Do you have a special thermometer (Part 19)

A message from Dr. Ziv Simon

April 10, 2020

Hi!

I hope you are feeling well my friend.

In my last email I talked to you about Patient Appointment Coordination (PAC). I got some feedback about not letting the accompaniment come in ("only scheduled patients are allowed").

We will naturally have to make exceptions for disabled patients. The person assisting the patient doesn't have to stay in the office. We will notify the accompaniment when the patient is ready to leave.

Remember- Our goal is to minimize the number of patients in the office. Unfortunately, we will not be able to accommodate patients that bring along their children including babies.

Things are different now and we must have good verbal skills to communicate with patients about the current limitations. I'll work with you on communication once I establish the protocol in my own practice. 

Let's continue. The patient is at the door.

Our note on the door will screen for symptoms/travel ("Do not enter if you have any of these symptoms....").

As they walk in they will face 2 processes:

1. Disinfection and protection
2. Check in (new protocol)

Disinfection process

1. Provide patient mask (not N95)
2. Hand sanitizing 
3. Pair of booties on shoes (covers)

The goal in this process is to prevent potential contamination of the practice surfaces and the people in it (staff, doctors and other patients). We also want to prevent contamination from shoes and we can assist some patients with putting on the shoe covers.

I am still contemplating this part and trying to figure out if it is realistic to implement. I have a feeling that this would exceed CDC requirements.

A sign with this 3-step protocol will be visible and have a staff member walk the patient through the disinfection process. I plan to create a written protocol that will be emailed to the patient prior to arriving so this process doesn't come as a surprise. It would also be good to communicate that at the time of phone confirmation.

I believe we could stream line this process quite well. It's for everyone's benefit.

Moving on to the the check-in process

I envision a plastic barrier between the welcoming receptionist and the patient. This may not be realistic for every practice. The staff should be wearing masks (N95).

Here are the steps:

1. Screening form for symptoms/travel (in case the patient didn't fill it out electronically). 
2. Measure fever (thermometer)
3. Conventional check-in (page assistant/hygienist/doctor)
4. Confirm payment method (ideally electronic). Send payment link if needed. 
5. Schedule next appointment (hygiene/follow up). 
6. Assistant/hygienist "gets" patient and accompanies to treatment room

What's needed:

1. Patient masks (regular surgical masks)
2. Staff masks (N95)
3. Patient hand sanitizer (touchless)
4. Booties (shoe covers)
5. Thermometer (gun)

Please be very sensitive when you use the thermometer. It kind of looks like a gun. Make sure you train your staff well. Don't just approach the patient with it. It looks intimidating.

Tell-Show-Do.

We simply want to make sure we don't allow patients with fever in the practice. By the way, we will start measuring temperatures of staff members as well.

Start ordering those thermometers. They are still available.

I'll stop here because we need to elaborate a little more in regards to communication.

This part is going to feel very awkward and foreign to all of us. The warmth and fun has been taken away.

However, don't forget that you are still the same kind human being and your patients are still as lovely as they always are.

We must find good verbal skills to communicate and keep the warmth and kindness. 

We are still the same underneath the PPE.

Let's not "hospitalize" our dental practice although in many ways our new protocols and processes will resemble the ones in hospitals.

We must think about the greater cause.

The protection of all people and making sure we minimize the risks of disease transmission.

I believe that we'll have growing pains and that we'll overcome the difficulties.

As humans, if there is something we do well is adapt.

And adapt we will.

I hope this process of exploring the future of our practice operation is helping you. We'll keep going at it until we figure it out.

Tomorrow is a live broadcast on soft tissue grafting. I'm putting some final touches on my presentation. I just saw that almost 500 dentists signed up. I better get a little sleep!

Stay strong!

Ziv.

PS

Here's the link for tomorrow's broadcast about soft tissue grafting. I'll be talking about a graft we call "send your kids to college graft". More on that tomorrow. If tomorrow is already here for you and it's April 10, then it's starting at 10:00AM (Pacific time).