Article

Reopening Refresh

One Houston optometrist skilled in reopening protocols provides a from-the-field update on newly adjusted procedures PLUS 5 bonus ideas for new revenue sources.

My practice, Vision Optique, in Houston has been safely open since May 1. In the May issue of Eyecare Business, I shared our Action Plan for Reopening, and now—with eight weeks of new protocols and practices under our belt—here we take a look at the critical procedures and areas that our practice has since adjusted to better suit our needs and those of our patients.

I hope you will find our refreshed Action Plan helpful as you reopen your own practice safely—and work to recapture lost business.

IMPLEMENT + ENFORCE NEW SAFETY PROTOCOLS

STEP #1:
COMMUNICATE CLEARLY & REQUIRE FACE MASKS

Before we reopened on May 1, we sent an email to the entire patient base outlining our new safety protocols, and we posted front door and front desk signs. Most of our patients have followed and appreciated our strict protocols.

Since we have reopened, we updated our signs and procedures to clearly illustrate the following safety protocols:

Covid-19-diagnosed or -exposed patients are required to schedule at a later date with proof of negative testing.

Face masks are required.

Screening checks and strict disinfections will be done in office.

Our team members are given the authority and support to turn away patients who do not follow our safety protocols.

STEP #2:
SCREEN PATIENTS MULTIPLE TIMES

At appointment scheduling: We offer our patients the ability to extend their prescriptions and to choose curbside pickup or shipping of the products they need. This offer is given to all patients, not only positive Covid-19 and high-risk patients.

At our practice’s front door: We have found it helpful to keep our front door locked, and patients are asked to call before they are allowed into the practice. During this call, Covid-19 screening questions are conducted in case health conditions have changed since the appointment was made.

100°

PATIENTS WITH EITHER A TEMPERATURE HIGHER THAN 100 DEGREES OR OXIMETRY LOWER THAN 92% ARE ASKED TO OBTAIN COVID-19 TESTING, AND TO WAIT FOR ASSISTANCE OUTSIDE.

This new step also helps to screen customers who plan to shop at our optical but who are not on our schedule as patients. For those people, we repeat that “face masks are required” and that our front door handle (outside/inside) is disinfected throughout the day.

Upon entry into our practice:

  • We check every person’s temperature and pulse oximetry upon entering. Both staff and patients sanitize their hands before the temperature and pulse oximetry check. The oximeter is sanitized with alcohol prep pads both before and after the reading in view of the patient.
  • Patients with either a temperature higher than 100 degrees or oximetry lower than 92% are asked to obtain Covid-19 testing, and to wait for assistance outside. We then also determine a safe solution for addressing the patient’s specific eyewear and eyecare need.
  • Screening question results, temperature, and oximetry reading are recorded in patient’s EMR.

We purchased high-quality plastic chairs (that support 300 pounds) for the dispensing tables for easy spray and disinfection. These will be used until there is a vaccine. Both the table surface and chairs are disinfected after each patient encounter.

At the preliminary workup station and exam room:

  • Patients who are on the appointment schedule are courteously asked to wash their hands with soap and water before they are seated in front of the preliminary testing equipment. The staff also washes their hands.
  • Doctors wash their hands with soap and water immediately after they walk into the exam room.
  • The exam room chairs, table surface, door handles, pens/highlighters, computer keyboard, and all equipment are disinfected after each patient encounter.

Although these extra steps are tedious and time-consuming, it is important to provide a safe work environment to reduce the possibility of Covid-19 transmission. Until a vaccine, mass testing, and tracing/tracking are available, we need to be vigilant with these safety precautions to keep the practice open and people safe.

The majority of our patients have expressed appreciation of our strict protocols and reported that they felt safe in seeking annual eyecare and eyewear needs for their families.

STEP #3:
PURCHASE NECESSARY PPE + SUPPLIES

For our team members, we are supplying full-face shields and cloth face masks. For the practice, we also purchased additional 80-100% alcohol solutions, sprays, pads, sanitizer, and disposable gloves.

We also purchased a noncontact IR thermometer, pulse oximeter, and new plastic chairs for the optical, waiting area, and exam room.

For medical procedures and therapeutic visits, we provide patients with disposable surgical masks. We are not charging patients an additional “PPE fee.” However, we do plan to increase our professional fees and some ophthalmic lens treatment fees in general to help offset the significant increase in cost of conducting business safely in the midst of a pandemic.

STEP #4:
INCREASE PATIENT SCHEDULE GRADUALLY

Our eyecare practice was closed from March 23 to April 30. Many practices that are opening now have been closed even longer.

Our experience is with a practice that is 1,800 square feet, with two exam rooms and one treatment room. We have a team of three doctors and seven staff members, and we provide both primary and medical eye care.

Our First Two Months: May + June

  • Weeks 1-2: Only one doctor each day and one patient per hour. We added a sixth day (Monday) to create appointment times in addition to our normal Tuesday-Saturday schedule.
  • Weeks 3-4: Owner doctors and associate doctor doubled up (two docs/clinic day) on Fridays/Saturdays. Patients are booked every 45 minutes for regular exams.
  • Weeks 5-6: Owner doctors doubled up on alternating Mondays/Wednesdays, in addition to running two doctors on Fridays/Saturdays.
  • Weeks 7-8: Back to Tuesday-Saturday schedule; schedule only two doctors each day; hope to return to three doctors.
  • Associate Doctor: Gradually adding one clinic day per week as business picks back up.

All of us have been impacted by this pandemic professionally and personally. How we act and adapt now will make a difference for our patients, our staff, and ourselves.

BIG BUSINESS STRATEGY: ADD NEW REVENUE SOURCES

This Covid-19 pandemic is unprecedented in our lifetime, it is not under control globally, and it may take years to develop a safe vaccine. Adding extra safety measures will be the new norm in how we take care of patients and conduct business. We will not be able to “see” as many patients at our physical locations for some time.

To compensate for lost revenue, our practice has added services by taking the following steps:

Build new website, online store, and virtual frame try-on services

Add new aesthetic and dry-eye product for in-store and online retail opportunities

Review credit card and patient financing terms and change vendors

Offer additional telehealth services to protect chair time

Improve patient experience and check-in efficiency with “contactless service” mobile phone app

TRENDING VIDEO READY TO REOPEN

EB Editor-in-Chief Erinn Morgan took a virtual tour of Dr. Shen Lee’s Houston practice on the morning of its reopening. View the video here.

—BRIDGITTE SHEN LEE, O.D., FBCLA, FAAO