COVID-19 infection rate among dentists remains lower than other health professionals. ADA study finds 2.6% of dentists had contracted COVID-19 as of November 2020
Source: COVID-19 infection rate among dentists remains lower than other health professionals
A May 2020 of healthcare workers including nurses and physicians, found their reported COVID-19 prevalence rate to be 29%.
From Newser: Hmmm very interesting.
…many people are hurrying to have their teeth straightened after months of staring at themselves on Zoom calls. One New York orthodontist said new inquiries have risen 50% since fall. And the owner of Invisalign clear aligners said the number of people starting treatment in the first quarter was up 69% from a year before,…
Source: As Masks Come Off, People Try to Get Their Teeth Straight
If you offer Invisalign or other orthodontic services be sure your patients know. Mention it at recall, put it prominently on the web page and consider an e-blast.
From Healthline:
- Before a population can reach herd immunity, an inflection point has to occur — the point where there’s enough immunity, through vaccination and previous infection, that cases begin to decline consistently.
- Experts suspect the United States hit an inflection point in late April.
- Cases may continue to steadily decline, especially as vaccination rates increase.
Source: Have We Reached a Vaccination Tipping Point for COVID-19?
Private dental practices are seeing patient volumes at an average of 86 percent, the highest since the onset of the COVID-19 pandemic in March 2020,
Source: Highest US dental patient volume seen since March 2020
Teledentistry, the practice of consulting with dentists virtually, is not currently legal in Texas, but some state lawmakers hope to change that this legislative session.
Source: Democrats, Republicans push for teledentistry to be legal in Texas
The Texas dental practice act has been interpreted to require in person exchanges making tele dentistry illegal. Legislators have proposed new laws to change this.
As usual inside the box thinkers are opposed. If it worked for G.V. Black then it should be good enough for us.
From Fortune:
Taken together, these survey questions help paint a picture of how workers have evolved—and how the workplace must evolve, too.Here’s what we found. The numbers to know 63%… of knowledge workers prefer a hybrid model. Another 20% prefer fully remote, and 17% want to always work from the office.
Source: Is the 9-to-5 office routine dead? Here’s what workers want | Fortune
These findings apply to dentistry.
Do NOT be in a big hurry to get back to normal; defined as the way we did things prior to February 2020.
The pandemic and shutdown showed us we can do many of the management tasks in a dental office remotely using technology. There are three different systems that we can use.
Do tasks that used to be done in the office using the office website. For example take payments and collect forms.
Use an e-service to do tasks that people had to do. For example send reminders and statements.
Work from home. For example run and evaluate month end reports.
Some tasks can simply be eliminated. For example you do not need to pull and replace paper chats if all charts are electronic.
This is nice…but.
In reaction to the ongoing COVID-19 public health emergency, the Code Maintenance Committee accepted and approved the inclusion of eight pandemic-related CDT procedure codes in CDT 2021 during its virtual annual session in March.
Source: Codes concerning COVID-19 vaccine administration approved
The new codes are for vaccinations and diagnostics.
I would like to see some real progress on telemedicine codes with real value. In other words not limited by old fashioned thinking.
Do you have a plan for office work of the future?
Policies about the mix of remote and in-office work have ramifications beyond short term cost and efficiency. Because of what we’ve gone through over the past year, we are about to enter a new era in the evolution of organizations. Decisions that CEOs make over the next few months will set the tone for how work will be done in the future, impacting the relationships employees have formed and their emotional connection with the company. They should be made carefully.
Source: A CEO’s Guide to Planning a Return to the Office
The pandemic has shown us that a great many of the tasks we used to do in the office can be done as well or better remotely. That is either as work from home or outsourced to an online e-service.
Don’t be in a big hurry to get things back to the way they were in February of 2020. Now is a perfect opportunity to redesign the workflow of the office to outsource some work, transfer some tasks to your web page and reassign some tasks to remote work from home options.
For example:
Online bill pay instead of a person answering the phone to take a credit card number or opening an envelope and depositing a check.
Month end billing, reports, and accounting can be done by an administrator working from home.
No paper charts to pull and refile at the end of the day if you use fully digital charts.
Billing, and insurance claims can be done from home or outsourced to an e-service.
No paper re-call cards with postage but use text or e-mail to send reminders electronically. This can be set up and monitored remotely as work from home.
There is more, be creative.
From Hotel Business:
A new survey by APCO Insight affirms that Americans working from home are eager to return to in-person meetings and conventions. The survey finds that even after adapting to the new digital workplace, 81% of professionals who attended in-person meetings and conventions before the pandemic miss doing so and would be just as likely—if not more likely—to attend in-person conferences, conventions, trade shows and other business events in the future.
Source: 81% of Americans working from home miss in-person meetings and conventions | Hotel Business
Zoom and the like has been amazing during the pandemic but there is still something about a live meeting and the serendipity of seeing things and meeting people unexpectedly that makes in person meetings special.
My speaking business has essentially disappeared in the last year. I am looking forward to getting back out and seeing people and visiting new places.
From McKinsey:
American consumer respondents are optimistic and cautiously eager to resume their daily lives. More than two-thirds of respondents surveyed between January 4–11, said they expect the COVID-19 pandemic to be better within the next nine months.
Source: Consumers are interested in a COVID-19 vaccine | McKinsey
One of the things consumers report doing or planning on doing once they have received the vaccine is to return to in person doctor visits including seeing the dentist.
From HealthDay. GOOD NEWS
Dental hygienists have a low rate of COVID-19, even though their jobs are considered high-risk…
…The COVID-19 rate among dental hygienists is similar to that among dentists and far below that of other health professionals in the United States.
Source: Very Low COVID Infection Rate Among Dental Hygienists: Study – Consumer Health News | HealthDay
Telehealth visits accounted for approximately 30% of total outpatient visits early in the COVID-19 pandemic, with uptake varying among specialties and by patient characteristics…
…Among specialties, telehealth was used at least once by 67.7% of endocrinologists, 57% of gastroenterologists and 56.3% of neurologists. However, the use of telehealth was considerably lower among some specialties, with just 3.3% of optometrists, 6.6% of physical therapists, 9.3% of ophthalmologists and 20.7% of orthopedic surgeons using teleh
Source: Telehealth used in 30.1% of visits during COVID-19 pandemic
From the ADA via Becker’s
The percentage of respondents by dental specialty who said they were using any kind of virtual service:
From mHealth Intelligence:
The TREAT Act, which has the support of dozens of health systems and connected health organizations, would allow providers to bypass licensing rules and use telehealth to treat patients in any state during the coronavirus pandemic.
Source: Congress Gets Another Shot at Easing Telehealth Licensure Restrictions
I have often made the point that the primary barrier to increased acceptance of telemedicine is not the technology but the politics. This act is a good step but it is very limited. Hopefully it will lead to more permanent rules.
I am usually a big fan of local control in politics however the Internet has expanded the meaning of local. I cannot determine how it is in the best interests of our patients to not allow them to seek the best most timely care online simply because it is offered by a dentist in a different state. Or why insurance companies will not pay for a telemedicine appointment if the outcomes are good and the cost is lower.
Good to know:
The federal government has inked deals to buy an extra 200 million doses of Pfizer and Moderna’s coronavirus vaccines, … boosting its orders by 50% and securing enough doses to immunize almost every American.
Source: Biden Buys Enough Covid Vaccine Doses To Immunize Almost Every American — But Not Right Away
I am a huge fan of the concept of telemedicine and teledentistry. I believe it has the potential to reduce costs and improve care to a remarkable degree. This is critical to solving the “Healthcare Crisis”.
From Healthcare IT News:
WHY IT MATTERS
The bill, which was first introduced in July 2020, would help safeguard access to virtual care after COVID-19 via four main provisions. According to a press statement from Thompson’s office, it would:
- Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site.
- Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency.
- Make permanent the disaster waiver authority, enabling Health and Human Service to expand telehealth in Medicare during all future emergencies and disasters.
- Require a study on the use of telehealth during COVID, including its costs, uptake rates, measurable health outcomes, and racial and geographic disparities.
The bill avoids some of the thornier issues around telehealth, such as coverage parity or interstate licensing issues, while making permanent broadly popular policies such as eliminating geographic and originating site restrictions.
Source: U.S. lawmakers reintroduce House bill safeguarding access to telehealth | Healthcare IT News
The primary barriers to the acceptance of telemedicine are not technological but political. Government, especially regulatory agencies, professional associations (including the ADA) hospitals, insurance companies and others all have a vested interest in the status quo and an incentive to block the acceptance of robust telemedicine.
One of the few good things to come from the Covid 19 pandemic is the use and acceptance of telemedicine.
From Fast Company:
It’s time to get realistic about how people work in the 21st century. To the degree that we can acknowledge what is actually happening—and what is actually effective—we can begin to experiment with work hours in ways that simultaneously increase productivity and well-being.
Source: Why the five-day workweek is outdated for working from home
Technology allows us asynchronous work from home options. Doctor do you care if your office manager submits the days insurance claims, sends out statements and records payments from the computer on the right side or the left side of the office? Of course not. Then why can’t she/he do it from a computer in a different building? Why not from home?
The 9-5, five day a week office work week was needed when everyone needed to be in the same place and have access to the supplies and data to do their job. Now all they need is a computer with an Internet connection and they can do the work from anywhere. Not just anywhere but any time.
A poll taken the week of Dec. 14 found patient volume was estimated at 78 percent of pre-COVID-19 levels.
Source: Dental patient volume at 78 % of pre-pandemic levels, ADA poll says
That is good news, kind’a. With average US overhead at 73% most offices are barely breaking even.
Every dental practice should have had these online digital tools before the Covid 19 pandemic. Now the pandemic has forced us to consider no touch and even no appointment processes. Patients appreciate the ability to do business with you from home now even more than they did before.
Online Bill Pay: This is so simple and inexpensive it is surprising how few dental offices offer this. Your patients do not want to come to the office to pay you, They do not want to mail you a check (how last century). They do not even want to call and be put on hold in order to give you a credit card number over the phone. They want to be able to pay you just like they do everybody else, online using a credit card or PayPal. Make it as easy as possible for someone to give you money.
Online Forms: That is true online forms that synch with the practice management system NOT a pdf that the patient must download, print, fill out by hand, remember to bring to the office just so an staff member can type in the data. Forms are not just for new patients. Existing patients need to update demographics such as address or employment as well as updating their medical history at least once a year.
Online Scheduling: Many offices offer online schedule requests. The newest trend is to offer true online appointments for selected procedures, such as re-call or new patents.
Not only do these digital tools allow patients to do business with you from home they also allow your team members to work from home.
All of these tools should be part of your practice website. For help check with my friends at TNT Dental.
Interesting, from McKinsey:
“There is no doubt that the patient–provider experience during the past several months has accelerated virtual models of care by five to ten years.
…Hospital systems have been the drivers of our healthcare system. Our nurses and doctors in those hospitals have been heroes throughout the COVID-19 outbreak. But the reality is that if we want to lower costs, if we want to provide the best care, the future of healthcare has to be driven from outside of the four walls of a hospital system.
Source: The shift to virtual and home care: An interview with Annie Lamont | McKinsey
The “Health Care Crisis” is not a crisis of care it is a crisis of affordability. New techniques and new uses if digital technology will lower costs and improve quality. The linked article focuses on medicine but applies equally to dentistry. In dentistry we will eventually have to actually touch the patient but there are many diagnostic tasks and business tasks that can be done virtually.
From NYT:
Thousands of medical practices have closed during the pandemic, according to a July survey of 3,500 doctors by the Physicians Foundation, a nonprofit group. About 8 percent of the doctors reported closing their offices in recent months, which the foundation estimated could equal some 16,000 practices. Another 4 percent said they planned to shutter within the next year.
Source: Doctors Are Calling It Quits Under Stress of the Coronavirus – The New York Times
The linked article is about physicians not dentists. It would be interesting to know if dentists are experiencing the same issues and leaving the profession. I found this article from an ADA Morning Huddle link, but no word from the ADA regarding dental retirements. However most of the physicians in the NYT article who were leaving medicine were solo or small group practitioners. The same practice type as the vast majority of dentists.
What the article fails to address is how many more physicians are leaving now compared to other years. That would be significant information.
It is a personal tragedy for every dentist whose private practice fails or who is forced into early retirement. On the other hand it is an opportunity for those dentists who can stay in business, as the patients of the dentist who has left will need to find a new dental home.