Practice Management

A Practice Works to Outlast COVID-19

April 13, 2020

By Robert Burke

Pamela A. Lowe, OD, FAAO, Dipl. ABO

It takes a lot of smarts and strength to build a practice that can last 28 years and keep growing.

That’s what Pamela A. Lowe, OD, FAAO, Dipl. ABO, has done, and this year she was expecting to build on that success. “I gotta tell you, 2020 was my year,” she says. She had hired an optometrist to take on her patient-care duties and wanted to spend these months expanding her business consulting work.

The COVID-19 pandemic flattened that plan, and now her sole focus is keeping her practice afloat. “It never entered my mind that I would have to close my doors and maybe lose my business,” she says.

Professional Eye Care Center is a Vision Source member in Niles, Illinois. There are three optometrists including Dr. Lowe, and the practice treats a wide range of eye diseases and conditions, including myopia.

Everything changed in mid-March after guidance from the Centers for Disease Control and Prevention urged tighter protocols and the Illinois governor issued a stay-at-home order. The news came on a Wednesday when the practice is usually closed to do administrative work. “We called a meeting and said, ‘Okay, Thursday is going to be a different day for us,’” she says.

Now they see only urgent-care patients, between 10 a.m. and 2 p.m., on four weekdays. Patients who need to enter the practice are screened in a vestibule that is already part of the practice building. Staff, wearing gloves and masks, take patients’ temperatures in that space before escorting them directly to an exam area.

Inside the practice, staff members sit a safe distance apart and take care to wipe down their keyboards and phones, she says. “So whenever you’re using a work station you clean it, and when you walk away you clean it.”

The practice provides curbside pick up as well for some items. At first there were plenty of eyeglass orders to deliver, she says, and the practice also does a lot of business in ocular nutrition. There is an online portal for patients to order supplies “and we bag it up for them and take their payment over the phone,” she says.

Myopia care presents its own challenges. The practice offers low-dose atropine, center-distance soft multifocal contact lenses and orthokeratology lenses. Just as the practice was reducing its access, two school-age children came in, Dr. Lowe says. There wasn’t time for an in-person visit to teach them how to insert and remove the lenses, so the parents opted for low-dose atropine until the practice can re-open. For now the practice will supply the drops and use telehealth technology to examine the eyes. “We can at least do something,” Dr. Lowe says.

Her current telehealth option is, a free service, she says. She’s also able to bill for some services with established patients, but that doesn’t help some retinal patients, including myopes and high myopes, that she has to see in person.

In the meantime, she has employees whom she needs and who need to know what’s going to happen to them. She has applied for funding through the Paycheck Protection Program, which would provide a loan that would be forgiven if most of the money goes toward payroll and insurance, or rent and utilities. “My goal has been to keep everyone gainfully employed” until that funding arrives, she says.

It’s hard to know when the practice can open again. Dr. Lowe has one staffer who sits in a back office and only handles rescheduling. “At first we said we’d schedule in May, but now we’re saying June and after,” she says.

When the practice does re-open, Dr. Lowe expects to be working full-time again in patient care. “We have to make up all this revenue,” she says.

Plus, the re-entry into a full-time business is going to be difficult. “Now everyone’s going to be fighting to recoup their share of the pie,” she says. Whenever she does re-open she is taking a clear-eyed view of that challenge. It doesn’t matter that she has been in practice for nearly three decades. “I’m just thinking, ‘I’m a cold start.’ It’s a new world so I’m a cold start.”

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