Eyeworld

N EWS 34 | EYEWORLD | MAY 2020 COVID-19 NEWS YOU CAN USE Contact McLeod: Stephen.McLeod@ucsf.edu Patterson: michaelp@ecotn.com Tsai: jtsai@nyee.edu of employees, their families, and patients. Dr. Patterson said in early April that he and his fa- ther, Larry Patterson, MD, are taking on urgent cases, and he was taking call for the month. "Eleven doctors are not working currently, and 120-plus staff are not seeing patients right now," he said. The eight-location practice is still seeing "walk-in" emergency cases (which might be up to 10 a day) and performing retina injections. Dr. Patterson said the practice is not offering telemedicine right now, in part because his pa- tients don't want it. Before coming to the clinic, patients are screened with a call for symptoms and travel history. The patient is told there will be minimal conversation with the doctor during the exam. Once they arrive, a nurse conducts further screening outside the clinic. Patients are admit- ted one at a time without family members, with few exceptions. There are no chairs in the wait- ing room, patients are led straight to the exam room, and everyone wears a mask, Dr. Patter- son said. If a patient does need urgent surgery, Dr. Patterson said they have a one-room ASC that is only used for ophthalmology. Dr. Patterson, serving 7 years in the mili- tary, has offered his services as a physician to the local hospital but said they don't currently need him. "Our hospitals are laying off employees right now. Hospitals are going under because they've canceled elective surgery," he said. As for the economics of his practice, which is also not doing elective surgery, Dr. Patterson said the executive team has taken out lines of credit personally to pay the payroll, rent, etc. They hope to apply for and receive government stimulus loans to help with this. The current state of things can't continue at this pace for too long, Dr. Patterson said. For example, even the cleaning supplies being used in his practice to make sure patients and staff stay safe are hard to come by. If they can't be replenished, he said they might need to shut down further. For now, he said "we take a deep breath, do the best we can." "Our job as doctors is to be calm; our staff is looking to us," Dr. Patterson said. a minimum while in person, and some testing methods have shifted to reduce exposure. When the patients arrive, they are commu- nicated with from their car, then taken directly to the exam room. If arriving on foot, they speak with staff from the waiting room with reminders to keep a 6-foot distance. Patients are also reminded not to talk at the slit lamp, Dr. McLeod said. Only essential personnel and the patient are in the exam room. After the exam, Dr. McLeod said a few summary statements and directions are given to the patient from a distance. If more discussion is needed, the patient and the physician commu- nicate remotely once the patient is in their car or schedule a time to speak on the phone. Dr. McLeod said UCSF has established a "drive-through" IOP testing protocol as well. A tech is stationed outside the building with a tonometer. Patients are given a mask to wear and are asked to roll down their window for IOP to be checked with a portable tonometer. Based on the data, the physician follows up with the patient with phone or video. For urgent surgical cases, Dr. McLeod said requests are made to department leadership and, if approved, placed on the surgical block. All UCSF ASCs are closed, so surgeries are be- ing performed at Mission Bay Hospital inpatient operating rooms. As for redeployment potential, Dr. McLeod said UCSF has a redeployment plan for all de- partments and all physicians. "The current plan proposes ophthalmology physicians be redeployed to outpatient medicine services, if necessary," he said. Michael Patterson, DO Captain, United States Army Reserves Eye Centers of Tennessee Crossville, Tennessee Dr. Patterson's practice serves Tennessee's Upper Cumberland region, which comprises 10 rural counties. As of April 23, there were just over 200 positive COVID-19 cases within this whole region. "We're a very different area than the average practice," Dr. Patterson said. Despite the low numbers compared to more populated areas of the country, Dr. Pat- terson said his practice shut down for the safety continued from page 32

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