COVID changes to a dermatology practice
Answers in Practice
By Emily Margosian, Assistant Editor, September 1, 2022
DermWorld talks to Sarah Jackson, MD, FAAD, from Audubon Dermatology in New Orleans, about how her practice has found its ‘new normal’ in a COVID world.
DermWorld: Tell us about your practice.
DermWorld: As we approach the third year of the pandemic, what has been the biggest change to your practice?
Dr. Jackson: The biggest change to our practice is how we structure our clinical hours. We have six exam rooms. Prior to COVID we wouldn’t think twice about both dermatologists seeing patients in clinic simultaneously, resulting in our waiting room being filled to capacity for significant periods of time.
Now, we split our clinical days and extended our hours. We have one person seeing patients in the morning and the other in the afternoon, and these are longer clinics than we had prior to the pandemic. So far, everyone loves the change as the patient flow is much less congested.
DermWorld: How has your office’s workflow evolved?
Dr. Jackson: The efficiency of our office’s workflow has improved drastically since the start of the pandemic. We previously let patients fill out their paperwork in the waiting room before being brought back to the exam room. Now, we require them to upload insurance cards and complete all paperwork ahead of time through the online patient portal. This allows us to bring most patients back to the exam room almost immediately. We plan to continue this policy in our practice because it has drastically reduced the amount of time for patient intake and crowdedness in the waiting room.
DermWorld: Do you still offer telehealth options to patients?
Dr. Jackson: Yes, that’s another significant change in our practice. We utilize telemedicine much more frequently, especially for our acne and rosacea patients who simply need prescription refills. We also require patients to submit high-quality photos of the affected area before their appointment, which is helpful if someone has a spotty internet connection. When there is not an in-person examination involved in determining a diagnosis, we can effectively see these patients outside of our physical clinic. This saves a significant amount of time for our patients who truly need to be seen in clinic for skin exams. I think telemedicine is a good thing and is here to stay in dermatology. We also offer store-and-forward, which we did not utilize before.
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DermWorld: What safety requirements have you put in place that patients must follow?
Dr. Jackson: We simply ask patients to stay home if they are ill or are showing symptoms of COVID.
DermWorld: Do you require masks to be worn in the office by patients and staff?
Dr. Jackson: We required patients and staff to wear masks in the office until recently when the hospital we are affiliated with lifted their mask policy. As part of our protocol, we do let patients know we are happy to wear masks in their presence if the patient prefers it. We will also be flexible with our policy as new waves of the coronavirus will possibly affect our local community.
DermWorld: Does your office require staff to be vaccinated for COVID-19?
Dr. Jackson: We never officially mandated vaccination in our office. We were waiting for federal guidance regarding Medicare providers. There was a distinction made about whether you were a Medicare provider versus if you were a Medicare facility. Eventually the federal policy did not include private practice doctor’s offices. Since we were exempt, we did not make an official mandate. However, we did strongly encourage our staff to be vaccinated and officially presented the data to them during a staff meeting. This resulted in an almost complete vaccination rate among our staff.
DermWorld: Has COVID changed your office’s remote work policy?
Dr. Jackson: We’ve realized that we can utilize remote work much more effectively, although most of our employees have chosen to work in the office full time. We do have one employee, our billing specialist, who was already working remotely prior to the pandemic. We also switched to a cloud-based EMR system so most of our employees can log on remotely from home, if need be. This was helpful in the event that someone was out due to a COVID diagnosis or exposure, but was symptom free and willing to help with desk work.
Sarah Jackson MD, FAAD, is in private practice at Audubon Dermatology in New Orleans.
