The novel corona virus Sars-CoV2 is wreaking havoc on people in a number of ways. The economy and especially the healthcare system are under great burden as the virus continues to spread rapidly.
With many people choosing to quarantine themselves at home, doctors are facing major slowdowns in business. We spoke to several doctors on how COVID-19 has impacted their business what measures they’re taking to adapt to these challenges.
Dr. Kenneth Jainandan
Dr. Kenneth is a general dentist who has been practicing for 9 years. He currently works in a DSO (dental service organization) and provides full scope of dentistry, restorative and surgery endodontics.
Logic Inbound: In the current situation with COVID-19 what are the major challenges?
“Performing elective dental procedures – you don’t know which patient may be positive, and the aerosol created with dental procedures poses a great risk to yourself and your assistant. Patients may be unknown carriers, as many people may be asymptomatic. The Florida Board of dentistry chose to prohibit all elective dentistry procedures until May 8th. Dentists are now only seeing emergency patients. True dental emergencies are advised to seek care at their dentist and avoid going to emergency rooms. A lot of practices are closed and employees are furloughed until at least May 8th – if not longer.
Logic Inbound: Any advice for dentists on what they should do about the current situation?
“Follow the Florida Board of Dentistry guidelines, and keep abreast with the situation as it is dynamic, where things are changing daily. I would advise dentists with multiple offices or practices to see if they can rotate your staff or rotate your front desk so each person has some sort of hours so their pay is not fully cut at this critical time.”
Logic Inbound: Suggestions for dentists who are not yet affected by these changes?
“Do temperature checks on all patients, utilize a N95 mask for yourself and assistant, as well as a new disposable gown for each patient.
Keep up to date with the news and keep up with what’s happening with your specific state dental board because things are changing every day.”
Dr. Austin Fontenot
Dr. Austin Fontenot is a Chiropractic and Functional Medicine practitioner, and has been in practice for 4 years. He specializes in clinical nutrition and functional medicine, and takes a non-pharma approach to patient care.
Logic Inbound: In the current situation with COVID-19, what are the major challenges?
“Ensuring safety of people. It’s never guaranteed but you take extra precaution on sanitation and cleanliness. We haven’t had a whole lot of people cancel appointments yet.”
Logic Inbound: Advice for doctors and what they should do about it?
“Do just exactly that — take every precaution to minimize exposure and extra precaution on sanitizing and cleaning. Space out appointments so you don’t have so many people clogged up in a waiting area or mixing with each other. Most offices are going to be taking a decrease in volume for the time being. It’s necessary right now.”
Logic Inbound: What’s your outlook for 2020?
“Positive outlook. There’s going to be a lot of innovation that takes place, a lot of new businesses started. Especially with online entrepreneurship. Telehealth will take a larger role in the future.
Immediately it’s going to be hard to see because everyone is focused on loss of income and change in lifestyle. We’re all in it together and we’re going to adapt.
People are realizing who is more productive at home and who is much less productive at home and in business in general. Realizing what meetings could be a phone call or an email.
Online anything is going to be fast tracked during this. Even personal trainers are getting creative doing online training sessions and so on.”
Logic Inbound: In the current situation with COVID-19, what are your major challenges?
As a provider: Adjusting. The governor said first to discontinue specific services. Then it was a mandate. Adjusting to things that are just unprecedented are a challenge. If you haven’t been in business for a long time and had to adjust to big economic changes quickly it might be a shock.
Getting the word out that they ARE still available for sources. Restructuring debt, calling lenders to get forbearance on your liabilities to stay open and reduce your monthly expenditures.
Utilize everything at your disposal to profit and maximize your outcomes in this situation.
I’m utilizing my nonprofit arm to do good and bring in extra capital to remain viable as a business.
Planning to extend reach because we’re already mobile. There’s some areas with very few or no providers.
Initially we were limited to Metropolitan Louisville areas, now we’re using Facebook targeted ads and social media to other areas and they will go to that area and provide services for them.
It’s a 1 doctor 1 assistant model, you’re not walking into a waiting room with multiple other people you’re in close proximity to.
We screen people to make sure they’re not having a fever.
Doing extra air filtration and doing everything possible to provide a safe environment for services rendered for patients and practitioners like using N95 masks to protect the provider.
Logic Inbound: How are you managing medical supplies through this COVID-19 situation?
Just had a call with our supplier to make sure our last order is en route. Made contact with the metro government to find any other avenue to obtain PPE (personal protective equipment) through the city.
Dentistry is just as important as some of the other services out there. Someone with a toothache can’t just wait. The supplies issue will be a bigger question for another week or so.
At this point it’s a short duration so supply shortages hasn’t been a problem until now.
April Rhoads is a healthcare consultant working with physicians in the cash based space.
She mostly works with Doctors in aesthetics and doctors who want to enter the cash-pay space.
Logic Inbound: In the current situation with COVID-19, what are the major challenges you see?
“All providers are going to have to pivot. The ones that are flexible and creative enough to pivot are going to be successful at the end of this.”
Logic Inbound: Any advice for doctors? what should they do about it?
“One: This is a great time to take a step back and do training.
A common objection is “we don’t have time for training” so now when all these offices are not able to have their normal patient flow– now you have time for training.
If all your staff is willing and able to work, now is the time to do all those things you wanted to do but didn’t have time.
- Training on a device
- Training your staff
Operationalize your business so when it is time to open your doors, you’re running even better than before.
The #1 barrier in the past for training was: “We don’t have time to close the doors for a non-revenue chunk of our day.”
Now you have time, more than ever to do all these training, team buildings, more than ever.
This is a great time to ramp up your social media presence because you have more time for that.”
“Two: A lot of offices are also offering free consultations right now.
For example going live on Instagram and saying “ask me the questions you might be afraid to ask”
You’re speaking not just to current patients, but to new patients so you expand your reach.
Everyone is on instagram right now so there’s an amazing opportunity to pick up new patients.”
Logic Inbound: What’s your outlook for 2020?
“Uncertainty is the name of the game right now.
We may be able to get through April, but what happens if this continues into May? June? July?
Every week each office should be sitting down with key team members and asking: “What’s working, what’s not?” What does this outlook look like?
Every provider is feeling uncertainty they’re going to have to be really creative and flexible almost every day and every week.
What’s working in this landscape could change completely by next Monday.
Just accept this and know that you’ll be changing every day.
Now is the time to get creative and pivot as much as you can.
Go back to the drawing board and talk to people who you consider to be your experts.
Whoever your peers are and people you respect, ask what’s working — share what’s working for you.”
Dr. Michelle Farnoush
Dr. Michelle Farnoush is a cosmetic and implant dentist, specializing in bisecting nutrition with functional dentistry in both group and private practice in Las Vegas, NV. She has a BSc Kinesiology from McGill University, ALM Business Management from Harvard University, a MSc. in Human Nutrition from Columbia University and completed her DMD degree at UNLV School of Dental Medicine. She is a graduate of the Kois Center and an Affiliate Associate Fellow of the American Academy of Implant Dentistry. She is an active member of the AACD Member Relations Committee and serves on the board of her local dental society chapter. IG: @DoctorFarnoush
Logic Inbound: In the current situation with COVID19 what are the major Challenges for you and for the doctors you work with?
“In Nevada, according to the ADA they sent out recommendations on the week of March 16th. The Nevada dental association sent out their recommendations for that through April 16th.
Most or all dental offices are stopped and moved to emergency only. Now most states have done that. The governor will ultimately dictate the day you go back.
That means you don’t see the same volume or number of patients. That’s the bulk of the business.
For most dentists offices, employees are furloughed or laid off. You’ve lost staff and patients and the income that keeps your doors open.
Now: How do you screen people and decide who you ARE going to see?
The guidelines just came out yesterday and there’s a lot of uncertainty of how to go back. It’s unclear When can you even start to schedule people to go back?
You have delayed patient treatment. If it’s pain and things like that you might do temporary things. There could be emergency care options depending on your state.
The ADA released a protocol — ADA protocol algorithm (released 4.1.20) “ADA Interim Guidance for Management of Emergency
and Urgent Dental Care” https://www.ada.org/~/media/CPS/Files/COVID/ADA_Int_Guidance_Mgmt_Emerg-Urg_Dental_COVID19.pdf?utm_source=adaorg&utm_medium=covid-resources-lp&utm_content=cv-pm-ebd-interim-flowchart&utm_campaign=covid-19
Next, there’s speculation about what insurances will or won’t do. You can’t really control that so it’s not worth spending energy on that.
Logic Inbound: Do you have any advice for doctors? What should they do in this situation?
“For now: Build value for your team and your brand. It’s challenging.
You can leverage social media, email blasts and things to stay in contact with your patients.
Next: You have to make sure that you’re listening to FACTS because there’s a lot of BS out there. You can really get caught up in it. Make sure you get your facts straight from multiple different sources.
A lot of associates are independent contractors, and unemployment insurance might not include that in some states.
That challenges a lot of newer people. Just because you don’t own the office doesn’t mean you don’t have your own stressors. This is a really good time to empathize with others and analyze new ways of approaching dentistry.
Figure out 5 things you could improve your life both personally and professionally.
Just because you’re not IN the office doesn’t mean you can’t work ON the office.
Talking about 1 thing with your team every day. Be responsible and available.
Talk to patients, screen them over the phone.
Really be honest, be clear if you don’t have an answer or if now is not a good time to see patients.
For example patients with immunocompromised systems. Putting their final implant crown on can wait.
It’s easy for some people to turn things into an emergency.
Everyone is in the same boat, learn how to be lean and how to best work smarter.
Head team meetings virtually. Protect your staff even if you’re an associate. Touch base with everybody.
Stay up to date with the SBA, EIDL, PPP and other options. Most people have already applied for the EIDL loans.
Independent contractors can do that too, not just practice owners.
Biggest advice; This is the catch up game.
- Catch up on insurance claims
- Inventory revisions
- Maintenance, take the office apart.
- Take all your Continuing Education virtually.”
Logic Inbound: What’s your outlook for 2020?
“On Being Lean — there are many resources online.
Look at your last collections, look at the SBA things and EIDL things you could get.
Look at advertising and other expenses.
Put that in the model building, you could look at an excel sheet.
Link for COVID-19 ROADMAP to Success! c/o ACTDental:
Make a plan and talk with your team about it.
(On the comeback)
Some people don’t have jobs, and they’re spending less, meaning they keep some income, and there’s SOME money being saved.
In the ramp up: People won’t rush for all the elective cosmetic work, that’s going to be slower, but it’ll come back. Maybe we’ll see more single-tooth dentistry and coming back to basics.
It’s important to create value with your patient base. In changing and planning for that change
On Model building
What you want to do this week, next week, 1 month, half year, 1 year Goals
Jot a couple of ideas down. Be ahead of that change.
Honing on alternative skills like photography, develop those skills.
Revitalize your staff, get on those virtual calls.
Invent your competitors — what would they look like, what would their team be like?
Get a good screening protocol in place.
There’s a few additional questions you might want to add to that when you’re coming back to the office.
- Ask if they’ve taken any medications that could impact their temperature.
- Ask if they’ve had a change or loss in smell, or altered senses.
- Ask them take and hold a deep breath for 10 seconds and let it out slowly — if they struggle that could be a sign to see a primary care physician before seeing you.
N95 masks are being recommended, disposable gowns etc. Things like that are the planning stages to position yourself to come back.
(Followup question — when will things reopen?)
[Look outside the industry for clues]
“For example democratic convention in August is cancelled, Olympics are postponed to next year.
We haven’t hit the peak yet, and that’s going to dictate when we come out of it. If you do it too early you risk another wave of infections.
For example Oregon is pushed out until June, maybe even September now for dental stuff to come back.
I think it won’t be until June or July. April not at all. May could be pushing it.
Late in the year we’re thinking of a slow ramp up and it won’t be until next year to see what the new normal is going to be.
Dentists are very well positioned when it comes to PPE sterilization and sanitization measures for years.
When can you say the last time you were on an airplane your seat was wiped down?
In the dental profession they’re already used to all that so it’s a perk for the field.
This is the Positive outlook, having had these practices in place already in their habits.
It could still be a slow ramp up due to people getting to work and insurance.”