- The Washington Times - Tuesday, May 19, 2020

Dr. Keesha Williams-Elliott had to cut her practice at her comprehensive eye care center in the District by 90% as part of a citywide shutdown on elective medical procedures during the coronavirus crisis.

Now on the verge of a reopening, the ophthalmologist worries about being able to resume business as usual.

“Until we get back to operating, my practice is going to suffer because we’re mainly a surgical practice,” Dr. Williams-Elliott said. “As things subside, my hope is that we can get elective care back on and have a backlog of patients that need surgery, cataract surgery and glaucoma surgery … and that we have a whole lot to do in a short period of time.”

Operators of dental offices, eye specialty centers, women’s health facilities and other “nonessential” medical services have had significant reductions in their workloads since stay-at-home orders were implemented two months ago.

As restrictions are eased, they see huge challenges in providing services and maintaining their businesses while changing how they serve patients.

Since mid-March, Dr. Williams-Elliott has furloughed most of her employees, reducing the staff from nine people to just herself and one other worker. She said she is waiting on a loan through the federal Paycheck Protection Program to get her staff back to work.

Her office went from being open five days a week to two days a week for three hours daily — a total of six hours a week.

The eye care center has been open only for patients with urgent cases, including eye pain, trauma, change in vision and any postoperative treatment. Routine appointments had to be rescheduled. Dr. Williams-Elliott estimates she has seen four or five patients per week since mid-March compared with 150 before the coronavirus outbreak.

Dr. Larry Bowers, owner of East Capitol Dental in the District, is operating at about 10% capacity and is seeing patients only for emergencies such as swelling, pain and broken teeth. He had to cut his staff from eight full-time employees to four part-time workers.

“I’m trying to figure out a way to keep my business intact until we’re allowed to reopen and when more patients are comfortable coming back,” Dr. Bowers said. “You don’t really have any idea what demand is going to be when you open up.”

Data shows the U.S. has about 13,000 dermatologists, 18,000 obstetricians and gynecologists, 24,000 ophthalmologists and 110,000 dentists.

Nearly 1.5 million jobs in the health care sector nationwide, or about 9%, were cut from February to April, according to the U.S. Bureau of Labor Statistics, and a large proportion of those job losses were at dental offices.

Dentists who have reopened in other parts of the U.S. are operating at about 25% volume, said Dr. Bowers, citing the American Dental Association.

What’s more, procuring personal protective equipment, which has been prioritized for hospitals, has been almost impossible for Dr. Bowers. He said he is still waiting for 1,000 N95 masks he ordered earlier this month.

In Northern Virginia, Dr. Damon Hou, a physician at Capital Women’s Health, said he has tried to limit in-person appointments for emergencies, even though preventive procedures were allowed, unlike in the District and Maryland.

His practice has largely pivoted to telehealth, keeping the business afloat by relying partially on virtual visits and significant pay cuts for partner physicians.

Through virtual visits, Dr. Hou said, staff members have been counseling patients about birth control, infertility and incontinence. Although wellness exams are allowed in Virginia, some patients have delayed or canceled annual screenings, he said.

“COVID-19 has impacted so many businesses, medical practices especially,” Dr. Hou said. “It’s been tough. … It’s a costly business to run.”

“We just want to make sure we keep the company healthy because we want to stay in practice for our patients,” he said.

Dr. Stephen Suah, of FoxHall Dermatology in the District, said he also is dealing with a smaller staff and a reduced workload.

“Obviously, post COVID-19 world is just a different place. All of us, whether we like or not, have to change and adapt with the realities that we’re given,” Dr. Suah said. “I don’t see us returning back to pre-COVID-19 until there is a vaccine in place. … This is now our new normal.

“To make sure we can still take care of people like we want to and that they deserve, we have to transition. And that might be more me sitting on FaceTime and spreading out visits when patients come in,” he said.

His clinic’s staff asks patients to fill out intake forms electronically to avoid paper exchange and go directly to a procedure room. Patients also are asked to stay in their cars instead of the waiting room until the staff is ready for them.

The clinic’s entrance opens automatically to avoid contact with door handles. Plexiglass has been installed at the front desk, and touch-free hand sanitizers are attached to the walls.

During the weeks the clinic has been closed, Dr. Suah said, he has been seeing 90% of patients via telemedicine. He has handled a few emergencies in person including patients with infections, melanoma or a recent diagnosis of melanoma.

Meanwhile, Dr. Bowers said that in his 39 years at his practice, his dental care clinic has never struggled as much as it has during the COVID-19 pandemic.

“There’s always been a risk in dentistry,” he said, noting that dental work involves close contact with patients. “Now as risky as it gets in terms of COVID stuff.”

Dr. Bowers said dentists always have taken sterilization and personal protection seriously and are modifying procedures to provide the safest possible care during the coronavirus outbreak.

He said he is not sure when people will feel ready to come in for routine exams and estimates it will be at least a year until his clinic is operating as it did before the pandemic.

“The uncertainty is overwhelming,” he said.

Dr. Williams-Elliott said she thinks her eye care center will make it under different, but necessary, operating procedures.

“This has been a very trying time. It was very abrupt,” she said. “It’s a very frightening time. I have five kids, so I’m still exposed to patients on a daily basis. … The potential for me bringing it home, I have to change the way I interact with my own family.”

“As far as businesswise, we were a thriving practice. And I’m not alone in that,” she said. “We’re all trying to figure out what that new normal is going to look like. And it’s uncertain. … But I hope things will work out the best that they can, making modifications, because we still have a lot of patients that we need to serve, and that’s my main goal.”

• This article is based in part on wire service reports.

• Shen Wu Tan can be reached at stan@washingtontimes.com.

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