Northern States, Are you seeing Sick Pts Outside or Letting them In?

Our clinic is located in Raleigh, NC. We currently see all WELL/Med Checks/ADHD in our office from 8am - 3:00pm. After 3:00pm we will see our sick patients outside in the parking lot. Nurses and providers in PPE. The weather is getting colder so seeing pts in their cars is becoming more uncomfortable for staff and providers. Do you allow sick pts to come into your facility? We tried a tent but it was very expensive and the optics SCREAM COVID which further scares parents. My providers are hesitant to bring anyone inside, but I am not sure I have any other options. We are a stand alone building with a dedicated parking lot. We only have one entrance to our clinic. Any ideas suggestions are greatly appreciated.

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We see well all day, virtual visits in between and parking lot sick patients in their car. Most of the info is taken from the virtual visit so when the doctors goes to the parking lot, he/she is just swabbing or looking in ears. We are not allowing any contagious issues in the office. We will see an injury in the office.
We ask parents if they have an SUV and if yes, we ask that they arrive with it empty so we can see the child in the back of the SUV. We are in Southern California so the weather is easier for this.

We are a large group with 4 offices in the Atlanta area. We initially did only well in the office but for the past 3 months we have been seeing both sick and well in the office. We do reserve morning hours for well only for those that want to come in during ‘well hours’ but the rest of the day is a hybrid of sick and well. If we know there is a covid contact, we do a telemedicine visit and then they can come by and we get a rapid test in the parking lot or refer to another location for a PCR, but unfortunately we have so many kids that are “fever, cough, daycare, no covid contact” and then they get an in office appointment, we just assume they could have covid. We see those in the office with a KN95 and face shield. We did buy some portable HEPA air filters that we run throughout the day in the exam rooms. So far we have done well without providers and staff getting sick and we have had very high rates in our community.

Ashley,

Thanks for the information. It sounds like in the afternoon your providers are alternating between sick and well. We’ve struggled with making that decision. I think we may have a sick hallway and well hallway with dedicated nurses, but I am sure the providers will still want to see their own pts. Thank you for sharing. It’s nice to know what different practices are doing.

Stay Safe.

Rafael

Thanks Carmel! Your practice flow seems very much like ours. However, these 30-50 degree temps will take their toll on our providers, staff and patients. Thanks for sharing

Sincerely,

Rafael

We are in Massachusetts and have 4 bays in a tent. Staff works out of a old loading dock and still are visiting patients in their car. We have placed temporary heat in the loading dock, supply hand warmers, drinks, etc out there as they are seeing patients from 9-5 m-f and 8-12 on Sat & Sun. However, its getting really tough on the days that’s 15 degrees. I have paid them extra bonuses etc as I have mostly the same staff in full PPE since April. We are currently building out a separate sick office with its own HVAC system and we have an electrostatic sprayer so we can spray down a room and hallway is someone tests positive. We have had the 15 min Abbott test since April which saved us. We still have been seeing all well visits inside since April but follow the necessary precautions etc. We are in an area in Mass which has had high numbers all along but our staff have been great and cautious. We have had only 4 staff members out of 76 that have had covid (no providers). We are hesitant bringing them in for Jan, Feb, and March but if staff takes the same precautions that they have in full PPE since April and keep up with the cleaning etc. I hope we will be good. Mark

Hi Rafael,
We are a large pediatric practice in New York, located midway between NYC and Albany. We have 8 offices.
Initially everyone was very nervous about seeing any patient’s in person as we all know about asymptomatic spreaders. After 9 months of dealing with this, we have not had anyone get COVID from our patients once we started to use masks and require all patients/parents to do the same. Some of us use KN-95s but most use surgical masks. We use eye protection as well, but mostly for symptomatic patients. We see all our patient’s in the office. It is clear to us that surgical masks go a long way in preventing COVID.
We separate well and sick (well in the am, sick in the pm). We sometimes will see well in the afternoon but then we will have a break between them and any sick scheduled to come in. We do not have people wait in the waiting room, they come in get put into an exam room, everything is done in that room and then they leave. We are trying mobile check in, which when it works is nice.
Everyone needs to get to their own comfort zone, however, I think our practice has proven that you can safely see patients in-person in the office without getting COVID.
Stay well.

Mark,

Thanks for sharing your insights. I think we are ready to come inside, the 30 degree temps are enough for us. At 15 degrees my providers may close our sick clinic. LOL I am sure we have treated asymptomatic patients and have not a single case of staff/provider COVID in the clinic. Thanks again, stay safe and stay warm.

We are a 5 physician practice just north of Chicago. We have been seeing both sick and well in the office since March. We do most well visits in the morning and sick at the end of the day. No one waits in waiting room, they wait in car and we call them when we are ready to bring them straight back to room. If no known Covid contact ( parents not sick etc) then we see in office with N95 and eye protection. If pt has known Covid exposure ( parent has Covid- which is usually the case) the we will do TM and then do rapid covid test in car. So far no staff or physicians have been infected. We feel fairly confident in mask wearing and additional protection as necessary.
Val Kimball

Great to hear that the masks are working. We feel the same. Thanks for sharing and stay safe.

Marc,

I appreciate the help. Thanks for sharing. I think the move inside is inevitable.

Rafael