What kind of PPE are you wearing in private practice clinic setting?

[JK]

There has obviously been a lot of talk about PPE, N95, etc... in the news - mainly related to shortages, wearing the same mask for an entire shift or several shifts, etc... Usually, however, I've seen them in reference to the hospital setting (ER, ICU) and when taking care of COVID-19 patients. I'm curious what people here are doing to protect themselves in the private practice clinics, especially in specialties where there is an emphasis on higher patient volumes. Not talking OR cases, intubations, etc...

Essentially, we've only been seeing a select group of patients the past month at our outpatient practice for emergencies but that will start to increase (albeit slowly) as the country starts opening back up...and the virus isn't going away anytime soon. Temperature checks, questions before patients enter, having patients wear masks, lot of hand washing/cleaning are easy choices we've been doing but beyond that I was wondering how the providers on this forum are protecting themselves during the visit...even more so when the exam involves the face/oral cavity (mouth complaint, dentists, ENT, derm, etc...). N95 masks aren't practical due to shortages and patient volume with reuse issues. Additionally the now interspersed telemedicine appointments throughout the day promotes frequent removal of the mask anyway almost a necessity so the patient can hear what is being said. At this point some of the providers have just been using regular surgical masks, surgical glasses and their white coat in an effort to strike a balance.

What is everyone else doing?

[8arclay]

Our office calls beforehand to do screening, we also temp check at the door. Patient alone allowed into the office. During the phone call we also instruct patients that theyre required to wear a mask themselves. Staff has been wearing either surgical or cloth masks

[doctorbone]

Temp check and questions at the front lobby. The docs and the staff are wearing procedure masks in clinic. Wiping down everything between patients and washing hands after each encounter. We’re also spacing out appointments so no patients are waiting in the waiting room. We bring them straight back as soon as they check in

[White.Beard.Doc]

Pre-visit screening by phone. Masks for everyone, staff and patients. Temp checks on entering and Purell hand washing upon entering and leaving.

[Kamban]

1. Limiting patients to 10 / day and having at least 5 minutes between patients.
2. Only patients in waiting room and in patient rooms unless they are very elderly needing assistance or have language issues.
3. Call 2 days before and instruct them not to come if they have fever or symptoms.
4. Temp checks, but can only do it in patient rooms.
5. Surgical masks and social distancing. I tried N95 and have difficulty wearing it tightly with glasses.
6. All staff in contact with patients wear surgical masks.
7. Aggressive washing with soap and water pre and post patient in each exam room.
8. Physical exam only if the condition dictates. Gloves if performing an exam. Otherwise deferring it for later.
9. 60-70% of patients wear a mask. I still have a few who don't but have not rejected them.
10. Finally a silent prayer at the end of the day, for the patients, staff, family and me.

[Lordosis]

We are doing the screening and temp checks as mentioned above.
I wear a surgical mask.
Limiting visits to allow patient distancing and time to clean rooms.
Patient wears mask.
No visitors except parents of children

[Kamban]

Where are you all getting surgical masks at affordable price? Most of my medical supply places I usually order from have that on backorder.

[StarTrekDoc]

1. Limiting patients to 10 / day and having at least 5 minutes between patients.
2. Only patients in waiting room and in patient rooms unless they are very elderly needing assistance or have language issues.
3. Call 2 days before and instruct them not to come if they have fever or symptoms.
4. Temp checks, but can only do it in patient rooms.
5. Surgical masks and social distancing. I tried N95 and have difficulty wearing it tightly with glasses.
6. All staff in contact with patients wear surgical masks.
7. Aggressive washing with soap and water pre and post patient in each exam room.
8. Physical exam only if the condition dictates. Gloves if performing an exam. Otherwise deferring it for later.
9. 60-70% of patients wear a mask. I still have a few who don't but have not rejected them.
10. Finally a silent prayer at the end of the day, for the patients, staff, family and me.

Good list.
1. Limiting flow with spacing out F2F with video visits in between; one doc top of the hour visits; paired doc bottom of the hour F2F visits.
2. No visitors/NO CHILDREN except absolutely needed - MARTI for interpretation
3. Front door screeners at building -- no temperature checks. since low sensitivity. ANY fevers or respiratory symptoms is asked to return to car and call clinic for triage.
4. Universal Masking -- everyone gets a mask, and required -- even VP Pence and his weekly PCR testing.
5. Hand sanitizer everywhere -- strict gel in/gel out policies
6. Minimize all contact -- no credit card handling by staff; clean/dirty pens pins; pictures of any insurance cards echeckin from home or own phone for forms
7. Gloves for exams

[goatmom]

Still not sure how I can do this and make it profitable. I have one employee who is office manager. Spreading patients out that much, expecting her (or me) to clean everything between patients (clean the bathroom each time a patient uses it??), expecting people to wait in the car to come in, being on guard for the "pop ins", taking temperatures, calling patients before visits..... I get tired thinking about it all. Thanks for all the ideas though!