By Eric Rettig, OD
June 10, 2020
The exam-room experience, like the rest of the patient experience, has been altered by the COVID-19 crisis. Here are key changes we have made in doctor-patient interactions and use of medical eyecare equipment.
Safety First: Masks, Scrubs & Gloves
All doctors and staff now wear masks while in the office. Our masks were purchased on eBay, as well as from a vendor through our alliance, Vision Source. I had very little difficulty findings disposable surgical masks on eBay.
Also, the doctors are switching from wearing street clothes to wearing scrubs during this time. We thought scrubs would have fewer surfaces for viruses to attach to. The scrubs we purchased from a local uniform shop (support your local businesses), and are made by Cherokee with an antimicrobial fabric. We figured they are easier to thoroughly wash than regular clothing. Each doctor got five sets of scrubs to get us through each week.
We also have gloves available for times when we may need to be in prolonged contact with the patient’s face (i.e. foreign body removal, punctal plugs, etc). We spent roughly $500-600 on masks, $200-300 on gloves and another $700 on scrubs for our five doctors.
Plexiglass Shields on Instrumentation
We put plexiglass shields on every phoropter so patients could lower their masks and not fog up the instrument. Some of our slit lamps already had plastic guards. One of the doctors in our office is handy and made large plexiglass sneeze guards for all the other equipment in need of one. We were also sent complimentary slit lamp guards from Zeiss, which we are using.
Finding Ways to Make Contact-Lens Insertion Safer
For first-time wearers, I still place the lenses on their eyes. I put gloves on and wear my mask while doing this. If this proves too difficult, I will take them our to our contact-lens center where a staff member can provide and insertion and removal tutorial through a plexiglass divider.
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We’ve told patients already wearing contact lenses that they can come with their contact lenses in. We are requiring that they wash their hands before and after both removal and insertion, as we always have.
We already educated patient on proper hygiene when handling their lenses, but are emphasizing it even more now. A 20-second hand-wash during these processes is appropriate both before and after, we instruct them.
In addition, we are further educating patients of the importance of using fresh solution each and every time they store and clean their lenses, and to wash the contact-lens case as often as possible (most contact-lens cases are dishwasher safe in the top rack, which we let patients know). We are also offering peroxide-based solutions much more often, as these work well for disinfection.
Shaking hands was a tough habit for me to break because it was always the first thing I did when I walked in the room and after I walked the patient out. We have added a statement regarding this to our reception area TVs. We provide information in these videos to all of our patients about we no longer shake hands and why all the other changes to our usual routines were made.
Patients Are Usually Accommodating of New Exam Room Experience
The biggest thing sometimes eliciting patient comments is the mask-wearing by doctors. However, given that many patients are now accustomed to wearing masks themselves whenever they leave their homes, it is not hard for them to understand why a doctor in an exam room during a pandemic would wear one.
The great part about all of the safety-based changes we have made is nearly all patients are receptive to the changes and want to be proactive in trying to keep themselves and others safe.