Interviews and Article by Samuel Haynes, Tax Accountant
The Covid-19 Pandemic is something that our country has not seen since the Spanish Flu, over one hundred years ago. It has impacted our society in numerous ways from schools and churches to small businesses and entrepreneurs. As a member of the Professional Services Team at Strothman & Company, I wanted to take a look at its impact on the medical community by speaking with some leaders within that community to see how they are surviving the pandemic and get their advice on things we could be doing during these times as well. I want to thank the following doctors that allowed me to interview them: Dr. Douglas Ansert, Dr. Amanda Chism, and Dr. Michelle Gombas.
As you will read in the article, the doctors will be discussing a broad range of topics including how it has affected their practices, what changes they potentially see long term, and helpful suggestions for patients and small business owners. They outline the growing public awareness of the infectious disease, its spread, and prevention as well as suggestions to patients on knowing your own health risks to better protect yourselves against disease. They also discuss the job Kentucky has done in flattening the curve to buy medical professionals the time needed to ramp up both supplies and treatment for patients. I believe their answers will help provide some insight and information into some of the lingering questions about this pandemic. Thank you again to the doctors for taking the time out of your busy schedules to speak with me and provide us with your words of wisdom.
How has Covid-19 affected your practice?
Dr. Chism – It has changed the day to day with how we do things; we still are seeing and treating patients, but how we do it is different. We are separating the sick and the well with different entrances and focusing on PPE now. We have more safety protection and separation from those coming into the office and those taking care of sick patients.
Dr. Gombas – In the PICU, the overall precautions have changed with PPE. The process of going in and out of the hospital each day has changed. Caring for patients has changed, the critical care has had to slow down due to the donning and doffing of PPE which has become more time-intensive. Scheduling for our PICU doctors has become more spread out to allow for a 14-day window to accommodate for exposure or illness whereas a typical rotation would have had up to a panel of 3 doctors seeing the patients in a day.
How has this situation impacted your staffing?
Dr. Chism – With the switch to more telemedicine visits, we decreased our nurse staffing which has been challenging. It has been a week on and week off; this has allowed the staff to recover on the week off and it also allowed for a contingency plan in case of sickness or exposure.
Dr. Gombas – Our hospital did not have to furlough any physicians that I am aware of thus far, and did allow staff to call off if they chose. Other staff members who were pregnant or immunocompromised were also reassigned to other areas that were less likely to see COVID patients.
How has Tele-Health/Tele-Medicine impacted your practice?
Dr. Ansert – We were fortunate to have the support of the administration and staff to adapt very quickly and were able to begin doing telemedicine visits on the date that it was announced by the government that it would be a covered service. These are a good way to make sure your patients are taken care of during all of this at a safe distance. There is a lot of chronic care that can be managed via telemedicine including anxiety and depression for example. The downside though is that the physical measurements that would be done in the office cannot be done, so office visits will not completely go away.
Dr. Gombas – Tele-medicine is not used in our PICU, but we have had to get creative with how we communicate with patients within their respective rooms. We have used phone calls, FaceTime, and other means to do so at times. I have seen that technology has played a large role in helping us relate with our patients in this pandemic.
What changes that have been made do you see staying around long-term after this pandemic has run its course?
Dr. Ansert – Telemedicine will stay to some degree as well as the procedures that people are doing now. The general population has become more aware of infectious disease and control. Spaced out waiting rooms, perhaps waiting in cars for appointments and potentially different patient flow in offices.
Dr. Gombas – This crisis has helped us to identify what needs to be done face-to-face (or in-person) versus what can be done remotely. We’ve discovered which meetings are essential. I cannot predict what will stay around but would expect Zoom meetings and telemedicine are here to stay. I would also expect to be wearing masks for a long time.
What advice do you have for other medical practices/professionals?
Dr. Ansert – For primary care, things are changing quickly. At our practice, we are focusing on Medicare wellness visits by telephone since the government has approved that now. It is good reimbursement for the office and good for the patient standards of care as well as free to the patient in most cases. They tend to be time-intensive in the office, but they can be done now via telemedicine and free up staff/physician time when you are back up and running to recoup some losses.
Dr. Chism – Continue the increased communication between medical practices and professionals. We’ve reached out to other offices to ask how they do things and they’ve reciprocated. My hope is the comradery continues.
Dr. Gombas – My advice to other physicians would be to make a priority of self-care during this pandemic because those who do not do so are getting very sick if exposed. I think it’s in our nature to help when needed, but we can’t lose sight of the fact that when we aren’t healthy we can’t take care of anyone.
What advice do you have for senior patients that fall in that age range of 60 years and older?
Dr. Ansert – Be vigilant, wear your mask and gloves. As a general note, have the public do its part too. Young people have the view that it will not affect them too much, but they can bring it home to grandma and grandpa who can then get very sick from it.
Dr. Chism – To know your own health risks. The patients that understand their own health risks tend to do a better job of protecting themselves because it helps you make better decisions.
What do you anticipate that the next few months will look like as things continue to reopen?
Dr. Ansert – Kentucky as a whole has done a good job of flattening the curve and providing the medical community with the time needed to ramp up both supplies and treatments for this. While the public may not see these benefits, it has been very helpful for the medical community and will hopefully enable them to save more lives moving forward. Medical professionals are hoping that this is a seasonal thing, but there is the possibility that it comes back this fall.
Dr. Gombas – I cannot say for certain, but I feel we have seen an uptick of cases even in the two weeks since Easter and since Indiana has slowly started to reopen. Lockdowns and quarantines have not stopped the disease and it is most likely here to stay for a while. I expect it to probably be more of an 18-month phenomenon that will wax and wane during that period.
What advice would you give small business owners looking to re-open their businesses over the next few weeks?
Dr. Ansert – Hopefully they’ve taken the time to set procedures in place to protect themselves and their clientele. I think going slow, gradually opening to test your procedures, seeing if they work, and making adjustments as necessary is best. Market those safety procedures to clients and don’t take them lightly.
Dr. Chism – Reopening safely with renewed precautions and adjust businesses as possible in ways that are creative and still lucrative including curbside and delivery. Be willing to make small adjustments and changes if possible. Although we don’t want any businesses to close or shut down due to this, at the same time we want to take this seriously so I appreciate all of those out there that have because it is important to try to protect the lives that we can.
Dr. Gombas – Go slow and get creative. Don’t put people’s health and safety at risk due to a need to get the business going again. Please don’t do it at the risk of people’s lives. Start slowly, get creative, offer hand sanitizing, and offer masks if you can. Anything you can do to promote health and safety will help.