Running Your Dermatology Practice During COVID-19
Step 7: Patient screening
Prior to arrival for an appointment or on the day before the appointment, check with the patient if they have developed any symptoms of a respiratory infection (e.g., cough, sore throat, fever, runny nose, or shortness of breath), diarrhea, nausea, or loss of taste or smell. Additionally, ask the patient if they have had any recent close contacts with others either diagnosed with or exposed to COVID-19. Consider using a screening tool. If COVID-19 is suspected, refer the patient to their primary care physician for evaluation and reschedule their appointment to a later date. If a primary care physician is unavailable, refer the patient to an urgent care center. It may be prudent to receive written clearance from the treating physician as to when the patient can be seen in your practice and is clear of COVID-19 symptoms. Contact your malpractice carrier to consult on COVID-19 related care including expectations on patient pre-screening.
Instruct the patient to come to your practice alone unless they need a caregiver (or parent for children) with them at the visit. If unable to arrive alone, suggest the individual accompanying the patient wait in the car or outside the office for the duration of the appointment. Also, advise the patient that face masks are now highly recommended by the CDC for all persons, except for young children under age 2, anyone who has trouble breathing, or unable to remove the mask without assistance when they go out in public. Due to additional screening activities, allow extra time upon arrival.
Once the patient arrives, consider having them wait in their car or outside the office until called or texted on their cellphone. Ask about the presence of flu-like symptoms (cough, fever, sore throat, or shortness of breath), loss of taste or smell, and/or contact with potentially infected persons . Consider non-contact temperature screening (the CDC defines 100.0+ degrees F as fever). If findings suggest possibility of COVID-19 infection, refer the patient to their primary care physician or local urgent care center for evaluation and reschedule their appointment to a later date. Screen any accompanying individuals who visit the practice as well.
Consider creating as much of a paperless check-in process as you can. Ask the patient to complete all their required pre-visit paperwork online through your patient portal, or securely email forms in advance.
Practice social distancing when you greet patients and staff with a nod, smile, and/or wave. Do not shake hands or hug.
Determine if any procedures being done that day will require additional PPE such as ablative laser procedures or dermabrasion. Most dermatologic procedures are NOT believed to generate aerosols or droplets.
Some states may restrict procedures requiring PPE, so you may need to assess with your state public health agency as to which procedures are permitted during the pandemic. For example, cryotherapy is considered a procedure but does not deplete PPE.
Some hospitals and ambulatory surgery centers require COVID-19 testing (antigen) of patients undergoing procedures in those facilities. If you operate in such an environment, follow the requirements. Patients undergoing such preoperative testing must quarantine between the time they get the test and admission to the facility.
Despite screening patients, all patients should be treated as potentially being infectious with COVID-19. Patients known or suspected to have COVID-19 that need treatment for a dermatologic condition related to or exacerbated by COVID-19 should be seen by telemedicine whenever appropriate. If an in-person visit is required, all safety precautions in the office should be followed carefully. In addition, the patient should interact with only one dedicated staff member plus the physician. They should stay in one exam room throughout the encounter, with the door closed. After the encounter, thoroughly disinfect all surfaces.
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All content solely developed by the American Academy of Dermatology