Panelists answer the questions physicians asked related to safety and testing during our webinar, “Medico-legal Concerns for the Private Practice During COVID-19.”
Randolph Waldman, M.D., Facial Plastic Surgeon, Editorial Advisor, Aesthetic Authority, Founder and Director of the annual multi-specialty Global Aesthetics Conference: Yes, we are not using the valved mask even though they are more comfortable to wear.
Dr. Waldman: I don't think so.
Dr. Waldman: We are using a system called Weave, which is a system that is like having an iPhone and patients can text our system and vice versa.
Dr. Waldman: We are still asking them to quarantine away from us through the month of June if they have traveled by plane, but we expect that to change in the next month or two.
Dr. Waldman: Great question and will need to be something every physician must decide for themselves. I think testing and temp checks will allow the physician to stay in the office as it would other office staff.
Dr. Waldman: Masks suffice in our practice.
Dr. Waldman: Virtual [visits] where possible and with caution in an isolated area of the office if not possible.
Jeff Segal, M.D., JD, Founder, Medical Justice Services: N95 masks (and eyewear/face shields/gowns/gloves) are limited to being around (a) patients with active symptoms; or (b) aerosolizing procedures – intubation/drilling/or arguably working on open mouth or nose. For being around “pre-symptomatic” people (assuming no exposure to aerosolizing procedures or exposure to open mouth), surgical mask and hand washing should be adequate.
Dr. Segal: If you are in front of the patient’s face and patient is breathing right on you as you do the injections – would recommend N95 mask, eyewear/face shields/gowns/gloves. Alternatively, one can be creative and have plexiglass barrier between patient and injector. This assumes you can work around the barrier comfortably. If so, then surgical mask and eyewear may be adequate.
Dr. Segal: If staff is not in front of patient’s open mouth, surgical mask and eyewear may be adequate. See answer above.
Dr. Segal: Hard to say. It depends whether there’s a second wave. Whether they are traveling to hot spots. I know most airlines are trying to be flexible to get people back on planes.
Alex Thiersch, JD, Partner, Salveo Capital; CEO, AmSpa:Businesses in a shared office space or with shared common space should coordinate to implement effective infection controls and sterilization procedures that apply to the entire office. An any health information obtained about an employee must be kept in separate confidential files, however. You are responsible under OSHA to provide a workplace free from recognized hazards, but this does not extend to non-employees. Nevertheless, a common plan and protocol should be implemented.
Dr. Waldman: Yes, I think most do and we have taken the extra step of having both an OSHA officer (which we have had) and also a COVID director.
Thiersch: There is no legal requirement to do so, particularly if you are following recommended protocols such as social distancing, wearing masks, wash hands and screening patients before they arrive. However, this is an individual decision that each business must make given that this is a sensitive topic with PR implications. Certainly, some screening will need to be done to see who the employee came into contact with, were they showing any symptoms (they shouldn’t be because that would require them to avoid work), were any other employees showing symptoms, etc. So, while not legally required, depending on the circumstances there may be wisdom in doing so.