Eye care is essential, so it’s reasonable for individual eye care practitioners to stay open during the coronavirus pandemic. My private practice in Philadelphia area is open and we continue to see a trickle of emergency patients and those who need essential care, with the following precautions in place.• Screening patients based on their needs. This way, only the most important cases are seen, and high-risk individuals are not scheduled. That said, there are some patients who feel it is absolutely necessary to keep an appointment because, in some cases, it just took so long to get it. After disinfection protocols are completed and screening questions for risk factors and symptoms are asked, while properly masked, patients with no symptoms and no history of exposure can be evaluated safely and examined with low risk. It's an individual practitioner’s decision to participate or maintain quarantine.
• Keeping regular hours. Even if direct patient care is not happening, this will facilitate appointment making, permit updating clerical duties, allow needed maintenance of equipment and the updating of documents and policies.
• Limiting staff. Doing so minimizes exposure risks. Additionally, the staff work schedule should be rotated, so that everyone has a fair chance at earning hours. Along with this, I should add that it is my opinion that no practitioner or staff member should ever be forced into service. If they have a strong conviction that the social distance initiative be carried out, they should be granted this privilege in this circumstance; in the United States a National Emergency has been declared.
• Using telemedicine. This has been permitted by Medicare, and there is a waiver issued by the Department of Health and Human Services regarding good faith use of telemedicine during this pandemic. (Read CMS guidelines on this here and the HHS waiver here.) I have found that video portals can allow the optometrist to view the anterior segment and superficial and adnexal issues with reasonable detail, to form a hypothesis, diagnosis and plan, which could then be reevaluated using the same system, while limiting traffic to your office. Yesterday, one of my patients got a piece of metal in his eye. I had him come to the office to remove it and receive proper cycloplegia and front-to-back evaluation of all tissues, however, I will be able to complete the care, so long as it stays uncomplicated, using a telemedicine platform.
— Andy Gurwood, O.D., editorial board member
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