Too much time on my hands


My buddy Dr. Paul Feuerstein always uses song titles for his articles. I suppose imitation is the sincerest form of flattery… sorry Paul. Oh and also my apologies to the band Styx...

Last week, COVID-19 was a topic of discussion and an annoyance. This week, it rocked the world. On Monday, March 16 and Tuesday March 17, 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 18, 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.

I’m pretty sure that all of you have similar stories to tell. This has been an incredibly awful week and, even worse, there doesn’t appear to be any consensus on when this all will end.

My practice is now only treating emergencies and non-aerosol generating procedures.  Unfortunately those procedures are not nearly enough to cover overhead. I’ve done a little research in my limited downtime and from what I’ve discerned, cutting back to the level advised by multiple agencies and organizations will drop office production 85-90%. You read that right.  If your office has been producing $5,000 per day, you can now expect about $750, and that would be on a good day. COVID-19 is not only going to affect biologic health, it is going to have a massive effect on financial health as well. 

By limiting procedures in our offices we are helping to fight this disease on the front lines (and as we know, we ARE on the front lines). Our next step is to try and figure out ways to fight the other problems that this crisis is causing. What follows here are some ideas on what to do with all of this time on our hands.

Clean, clean, clean
According to the Harvard Coronavirus Resource Center, a recent study found that the COVID-19 coronavirus can survive up to four hours on copper, up to 24 hours on cardboard, and up to two to three days on plastic and stainless steel. The researchers also found that this virus can hang out as droplets in the air for up to three hours before they fall. But most often they will fall more quickly.

Because we cannot be sure who in our office was positive for COVID-19 without showing symptoms, use this downtime to disinfect everything like you have never disinfected before. I have instructed staff to clean and disinfect everything in our clinic. When they are done doing this, I am going to instruct them to do the complete disinfection process again. Perhaps that is overkill, but when it comes to the health of our patients, I think this thought process is the best one.

I am also going to have a similar strategy for our reception area. Sometimes we forget about that spot when we are thinking about infection control. Hopefully any virus left in that area would be dead in a few days, but in this case, better safe than sorry.

There have been some questions about surface disinfection. Here is info from Kavo/Kerr regarding the surface disinfection product CaviWipes. It is a short but enlightening read.

We are also going to devote time to completely cleaning and refreshing the office in general.  Not just for COVID-19 but to eliminate those embarrassing “dust bunnies” that can hide under furniture, cobwebs in corners, etc. I will sometimes lay on the floor in the reception area and just look around to see if there are things that need to be cleaned. We’ve been so busy lately that I haven’t had a chance to do that, so now is the time!

If your office is like ours, these past few months have been very busy. One of my associates, Dr. Sainy Adel, mentioned to me the other day that “since I’ve come on board, we’ve been pretty much pedal to the floor every day.” He’s right. It has been a tremendously busy and productive time lately.

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Like everything, that can be a blessing *and* a curse. When things are busy, tasks such as organizing usually get less attention. That means entropy sets in and things become more disordered. To that end, this is a great time to have dental assistants tear the operatories down to the bolts and get everything restocked and re-organized. That will greatly help when this is over and the gates open. I am optimistic that when those gates open, there will be a flood of patients coming in and we will need to be prepared for that.

This also applies to the business office area. We have three members on our Admin Team and sometimes even that many isn’t enough. That means that their workspaces also get affected by entropy. They should also get ready for the tidal wave of things they’ll need to do when offices re-open.

Stay in contact with patients
Utilizing the technologies that we have at our disposal allows us to make sure that patients continue to think of us and put dentistry high on their priority list when all of this begins to fade.  

Let patients know how much you miss being able to provide their care and what you are doing during this time to ensure their safety when you re-open.

Another good idea I heard lately was to have staff reach out to your elderly patients. Let them know you care and ask if they need anything. Many of our elderly patients are frightened, immunocompromised, or both. If you community allows you to be out in public, offering to make a grocery or pharmacy run could be a huge help to these people. Plus it’s just the right thing to do. Dentistry has always had a tremendous social conscience and this is just one more way to help and to show our concern for our older demographic.

Focus on things you can control
We all have things in our offices that need more focus. Maybe you’ve been wanting to improve your endo skills. Maybe you have been wanting to decide with CBCT system you’d like to purchase.

As the Technology Evangelist, I’ve always got a long list of products to test and/or new things to focus on and implement. I’m using this time to get my “To Do List” straightened up and things checked off. We’ll be working on making our newer implementations have tighter impact on our everyday systems. I’m going to be spending a lot of time with our Axsys 5x400 Mill and our SprintRay 3D printer.

I tell people all the time that dentistry is one of the few jobs where the CEO is also the one in charge of creating the majority of the product. There are so many times when, as CEO, we think “if only I had some time to devote to ‘X’ business practice”. Guess what? Now you have that time.

Wrapping it up
Work hard on being the leader you need to be. Guide your team and your patients through this difficult time. Before we know it, we’ll be back to full schedules and all the time eating problems we normally face.  Take this time to work on and fix those things you’ve been dreaming of fixing.  Then get out there and work on making those dreams a reality!!!

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