Prepare your private practice (OPD) for coronavirus
Article By Dr. Farhan Fazal, Consultant - Infectious Disease, KMC Mangalore
Amid the coronavirus outbreak, patients are reaching out to doctors over the mildest symptoms. And now is the time for leaders to prepare for how they will help diagnose and treat patients and keep their practices running.
Start planning now for when a patient presents at your practice with symptoms of this novel virus. Hospitals are looking at interim guidelines from the Ministry of Health and Family Welfare, Government of India (MOHFW), but many of those guidelines don’t relate to a physician's office. Independent practices may have to work harder to create their own plan.
“The best thing they can do is just to prepare”
So, where to begin? Here are a few recommendations by Dr. Farhan Fazal, Consultant - Infectious Disease, KMC Mangalore.
1. Getting an appointment
- No walk-in patients allowed
- Appointments should be given at a gap of 10 min each to reduce crowding
- Fixed number of appointments per day
- Failure to get an appointment – can do telemedicine in the designated time (payment beforehand- use Apps to help)
- If possible – train your secretary or yourself to triage covid cases and send them to designated fever clinics before they can see you
- Patients with chronic illness and comorbidities, aged > 60 yr– prefer teleconsultation over clinic visit. Decide after teleconsultation if they require to see you in person
2. Inside the clinic
- Social distancing to be maintained in sitting /standing arrangements
- Provide hand wash and mask at entry point, if not wearing already by patient
- Allow patient alone to come- if not possible, only one attendee strictly
- Keep a register of patients per day, for contact tracing in case there is any breach/exposure
- If possible – Video record the session to decide the level of exposure in case some patient turns positive or to identify primary contacts
- Put education posters on walls regarding respiratory etiquettes and social distancing and usage of mask for the patients
3. Inside Chamber/Examination Room
- Assuming all patients are positive, take standard precautions
- Ask triage questions at the beginning of history taking as some patients may not give a history of exposure over the phone
- Do not take any previous reports or papers from patients, since they may cause transmission of infection. Ask them to hold it in front you without touching (difficult to practice in case of repeat patients)
- Keep a 6 feet distance between doctor and patient
- Wear N95 and gloves, change gloves between each patient to prevent cross-infection of covid as well as non-covid infection.
- Wash BP apparatus with sodium hypochlorite after examining each patient.
- Ask patients to share reports online/WhatsApp before visiting the clinic. Prescription details can be sent on the phone after examining reports. Follow Telemedicine guidelines by MoHFW while doing so.
4. Medical Representatives – Since they visit multiple clinics, ask MRs to send product information online and avoid physical meetings.
5. Comply with the local authority and their guidelines
It is imperative that practice leaders stay up-to-date on the ever-evolving coronavirus pandemic. There is no shortage of news about the coronavirus, and CDC & MoHFW provides information & guidelines.
6. Patients may not provide true history due to fear/stigma of covid suspected cases and harassment – Build confidence at the beginning of the interview itself.
7. Be mentally and physically prepared for a possibility of you becoming infected. If any symptoms appear, test yourself for Covid-19.