Policies and laws on wearing face coverings to prevent the spread of germs vary across states, cities, and even individual businesses. Here's how to communicate yours - and how to handle patients who don't agree with your policy.

Posted in Coronavirus on Tuesday, August 18, 2020

Restaurants, grocery stores, and big box stores typically have a sign at the door “No shirt, no shoes, no service.” As long as a policy is applied to everyone equally (regardless of gender, race, religion, or age), it is not discriminatory and is not in violation of any legal statute.

As a business owner, you can set the rules within your own physical space (as long as you comply with state and federal regulations*). Just as you have the right to establish rules for your business, a patient has the right to not enter your business if they don’t agree with them or can’t comply for medical reasons, so it’s best to clearly communicate your mask requirements up front.

Tips for Communicating Your Policies

You may choose (again, per state/federal regulations) to require masks. You may choose to encourage but not require masks in an effort to respect and protect everyone. Or you may choose to make masks a matter of personal choice. Whatever you decide, consider these tips for communicating your policies:

• Post or display the expectations of your business at the door and make masks available to visitors.
• Consider posting a similar note on your social media “about” pages and your website.
• When scheduling an appointment via phone, let patients know your mask expectations – “personal preference” is as important to note as “required” might be. This allows them to decide if they would like to keep, cancel or postpone their appointment.
• Have masks available for patients outside your front door/lobby or meet the patient outside and provide them a mask

What to Do If a Patient Refuses

If the patient says they will not wear a mask or comply with your protocols:

• Remind them this is a requirement to enter your practice
• Gently ask them for their reasons.
  • Do they have a medical or psychological issue which prevents them doing so? 
    • The latest “scam” to counter the masking wearing mandate has been patients presenting laminated cards from nonexistent government organizations “exempting” them from wearing masks.   
    • If they have a medical issue, see if they are willing to wear a mask and be monitored (for breathing, etc.) while the mask is on.
    • If they have a psychological issue, consider scheduling them at the end of the day if an in-person appointment is necessary. This may also help you avoid any future claims of patient abandonment.
      • If you elect this route, the patient should be treated as if they are positive for COVID, meaning the provider wears full PPE and the patient is taken directly to the treatment room.
  • Offer a telemedicine appointment if care can be effectively provided in this manner.
  • Offer to reschedule the appointment when they are prepared to wear a mask.

Prepare Your Staff

Proactively, prepare your staff so they know what to do, when/if the situation presents itself, especially if a patient becomes confrontational during the interaction.  

• Have a chain of command in place to alleviate the situation
• Be prepared to call 911 or security if your staff feels threatened
• If there is a threat of legal action due to your protocols
  • Direct them to your attorney; it is unlikely any attorney would back them up; this is classic scare tactic.

In order to protect yourself and your staff, as well as reduce the potential of being named in a claim related to the transmission of COVID, it is important your practice is following the recommendations of your professional organization, CDC and local government authorities.  This will reduce the possibility of allegations of intentional harm or conscious disregard. 

*If state or federal regulations have established a mask requirement, you are expected to meet that expectation.