Coronavirus Update


We want our patients to know we are reserving extra time for each appointment to ensure the safety of your health and our staff. 

For your safety and the safety of our staff please wear a face mask to your appointment.


1) Training and Educating Our Team

One of the most important things we are doing at this time is to train and educate our staff.

  • Our team has had a refresher training in proper hand washing techniques.  This may seem basic; however, it is the most important thing we can do to prevent spread of the virus yet research shows that it is often poorly complied with and usually not done well.  Consequently, we have spent a lot of time ensuring that our team does it well and often, especially before and after every patient encounter.
  • They have practiced the appropriate use of personal protective equipment (PPE) prior to caring for a patient to prevent contamination.
  • We encourage staff that is not feeling well to proactively stay home for 2 weeks (we have a backup team if someone is ill). 
  • We have everyone in the office take their temperature at the begining of every day and we will immediately send home anyone with an elevated temperature (100.2 and above).
  • Limit the numbers of staff providing their care to facilitate social distancing within the office and among team members.

We have created a specific checklist of recommendation for our team to follow so that they arrive to work healthy and go home to their families without worry. 

2) Recommendations for Our Team

Before coming to work

  • Take temperature (do not go into work if you or any other family member are experiencing symptoms, cough, sore throat, fever, etc...)
  • Remove rings and leave them at home
  • Tie hair up, keep nails short
  • Avoid extra accessories
  • If bringing lunch, place in disposable wrapping
  • Bring work clothes in a washable bag (i.e. pillow case)
  • They have practiced the appropriate use of personal protective equipment (PPE) prior to caring for a patient to prevent contamination.

At Work

  • Change into scrubs and work shoes (preferably plastic and wipeable)as soon as you arrive 
  • Use PPE as appropriate
  • Leave all clutter (pens, phones, etc) outside of patient ops rooms
  • We discourage employees from using other employees phones, desks, offices, and other work tools and equipment when possible.
  • Clean phone after use
  • Discourage cell phone use at work

After work

  • Wash hands and arms with soap
  • Remove scrubs and place in a washable bag (pillow case)
  • Wash hands and put clean clothes on 
  • Sanitize rooms,  phone, glasses, etc.
  • Wash hands again

At home

  • Do not touch anything
  • Remove shoes and clothes
  • Wash clothes/scrubs in washing maching with detergent and hot water
  • Shower immediately with soap and water before touching anyone (including loved ones)

3) Patient Interviews and Social Distancing

Before patient arrival every effort is made to 

  • Filter patients during the phone call when scheduling appointments for care using established and recommended screening checklist and scripts
  • Prepare scripts and question to recognize potential carriers
  • Reschedule patients who show any signs of a cough or fever or who describe having any concerning warning signs.
  • Instruct patients to call ahead and reschedule their appointment if they develop symptoms of a respiatory infection (e,g.cough, sore throat or fever) on the day they are scheduled to be seen.

To promote social distancing

  • When booking patients, we are spreading out the schedule so there are less people in the waiting room.  (Maximum of 2).
  • If a patient is being accompanied, their escort should wait in the car to limit the number of people in the waiting room to promote social distancing 
  • Patients can wait in their car or outside of the office where they can be contacted by mobile phone when it is their turn to be treated.

Safety measures taken upon arrival

  • Limit points of entry to the clinic
  • Staff member will greet patient at door to avoid contact with door handles
  • Masks and tissues are made accessible immediately upon entry and instructions are provided on how to use tissues to cover nose and mouth when coughing or sneezing, to dispose of tissues and contaminated items in trash
  • Provide supplies such as alcohol-based hand rub (ABHR) with 60-95% alcohol, tissues and no-touch trash cans for disposable, at the entry and waiting room.
  • Post photos at the entrance and in waiting room to provide patients and HCP (Health Care Personel) with instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette.
  • How and when to perform hand hygiene
  • How to use tissues or elbows to cover nose and mouth when coughing or sneezing
  • How to dispose of tissues and contaminated items in the waste receptacle


4) Measures Upon Arrival

  • Immediately make sure patient has a mask on if not give them one and use hand sanitizer
  • Ask patient to rinse with 1% hydrogen peroxide before each appointment
  • Escorted into an examination room with the door closed as quickley as possible upon arrival to avoid lingering in the front office
  • Ask patient about the presence of symptoms of respiratory infection and history of travel or contact with possible COVID-19 patients
  • Assessed for respiratory symptoms and fever (with a non-contact digital infrared forehead themometer) 
  • If fever temperature of 100.2 degrees F or higher or respiratory symptoms are present, they will be advised to seek medical treatment and their visit will be rescheduled.
  • As testing for the virus becomes more available, we will be incorporating this added benefit to screen patients.

5) Measures Taken Upon Patient Entry to the Clinic

  • If an examination room is not readily available we ask that you wait in the car and one of the staff members will call you when ready.
  • Remove all clutter and anything that is not easily disinfected from the waiting room (magazines, area rugs, pillows, toys, etc)
  • Frequent wipe down of waiting rooms, bathrooms, door handles, tables, lights switches, computers, etc..

6) Protocols of the Clinical Team

We adhere to usual standard and transmission-based precautions in operatory but with greater attention to detail and ensure that procedures are followed consistently and correctly.

Furthermore, we will employ an additional team member/assistant whose main focus is only on sterilization.  This team member will be responsible for cleaning, sterilizing, disinfecting and wiping down everything in the operatories and in the waiting room: chairs, handles, light switches, tables, etc.. on a regular basis.

Hand Hygiene is performed by our staff

  • Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment (PPE), including gloves.
  • After removing PPE in order to remove any pathogens that might have been transferred to bare hands during the removal process.
  • Washing hands with soap and water for at least 20 seconds.

Personal Protective Equipment

  • Wear PPE (masks, gloves, cap, eye protection, face shields, disposable jackets (N95 masks when around confirmed cases)
  • Masks are one time use and replace if soiled
  • N95 respirators should be used instead of a facemask when performing or present for an aerosol-generating procedure.

Eye Protection

  • Put on eye protection (ie goggles or a disposable face shield that covers the front and sides of the face) upon entry to the patient room or care area
  • Resuable eye protection (e.g. goggles) must be cleaned and disinfected according to manufacture's reprocessing instructions prior to re-use
  • Disposable eye protection should be discarded after use.


  • Put on clean, non-sterile gloves upon entry into the patient room or care area
  • Change gloves if they become torn or heavily contaminated
  • Remove and discard gloves when leaving the patient room or care area, and immediately perform hand hygiene


  • Put on a clean isolation jacket/gown upon entry into the patient room or area
  • Change the jacket/gown if it becomes soiled.  Remove and discard the jacket/gown in a dedicated container for waste or linen before leaving the patilent room or care area.  Disposable jackets/gowns should be discarded and cloth jackets/gowns should be discarded and cloth jackets/gowns should be discarded and laundered after each use.
  • Jackets/gowns should be prioritized for all aerosol-generated procedures and during activities where splashes and sprays are anticipated.

7) Patients in the Operatory

  • Health care personnel (HCP) should strictly follow basic infection control practices between patients (e.g., hand hygiene, cleaning and disinfecting shared equipment)
  • Limit transport and movement of the patient outside of the room
  • No other team member should enter the room during a procedure and if necessary, should use PPE as described above.
  • Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized
  • After this time has elapsed, the room should undergo appropriate cleaning and surface disinfection before it is returned to routine use
  • Special precautions will be taken when performing Aerosol Generating procedures (AGP), in particular, procedures that are likely in induce coughing are avoided if possible.
  • Patients undergoing aerosol-generating procedures are in a separate op

8) Protocols After the Clinical Treatment

  • All non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer's instructions
  • Ensure that environmental cleaning and disinfection procedures are followed consistently and correctly
  • Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product's label) are appropiate for SARS-CoV-2 in healthcare settings, including those patient-care areas in which aerosol-generating are preformed

Safety Measures After the Visit

  • We are taking credit cards over the phone to ensure social distancing with the front desk
  • Review of estimates and receipts can be carried out via phone call or sent by email
  • Patients to sanitize their hands before leaving the office

At the End of the Day

  • Our staff has been trained to clean and disinfect the office from top to bottom in preparation for the following day

We are confident that these guidelines will help to create a safe environment for all of our patients and team members and hope that you feel secure in the knowledge that we are doing everything in our power to provide the safest clinical conditions in order to protect our patients, our team and our families




Dr. Rich and Staff

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