Overcoming the Challenges of the COVID-19 Pandemic

What are the main challenges your practice has faced during the past year?

“When the pandemic started there was a lot of uncertainty. It was initially extremely difficult to obtain N95 masks and other adequate PPE. All dental practices were advised to close by The Department of Health in March, during the first lockdown, and we also did not want to reopen until it was safe to do so.  I am very grateful for the help we have received from the UK government, such as a loan and grant. Nevertheless, as the practice was closed for over 3 months, the business has suffered a loss of revenue while overheads still had to be paid.

Re-opening was initially slow as we put in place extra infection control measures and increased sanitisation. This meant that we were able to see less patients per day. We have also had some staff absent, either sick or self-isolating. Our regular patients have returned but elderly and medically vulnerable clients are still postponing non-urgent treatment. For these reasons, the requirements to fulfil our NHS contract have been reduced for this year.”

Have you developed any new strategies for improving care provision, efficiency, or developing resilience in uncertain times?

“We invested in an air-exchange extractor fan to improve air quality in the surgery. This removes aerosols from the room, allowing us to reduce the fallow time required between appointments, according to the NHS England guidelines. Since the lockdown I have been studying online for a diploma to increase my knowledge and skills with clear aligner braces for orthodontic treatment. As a practice, we are continually expanding the range of treatment we provide, to benefit our patients and improve our resilience.”

How has your use of telehealth or digital technologies changed? Have you, or do you plan to invest in technological upgrades?

“When the practice was closed, we mostly triaged patients who had pain or swelling by phone. Currently we rarely use video calls, but I feel that we may use this kind of technology more in the future. I recently attended a UK-based webinar on video-consultations. We could use remote consultations for new patients, especially those enquiring about cosmetic or orthodontic treatments. Of course, most dental treatment requires physical contact, but systems which enable patients to take their own clinical photographs using mouth retractors and upload them can be useful for monitoring the  progress of treatment with clear aligners for teeth straightening.

We recently bought an intra-oral camera with digital scanner. This was a significant financial investment but provides many advantages such as improved accuracy for designing crowns, bridges and orthodontic aligners.”

How do you feel about the future?

“We are hopeful that things will improve, especially with the roll-out of vaccines for COVID-19, but the new variants of the virus are a concern. Although there is still some uncertainty, we are a well-established practice with a loyal client base. As we continue to keep up to date with new technologies and techniques, we feel confident that we will come through the current situation stronger.”

As my interview with Dr Pauline shows, practice owners are dealing with uncertainty and circumstances beyond their direct control. The level of financial assistance available from governments, insurance or lending agencies varies between countries. Short-term support can prevent medical practices becoming unviable, negatively impacting healthcare systems in the longer term.

How can healthcare providers develop resilience in challenging times?

• Concentrate on factors which are within your control, so that you are not overwhelmed by uncertainty.
• Find out about all sources of financial and business support available in your area.
• Where necessary, request landlords, creditors or equipment companies for deferred payments.
• Re-think and restructure your business growth strategy with contingency plans for unforeseen events.
• Support staff who are furloughed or laid off so that they are able to return to work when economically feasible, so that their valuable skills and experience are not lost.
• Maintain continuity of care for those you are unable to see in-clinic, by telephone or video-consultations.
• Make the best use of digital technology for communication and new models of care.
• Refresh your skills and keep up to date with new techniques.
• Ensure all safety protocols are followed, for the protection of both staff and patients.

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