed about changes to your practice because of COVID-19 including increased safety protocols, extended hours, and the use of telehealth. In addition, provide them with ongoing guidance from public health sources on the known risks, testing, and treatment for COVID-19.
Your patients may not have access to the same resources or medications during COVID-19. Some of your patients may be going financial hardship due to a lost job. Medication may be in shortage during the COVID-19 pandemic. Take these external factors into consideration and create alternative and backup plans for patient care.
As practices reopen, revenue and patient volume may increase slowly and unevenly. Keep in mind that many patients may be concerned about visiting a medical practice during the COVID-19 pandemic.
Make sure your practice stays financially healthy while patient numbers may increase slowly, and do the following:
As practices adapt to changing patient volume and the increasing use of telehealth, you should:
The CDC offers leaflets in several languages:
Protecting your patients and your staff requires that all of them wear a face mask. Provide your patients advice on the effective use of a face mask: How to wear a non-medical fabric mask safely
Telehealth describes the use of 2-way communication technology for certain health care services. During the COVID-19 health emergency, the Department of Health & Human Services (HHS) has taken steps to make it easier to provide telehealth services. The HHS encourages health care providers to adopt and use telehealth as a way to safely provide care to patients in appropriate situations. Those situations include routine health care (like wellness visits), medication consultation, dermatology (skincare), eye exams, nutrition counseling, and mental health counseling.
The HHS Office for Civil Rights (OCR) has issued guidance to empower health care providers to serve patients through telehealth during the national public health emergency.
HIPAA-covered health care providers may provide telehealth services to patients using remote communication technologies. During the COVID-19 pandemic, providers are even allowed to use apps like FaceTime, Facebook Messenger, Google Meet, Zoom, or Skype for telehealth services. Not all of those applications comply with HIPAA rules. Remember, this exception is COVID-19 specific and only temporary!
Prior to an office appointment, pre-screen patients for possible COVID-19 symptoms. This reduces the risk of having potentially infected patients visit your practice.
Here is a leaflet from the CDC you can share with your patients: Symptoms of COVID-19.
Follow the CDC Guideline: Using Personal Protective Equipment (PPE)
Follow the CDC Guidance on Quarantine and Isolation
With the uncertainty around the virus, patients are grateful for practices that prioritize safety. Be sure to let them know what you are doing to protect them and your staff. Finally, remember that reopening your medical practice during COVID-19 will take some time, and will require flexibility and cooperation from all parties involved. Frequently communicate to make sure everyone knows what is going to happen and has time to adjust to this new setting.
Centers for Disease Control and Prevention (CDC): Coronavirus (COVID-19) Guidelines
Department of Health & Human Services (HHS): Coronavirus (COVID-19)
California Department of Public Health (CDPH): COVID-19 Updates
California Department of Public Health (CDPH): Resuming California’s Deferred and Preventive Health Care
Health Officers Association of California: Reference Materials
California Medical Association (CMA): COVID-19 Resources
American Medical Association (AMA): COVID-19: A Physician Guide to Reopening
Medical Group Management Association (MGMA): COVID-19 Medical Practice Reopening Checklist
Small Business Administration (SBA): Coronavirus (COVID-19): Small Business Guidance & Loan Resources
Department of Health & Human Services (HHS): CARES Act Provider Relief Fund