With extra precautions, one surgeon says, ‘They’re safer in my center
than the grocery store.’
6:00 AM on Apr 24, 2020
In the third week of
April, the medical office of North Dallas Ear Nose &
Throat got just one phone call from a patient.
Usually, about 80
people a week come to see Dr. Morris Gottlieb and his staff, and he
typically performs about 40 surgeries a month.
That was before the
pandemic, of course, and the stay-at-home orders and the restrictions on
elective surgery.
On Wednesday, Texas’
rules on elective procedures were loosened, and Gottlieb has started
rescheduling sinus surgeries, tonsil removals and the insertion of ear tubes --
interventions generally aimed at stopping chronic infections.
While he’s back in
business, he knows it’s not going to be business as usual.
“People are a little
nervous about going out,” he said. “And there’s definitely a lot of fear about
picking up the phone and making that first appointment with the doctor.”
For his practice, as
with many companies, it’s not enough to simply say business has reopened. They
have to show that it’s safe for the public to come back again -- without being
endangered personally or undermining the community progress that’s been made in
slowing the spread of COVID-19.
How to restore
consumer confidence while the biggest threat remains top-of-mind?
Gottlieb’s strategy
is to proceed as if everyone in the facility has the disease and isn’t showing
symptoms -- at least until he gets enough tests for every patient and worker.
“We assume they’re
shedding the virus,” he said.
As a result, everyone
wears a mask, including patients. And he said he wears an N95 mask “at all
times in the facility” where the surgery is performed, Baylor Surgicare at North
Dallas.
Visitors must wait in
the car while their friend or family member enters the building. Patients go
through a temperature check and answer a questionnaire on current health
conditions and recent travels.
After surgery is
finished and the breathing tube removed, he said doctors and nurses remain in
the operating room for 15 minutes. That’s supposed to give the micronized
filtration system enough time to clean the air before the doors are opened and
the patient is moved to recovery.
As a surgeon who
works on people’s throats, Gottlieb is accustomed to dealing with the threat of
airborne diseases, but he’s ramped up his safety measures. He believes the risk
of contracting COVID-19 in his medical setting is lower than in random
locations people visit regularly.
“They’re safer in my
center, getting surgery, than going to the grocery store because of all the
precautions we’re taking,” Gottlieb said.
As Texas starts to
reopen parts of its economy, health care is a good place to start the process.
Doctors and nurses are among the must trusted professionals in America, and
they’re experts in limiting infection. They have the training, experience and
equipment to do their job and guard against the virus at the same time.
They also have a
service that people often need badly and can’t get anywhere else, which means
pent-up demand could unfurl more quickly.
“It’s completely
different than a person who needs a haircut,” said Vivian Ho, an
economics professor at Rice University.
She supports
reopening the economy gradually and carefully, and wants local leaders to have
enough time to ratchet down activity if COVID-19 cases spike again. She likes
the idea of starting the reopening process with health care because workers
have great expertise and the industry has a big impact.
“It’s the safest way
to add growth back to the economy,” Ho said.
Health care accounts
for more than 1.5 million jobs in Texas, over 14% of private employment. Many
health care workers have been furloughed and laid off, and
as patients return, those job numbers will bounce bank.
Gottlieb has
furloughed five workers but expects business to pick up next month, maybe to
about half its usual volume.
“All my patients need
[help] sooner rather than later,” Gottlieb said.
In other specialties,
it may be easier to delay treatment. Each case is different, said Dr. David Hassinger, an orthopedic surgeon and
founder of Direct Orthopedic Care.
His practice, which
has five locations in North Texas, has been rescheduling knee replacements and
rotator cuff surgeries that were canceled a month ago. He said he’s asking
patients: “How bad is it for you?”
Some may be able to
wait a few months, but most are in too much pain to delay for long. To make
them comfortable about coming in for surgery, he reviews the cleaning and
safety procedures. And he emphasizes that they won’t be at a hospital dealing
with coronavirus.
“That’s the best way
to minimize your risk -- don’t be near patients with COVID,” Hassinger said.
Sulman Ahmed, CEO
of Ideal Dental,
has temporarily closed most of its 85 offices in Texas because of the
suspension of non-essential services. But some of his dentists have been
performing emergency procedures, such as tooth extractions and root canals.
And their record
during the pandemic will be part of how they reassure customers when the
business reopens in coming weeks.
“We’ve treated more
than 2,500 patients who might have otherwise ended up in the emergency room --
and not had a single instance of COVID-19,” Ahmed said.
In the dental
business, providers are well-schooled in infection control, and they’re used to
isolating teeth, sterilizing equipment and using hospital-grade cleaners, Ahmed
said. But the company is adopting additional safety measures for the
coronavirus era.
Dental hygienists
will use a manual process to clean teeth because the usual machine cleaners
would increase the risk of spread, he said. Staffers will enter and leave
through a back door rather than the front lobby to reduce unnecessary contact.
Educational videos about what to expect at the facilities have been prepared
for patients and employees.
Perhaps most
important, each office plans to treat one patient at a time, rather than a
handful in various dentist chairs -- at least for a while.
“We’re not saying,
‘Hey everyone, just get back to normal,’” Ahmed said.
Editor’s note: The number of Ideal Dental
locations has been updated to 85 after the company said it had been using an
outdated figure on its website.
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