I have something to say regarding this subject. Something probably not understood before.
There is a lot of misinformation here, and frankly a lot of ignorance as to what is required of professional practitioners to return
to work and to continue working into the future.
We practicing dentists, whether a GP or an Oral Surgeon, or Endodontist, or Orthodontist, or Periodontist….(and for that matter all Medical practitioners and Physicians, with all of their specialties represented,
who similarly answer to their state and federal associations and to specific higher organizations, whose guidelines and directives they must follow.)
We all must adhere to the strict recommendations of OSHA and the CDC, to name the two most prominent organizations to whom we are accountable.
Then comes the individual state professional association who issues and maintains our actual licenses to practice, to our federal organizations (for me, the American Dental Assoc, for Physicians the AMA),
and even to our Individual Liability Insurance Companies. At the very least, it’s complicated, and it is also extremely costly.
My office was 100% shut down for 9.5 weeks. Zero income, ongoing overhead. The economic disaster of that is really incalculable at this time, as the impact continues to show itself.
Just returning to work will only be the first baby step. It may take a year or two to heal and simply get back on track.
It’s not like a regular business re-opening and all of a sudden everything is packed with customers and wonderful.
We local dentists have now returned to work—not sure about most, but we are at a production level of about 30% because of recommended patient appointment spacing, adhering to lower patient levels
to reduce exposure risk. I assume it’s pretty much the same across the board. It is understood by us all that to do otherwise right now would be negligence.
We must protect patients, employees, and ourselves, and ultimately the families of all of those and beyond.
PPE (Personal Protective Equipment) is "as good as mandatory" by our State Dental Board because we can be held liable if anything happens due to non-compliance by any office. Patients can report any practitioner, colleagues can report other practitioners, and Liability Insurance Companies can cancel all coverage if they have cause, and that would kill any practice instantly. We all want to comply, and we all have, to my knowledge,
but it has come at great personal cost to all. It took time to gather the PPE——2+ months for most everyone---- and it’s still ongoing. I foresee that it will never stop…the new normal.
Not to mention that the PPE ran out early on, and many, many items were simply 100% unavailable, so we had many back-orders. For weeks and weeks some things were not available at all.
Many offices chose to remain closed until everything was ordered and received and new office policies implemented.
The PPE is the easy part—the new “pandemic” office procedure and protocol is the truly time-consuming and most complicated part.
Some here have said something about, “well they already had masks and gloves….”
That’s a good one.
It goes FAR BEYOND masks and gloves. As for products it also involves face shields, bouffant caps, new specialty scrubs or uniforms for the whole staff, approved gowns, hand sanitizers,
wipes that kill all bacteria and germs, plus viruses--- TB, Coronavirus, and all other viruses. Also consider countertop barriers between patient and front desk employees, a dozen new forms and documents
that must be distributed to patients (several signed by patients), rest room sanitization, reception area sanitization, and in many cases Room Ventilation systems and Water Quality Control measures.
Also disposable plastic barriers that cover treatment chairs, various types of equipment in each treatment room including imaging devices, special plastic tray covers on which instruments are placed,
and new sterilization protocol involving even the steps taken in transferring the USED dirty instruments after each appointment over to
the pre-sterilization area of the ultrasonic cleaners,
then to the sterilization autoclaves, and then back to the patient rooms. It’s a much more time-consuming and expensive exercise now. And the time it takes to turn over a treatment room has caused
us to take additional time for the appointment so it can be done thoroughly and properly. So the production again is lower. There are also new front office protocols too lengthy and boring to elaborate on here,
one example being how simple patient record-keeping must be handled now.
Also 2-day pre-appointment health screening phone calls to each and every patient, followed up by the same screening process upon patient arrival—a document that must be signed, along with a long “treatment consent" form, issued in our case by none other than our Liability Insurance Company itself. How a patient pays now required purchasing from our bank the touchless payment system, whether it be credit card, electronic check transfer, debit card, etc. Even an occasional pen used in the front office by a patient or employee must be wiped down with the expensive virus-killing solution after each use, and the countertops must also be wiped down after each patient. Every product must be approved by several organizations,
including FDA and NIOSH.
So, is it ‘just a mask and gloves”? Personally that’s insulting and farcical.
There's a lot that people are not seeing, so they assume everything behind the scenes is same-old, same-old.
Nothing could be farther from the truth.
Please take a look at a few of our guidelines we much adhere to below
.......Please read them.
There’s also a link to the “Extra Fee” that we charge for PPE per visit, and how that originated nationally. You will understand after reading. And let it be known, it wasn’t us!
As I understand it, all Insurance companies were advised by governing bodies that they will be required to provide coverage for this, so it’s not some new greedy policy that dentists came up with to steal a new increase. The fee itself it a token fee, imho, and does not come anywhere close to covering all we have had to implement to keep going…..and mind you, we had to do it while still suffering from
an extreme economic disaster, having been shut down and having to purchase practice things from personal savings. It is justified.
Of course these things must be paid by consumers, but know that it's indirectly now because it will be required to be covered by the individual insurance companies and not the patient per se.
There might be some who must pay a portion out-of-pocket, but in this rare and serious pandemic situation, it’s the right and safe thing to do.
I must protect my staff, their families, and myself and my family, and guess what—the patient too.
I accept and have always treated Medicaid patients because I believe it is what I’m called to do. Anybody and everybody. The fees received are very low, less than 1/3 of normal fees,
yet I still provide all the same level of treatment, and protection via PPE, to all that enter my doors.
(Cars added catalytic converters way back when, and there are other countless examples of extra charges, but this is one that could be life-saving.
Hospitals do it by itemizing every single piece of anything….like an individual 2x2 piece of gauze….. and far more.)
Guidelines from organizations to whom we are accountable for PPE and EVERYTHING ELSE:
American Dental Association:
American Dental Association PPE reimbursement: (legislation pending on this)