07 Jul 3 Pandemic Lessons You Can Incorporate Into Your Practice

Now that summer is in full swing, pediatricians are evaluating what they’ve learned while navigating these times of social distancing and virtual care.

As you position yourselves to move forward, we’d like to share some lessons learned from Jeff Cooper, M.D., founding owner of Cooper Pediatrics in Duluth, Georgia. 

Located in an Atlanta suburb, Cooper Pediatrics includes Dr. Cooper, one part-time physician, and two full-time nurse practitioners, along with nurses, medical assistants, and support staff. The practice’s patient population consists of 50 percent Medicaid and 50 percent private insurance. 

Here are three ideas from Dr. Cooper on how to incorporate pandemic lessons into the future.

Alleviate Fears by Maintaining Separate Well and Sick Procedures

Preventative care has always been the cornerstone of pediatrics. If pediatric practices are going to be successful, we must have a robust vaccine and well visit recall process. That is even more important now as we move into flu season. Still, some families have fears about bringing their healthy children into the pediatrician’s office, and it’s our job to make them feel safe.

To reduce their apprehension, we should continue to separate well and sick care in whatever manner works best for your practice. You might choose to do well-care in the mornings and sick care in the afternoons. At Dr. Cooper’s practice, the team uses a separate entrance and suite for sick visits.

“We might have one provider who works sick and two who work well,” he explained. “When we have a family come in, everyone has their temperature taken. If someone happens to come in for a well visit and has a fever, they end up on the sick side, and the provider doing sick care also does their well visit. I suspect we will keep that setup forever.”

Continue Using Telehealth When Appropriate

Dr. Cooper was conducting telemedicine visits before the pandemic, but, like many practices, it became immensely popular — and necessary — during the crisis. To serve patients and meet his community’s needs, Dr. Cooper relaxed many of his previously strict rules. For example, he allowed new patients to see him via telehealth (it also helped that the payers allowed this.) He even conducted virtual sick visits for things like ear pain if it was the only way for a parent to agree to care. Prior to the pandemic, that was non-negotiable.

Going forward, pediatricians should set clear expectations about telemedicine and remind patients there will be instances when virtual visits are not appropriate. However, some examples of when telemedicine will be useful are:

• In the morning. This can be especially helpful when parents are questioning whether a child with mild symptoms should go to daycare or school. This might replace early morning walk in hours.
• During the evening. This is a time when caregivers might be tempted to take a child to an urgent care clinic or the emergency room. Access to your pediatrician via Telehealth can keep patients in your medical home. 
• When providers need flexibility. For example, a pediatrician who is recovering from surgery or is approaching the end of maternity leave may find it helpful to ease back into seeing patients with telemedicine.

In addition, mental and behavioral health visits for anxiety, depression, and ADHD are a great fit for virtual visits. “I can see for the foreseeable future that I’m going to do every other mental health visit that way,” Dr. Cooper said. “It’s also really great for college students who are managing their health on their own for the first time outside of their parents.”

Offer Close-the-Gap Visits

Following the multitude of virtual visits during the pandemic, many patients will need “close-the-gap” visits. These will be short appointments when you can do things you weren’t able to do via telemedicine, such as listen to the patient’s heart and lungs or check their hearing or vision.

When conducting these brief visits, keep in mind things you saw during the telehealth appointments. Having the rare chance to see inside patients’ homes may have offered valuable insights into social determinants of health, especially related to housing and nutrition. When families come to your office, they may not feel comfortable admitting their struggles, but telehealth may have given you the opportunity to see some of their challenges.

In many ways, the crisis prompted pediatricians to step up and add their voice as the voice to children who are often invisible.

As we emerge from the pandemic, it’s important to ask what families need from us. How do we design the pediatric practice of the future beyond our walls, and where are we meeting our patients and families in the future?