Practice Management

COVID-19 Shutdown: How I’m Managing the Crisis

By Eric Rettig, OD

April 1, 2020

Like most of you, my practice has temporarily, but indefinitely, closed due to COVID-19. Here is how we are working through the crisis to keep the practice on track and ready to reopen as soon as we can.

Making the Hard Decision to Close
We first floated the idea of closing the week of March 16, before there was a mandate in our local area of Altoona, Penn., to close non-essential businesses. Optometrists deliver essential medical eyecare services, so we wanted to do whatever we could to remain open.

However, as the week progressed, I personally felt less and less comfortable putting my staff, patients and myself at risk of becoming infected. The four partners of our practice, along with our management team and associate doctor, had a meeting in which we decided it was best to close. After our decision, our local government announced that all non-essential care, of which the local government classified routine eyecare, must discontinue. This further solidified to us that we had made the right decision.

The decision to close was extremely difficult. And it took a lot of convincing for many people in our practice to fully come around on the decision. Optometrists need to realize that we are health-care providers, first and foremost, and we have a duty to protect our patients, our staff and ourselves.

A statement from the American Academy of Ophthalmology said it best: “All other factors–business, finance, inconvenience, etc–are remotely secondary. This is an existential crisis. We as physicians must respond to it and support our colleagues and our communities.”

Message posted to Dr. Rettig’s practice web site. Dr. Rettig says the practice has had to layoff 80 percent of its staff, and is now only open for emergency eyecare.

Doing the Best We Can Financially
It’s very difficult to safeguard a practice’s finances during a time like this. Luckily, last year we changed how we budget and manage our finances, and that put us in a better position to weather this crisis, though I don’t think anyone can be truly prepared for a global event such as this pandemic.

Our practice insurance does not cover closure due to a pandemic. We are still seeing emergencies, allowing patients to order contact lenses by phone or through our web site. We are also offering curbside pick-up for glasses. These small steps have helped to generate enough revenue to continue to pay the staff we retained and stay afloat during our closure.

The Pain of Deciding You Have to Layoff Most Employees
Eighty percent of our staff had to be laid off, which was the absolute worst part about this decision. We retained a few key team members to answer phones and process contact-lens orders while we are closed. That may change depending on the length of the closure.

What to Tell Patients

Click HERE to download the letter Dr. Rettig and his partners have distributed to patients.

Using Telehealth to Provide Access to Care
We have opened up options to provide telehealth services to our patients. Currently we are using Doxy.me, which is pretty simple. All patient interactions, conducted via telehealth, are being documented and coded in our EHR as usual.

Stay Available for In-Person Emergency Care
The best thing ODs can do to help with COVID-19 relief efforts is to see emergency patients and let local primary care physicians, urgent-care centers and walk-in clinics know that you are available to see their ocular emergencies. If we can keep the emergency rooms and other clinics free from eye emergencies, that will keep those health-care professionals available to treat patients affected by COVID-19.

Reach Out To Vendors To Ask for Flexibility on Payment

Many of our vendors have been great about helping us through this crisis. I think having a good relationship with vendors has allowed us some leniency in paying off bills. Once we are back up and running at full capacity, we will continue to use these vendors’ businesses, and they know that.

Using the Closure Time for Practice Management Refinements
All of the doctors in our practice are independently working on ways we can improve our care when we reopen. For example, one of my partners is evaluating our current dry eye and AMD protocols. We are each taking this time to catch up on education and professional journals, which often fall by the wayside during our normal busy days.

Social media and eyecare networks, such as our own, Vision Source, have definitely made it easier for fellow ODs to communicate and present ideas to each other, which is great.

 

Eric Rettig, OD, is a partner with Mountain View Eye, a Vision Source practice in Altoona, Penn. To contact him: ericmrettig@gmail.com

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