If you decide to stay open, these guidelines can reduce the risk of transmission.

Posted in Coronavirus on Monday, March 23, 2020

If your state has directed you to close, the obvious answer is that you should not remain open. Your state and local governments are mandating closures to help slow the spread of the virus. By remaining open, you may be endangering your patients and be at risk of criminal prosecution. Remember, malpractice insurance does not cover criminal acts.

Note: Sixteen percent of people infected become seriously ill¹ and 2% die. This is not a situation to be taken lightly.

Only you can decide what is best for your practice (beyond direction from government officials). If you decide it is legal and choose to continue to see patients, here are some guidelines to reduce potential transmission of virus:

1. Establish and follow a thorough cleaning process for all areas of your office, including the waiting room, reception area, exam rooms and restrooms.
2. Do not allow staff members who are sick, have been sick or have sick family members to come to the office.
3. Have a detailed conversation by phone with the patient on the day they’re scheduled to come in, and ask:
   1. If they or anyone in their family has a fever, or has had one in the last two weeks. The incubation period can be as long as 24 days.
   2. Have they or family members had any symptoms of a cold or flu? Symptoms include fever, tiredness and a cough that isn’t necessarily productive. They may also have or have had aches and pains, runny nose or nasal congestion, and vomiting or diarrhea.
   3. Have they traveled abroad in the last two weeks?
   4. Have they been near anyone who has potentially had the virus through their own family or work contact? People can be contagious without symptoms.
4. Ask high-risk patients to delay if possible. High risk patients are those who:
   1. Are undergoing chemotherapy.
   2. Are immunocompromised.
   3. Are diabetic.
   4. Have heart disease.
   5. Have high blood pressure.
   6. Have asthma or another respiratory issue.
   7. Are over 60 years of age.
5. Stagger appointments to allow time for thorough cleaning between sessions.
6. Ask patients to wait in their car (rather than the waiting room) until it’s time for their appointment.
7. Ask anyone accompanying the patient to wait in the car during the appointment if possible.
8. Remove magazines and other printed reading material.
9. Remove toys or other diversions you may have in the office for children.

What If a Patient Gets the Virus and Claims They Got it From You?

If you are following the protocols above:

• Doing triage before patient visits
• Cleaning between visits
• Ensuring no staff are ill or near sick people

It is unlikely they could effectively claim they became infected at your office 

What if You Find Out a Patient Who Recently Visited Now Has the Virus?

Healthcare providers should consult with local or state health departments to determine whether patients meet criteria for a Persons Under Investigation (PUI). Providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient. You should also stop seeing patients immediately.

¹ https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html