The dermatologist is — online!

Now that Metro Manila is under GCQ, a new phase of the COVID-19 pandemic is upon us. It is a time for hope but also for caution. The end of the lockdown will not spell a return to the “old normal,” as different businesses resume operations at differing speeds. The virus still lurks and the ability to contain its spread will dictate what happens next.

Any resurgence will likely bring about renewed restrictions. Large- scale testing and tracing, the broad availability of masks, and sufficient intensive-care capacity in hospitals will primarily determine the pace of recovery while a vaccine is still not available. 

The eagerness of physicians to restart and rebuild is understandably large, but so are the questions that a return to practice raises. How practitioners navigate through this changed environment as the restrictions are loosened in the coming weeks is very important, as well as the financial health and state of mind of doctors and their patients.

Along with dermatology residents and consultants all over the country, I have been watching world leaders in our field as they try to keep a finger on the ever-changing pulse of the COVID-19 pandemic. For us dermatologists, we have either been forced into a technological world that we have not yet even fully embraced, or we have been pulled back into the world of clinical practice, where health and safety stipulations like protection for ourselves, our assistants and our patients depends solely upon us practitioners.

Another great concern is how quickly will demand return. With a lower income and an increase in overall expenses, how can we practitioners cope? Most of us are still being asked to pay rentals for the three months that we have not even been to our clinics. And lastly, how can we motivate patients to go back to the hospital?

So, when the transition to GCQ was announced, I was in a quandary. I was happy that I could go back to my clinic to clean it, water all my plants, spray fragrance in my room, see my secretaries again and update each other about our experiences during the lockdown. But I also asked myself if I really should start working back in the clinic because, to be honest, although it is more difficult to have a consultation online, I am beginning to like it.

First, there are no facial expressions, either by the doctor or patient, that can be misinterpreted, no voice modulation to contend with while trying to explain things with the patient, no secretaries to pay, no rentals to pay (or so I thought).

Well, I just feel that I am more relaxed and less stressed with the new normal of online consultations that is going on.

So, when the transition to GCQ was made, my stress level went even higher than before COVID-19. Why? Because I had to prepare myself for going back to the clinic.

One of the requirements is you should have an RT PCR (a test that will determine whether you’re positive that day for COVID-19) negative result before you can go back to work. However, if you contract COVID-19 a day after, it will be useless and can give you a false sense of confidence into thinking that you are okay.  

It’s okay if it’s the hospital that shoulders the cost of the test. I am lucky that AIDE APP is offering it for a much cheaper price in the comfort and safety of our homes. Still, it is quite a sum.

Then you have to make sure your clinic is safe. There should be a disinfectant spray upon entry of each patient and a thermal thermometer on hand. It’s best that you have a disinfecting mat to ensure that patients going into your clinic do not carry the virus.

Upon entry, a patient should sign a declaration-of-health form for contact tracing. Wearing a mask is mandatory. Doctors should wear a mask (I wear two masks), plus a face shield and/or goggles with head cap as much as possible. Some of my friends made an acrylic box for safety, but you need practice to get used to it over time.  

Then some procedures are still off-limits as of this time because you can boost the presence of viral particles in the air and put everyone in danger. I also have to fully disinfect my clinic after clinic hours. So, income for these procedures is gone.

I asked my secretary to go to the clinic to find out if there were a lot of people making appointments and to my dismay, no calls were made that day. It’s because people are still afraid of going out of their homes and contracting the disease, so they’d rather go to my online consultation, to which I readily agreed. First, because before they can go to my clinic, there are many steps to go through. They also need to queue to “Triage” to get a piece of paper to know if they can already consult with their preferred doctor.

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For inquiries, call 8401-8411 or 0917-497-6261, 0999-883-4802 or email gc_beltran@yahoo.com. Follow the author on Facebook @dragracebeltran.