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Dr. John Flucke is in private practice in Lee’s Summit, Mo. He also serves as technology editor for Dental Products Report magazine and keeps an active blog filled with thoughts and tidbits on the world of technology at blog.denticle.com.
The Coronavirus epidemic will continue to disrupt the healthcare industry in ways we aren’t even aware of yet.
We are in the middle of a healthcare disruption unlike anything many of us have ever seen. This pandemic has been frequently compared to the Spanish Influenza of 1918, however that epidemic took about a year to wreak its havoc, while COVID-19, thanks to the mobility of the world’s population, has propagated in just a few weeks.
This event caught the world’s healthcare system “flat-footed” and the necessary response has taken what many consider to be an excessive amount of time to create the required pieces to fight it.
In my time in dentistry, I’ve only seen one situation that is even close to what we are seeing now. I spent the first two years of my dental school education working in the human mouth with no gloves. That seems so shocking to all of us now, but at the time it truly was the standard of care.
We also did not wear masks and our handpieces were wiped down with surface disinfectant. They never went in a steam autoclave. The only time handpieces were sterilized is if the patient treated had active Hepatitis B-then the handpieces were sent to a nearby hospital for ethylene oxide sterilization.
And then the world shook. HIV appeared on the scene and it seemed that everything in dentistry changed overnight. I remember sitting in on a mandatory lecture where we were told that going forward gloves and surgical masks were required. Infection control radically changed. There was some initial resistance in the profession, but we adapted. We went through the fire and emerged stronger. The profession became an example to other branches of healthcare for its devotion to infection control.
We may very well be standing at the precipice of another serious disruption, although at this point it’s a bit hard to make anything but an educated guesses.
This has been a difficult time for both the world and our proud profession. The past two months have been fraught with rumors, innuendo, and pseudo-science. Yet, lots of true science and research has also been mixed in. The problem has been trying to separate the wheat from the chaff.
Every day, we’ve been faced with changing policies and suggestions, only to find that the next day the previous ones have been removed and new ones are in place. This has made it extremely difficult for dentistry to get a clear picture of where we fit in and how we can contribute.
My gut tells me that we will probably come out of this with some changes in PPE. There may be a move to require N-95 masks. However, we’ve been working in masks that do not filter viruses well until now, and we seem to have done just fine. Whether this is the tipping point for change is hard to discern. As Yoda said, “Difficult to see. Always in motion is the future.”
The other piece of this ever-changing puzzle has been the financial aspect that we have all had to face. At no other time that I’m aware of in modern history has the world been told to “stand down” in the manner that has happened with COVID-19.
In a post on my blog (blog.denticle.com) that I made in mid-March, I stated:
“Last week, COVID-19 was a topic of discussion and an annoyance. This week, it rocked the world. On Monday, March 16th and Tuesday, March 17th, my office was cranking along at a pace that made me proud. Patient satisfaction was high, employees were happy, and the financial numbers were more than sound. Then there was ‘that huge sucking sound’ that was COVID-19 tearing through the social fabric. On Wednesday, March 18th, everything changed for the office. I was forced to furlough six employees, cut the hours of those who remained, and begin dismantling a schedule that was a snapshot of front office efficiency.”
As I type this now, my office is a shadow of what it once was. From a staff of 15 employees, I am now down to one. I am going into the office for two half-days to treat emergencies.
I know that all of you reading this are in the same situation. This pandemic has forced the closure of businesses and created massive unemployment. I just received an email that states unemployment is at more than 17 million (and has risen since), the highest level of joblessness since the Great Depression.
Stress and anxiety are high because no one has any answers about how this all plays out or when anyone can expect to start earning a living again. In the meantime, we sit sheltered in our homes, and watch our bank accounts drop while simultaneously praying that the toilet paper shortage ends soon.
So, what can we do to help create a more positive experience out of all of this? Let’s take a look at a few ideas for managing the pandemic and coming out strong.
Keep patients in the loop
I recently received a compliment from a patient whom I was seeing to smooth a sharp edge from a fractured molar. She told me she had a friend who was a patient in another office. The friend had an appointment in a few days and knew that she would need to reschedule. However, when she called, she received a message that the office was closed and was unsure when they would reopen. My patient said her friend would be calling my office when this was all over because we do such a great job of communicating.
In today’s environment and with all the digital tools at our disposal, there is no excuse to not be engaged with your patient base. We use Weave (getweave.com), although there are other options as well.
We’ve been reaching out via email and text messages to do our best to help our patients understand how COVID-19 has impacted dentistry and to let them know we are here to take care of them as best we can.
Also, if you are looking for a way to give back during these difficult times, try contacting your older patients to see if they need someone to run an errand or pick up a prescription at the pharmacy for them. While I know it is risky to go out right now, it is even more risky for our elderly patients, many of whom are immunocompromised.
Review targets and know where you are aiming
Many of us take time over the holiday break to make plans for the upcoming year. That’s a great idea that I highly recommend, but who says you can only set goals around the new year? The downtime we all have right now is the perfect time to set goals if you have not already. If you HAVE set goals for the New Year, now is the perfect time to re-evaluate those goals.
Until the economy came crashing down, we were in one of the greatest economic upswings in history. That meant many of us were incredibly busy and with busyness comes entropy. Things naturally progress from order to disorder and it’s difficult to stay on top of goals and projects when you are busier than ever before.
Now is the ideal time to look at what you had planned and see how your goals are progressing. Sometimes you need to make corrections to stay on target. Evaluate things now and make those needed corrections. Then when we get the green light to go back to work, you and the team will be ready.
Evaluate new projects
If everything is where you want it to be, it’s time to work on growth. Take a look at something you’d like to get better and stronger with in your office. As an example, I was going to do some work to better understand teledentistry this summer.
Today, I’ll bet you that when summer is here, I’ll be so busy trying to catch up with treatments that have been postponed, I won’t have the free time I was counting on. However, I still want to learn more about teledentistry.
To that end, I’m spending some of my time now to do that learning. I’ve got a training session set up with the provider TeleDent to help me learn. By the time you read this article, I should be well on my way to understanding the concept and the program much better.
The enemy of orgaization is entropy. Things naturally go from order to disorder. That’s the law of nature. When we are busy (and before this all started, who wasn’t busy?) we don’t stay as organized as we should. As assistants and hygienists turn rooms over for the next patients, things end up being put where they shouldn’t. Often times, “I’ll put that back after the next patients,” turns into, “I’ll put that back tomorrow morning,” and it just continues to slide from there.
Have some staff take this time to reorganizethe treatment areas so there is a place for everything and everything is in its place. That way, when we are cleared to be doing elective procedures, your office will be ready to rock. Nothing is going to throw your efficiency a curve like trying to remember where you put something 60 days ago. Take advantage of the downtime and get things squared away.
There are always two ways to look at things. Half empty or half full, up or down, yin or yang. Despite all the negativity and stress involved with our current situation, I refuse to let this virus or the mess it’s leaving in its wake dominate me.
I look upon this time off as a huge dam that is holding back millions of gallons of opportunity. When the floodgates open, I want to be there with a big net to scoop up all the fish. There’s plenty of room along the downstream area. Why don’t you join me?