In light of the current concern about the Coronavirus and our interactions with patients, we will take several additional measures to reduce the number of patients assembled or in close contact.

• The clinic schedule will be adjusted to limit the number of patients in the waiting room to average no more 4 patients at any one time. Schedules should be adjusted to take into consideration that some patients such a lesion consults and follow ups take only 5-10 minutes while other post op visits and consultations take-longer. Groups of patients should preferably be spaced out 10 -15 minutes apart. Limitations on patients per hour although not strictly defined, needs to be considered in scheduling new and follow up patients.
• Long term routine follow ups should be contacted and advised to reschedule at least 6 weeks from now. For example 3, 6 and yearly follow ups.
• Clinic seating will be rearranged to foster 6 feet of separation by removal of some seats. Patients are allowed 1 visitor/support person, who must be over 12 years old, to accompany them to their appointment. Surgery center waiting room should only have 2 people and allow only one support person per patient. This can be discussed in a pre-op call.
• PPE may be worn by providers during close contact with immediate post op patients, when appropriate, especially with anyone is suspected of being sick. Keep a mask with you at all times (but conserve them!)
• As we have been doing, keep wiping down door handles, hard surfaces, and use hand sanitizers and frequently wash your hands.
• Screening patients by phone or personally should limit and prohibit potentially ill patients from coming to clinic. All patients should be screened for symptoms such as fever, cough, SOB, sneezing and advised NOT to come if having symptoms or recent exposure to a suspected COVID-19 patient.  See attachment for script for screening  all patients and visitors. See attachment for handout to give if answers yes to screening questions. Copies of handout will be at front desk and in workroom.

A national recommendation for consideration of limiting elective surgeries will be evaluated on a day to day basis in concert with our loco-regional partners (i.e. hospital systems, hospitals, surgery centers and private surgery clinics.)

This recommendation’s primary emphasis is to decrease utilization of resources and alleviate potential critical care unit utilization; both sequela not exacerbated by most elective outpatient specialty (plastic surgery) procedures. It is our intention to continue to meet all of our patient’s needs while doing our part to keep each patient and our staff safe. With thoughtful, evidence-based decisions we will work through this challenge as an office in the context of the broader medical community.

Until notified otherwise, we will continue business as usual while doing our best to limit interactions and the number of patients in the office at one time to assure the health of our staff and patients.

Sincerely,

Dr. High