Are you still seeing patients?
Here are some tips on what your staff should say during the COVID-19 pandemic

No matter the procedures they need, every patient is likely concerned about visiting a healthcare provider's office. Communication is key to ensuring your patients remain committed to your practice during and after the pandemic. Your staff members can use the following suggested scripts and talking points when communicating with patients about COVID-19 concerns.

Appointment Confirmation: Confirming patient appointments presents an opportunity for assuring patients of your practice's dedication to cleanliness guidelines and for an informal screening to help ensure sick patients do not arrive at the practice.

If patient answers:
Good morning/afternoon, [insert patient name], this is Dr. ____'s office confirming your appointment for [insert date and time].

• We are getting everything ready for your appointment, which includes taking additional precautions with our cleaning routines to keep you safe during the coronavirus disease outbreak. We are also conducting patient screenings before and during appointments, which includes asking additional health questions and taking your temperature.
• How have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Do you have any concerns to share with the doctor before your visit?
  
  [If patient describes flu-like or COVID-19 symptoms]
• I hope you feel better soon. Why don't we reschedule your appointment for a later date?
  [Reschedule appointment at one month later to ensure two weeks have passed after their symptoms end.]

If leaving a recorded message/recording automated message:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• To protect our patients and staff during the new coronavirus outbreak, we are taking additional precautions to keep you safe. This includes being more aggressive with daily cleaning in the waiting and clinical areas. If you are experiencing symptoms such as fever, coughing, shortness of breath or body aches, please reschedule your appointment for at least two weeks after your symptoms end. You will not be charged a cancellation fee for any appointments canceled due to illness until further notice. We are monitoring the situation at the national and local levels, and we will keep you updated with any changes.

If confirming an appointment rescheduled due to illness and patient answers:

• I know we rescheduled your last appointment because you were feeling ill. How have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Do you have any concerns to share with the doctor before your visit?
  
  [If patient describes flu-like or COVID-19 symptoms]
  I hope you feel better soon. Why don’t we reschedule your appointment for a later date?
  [Reschedule appointment at one month later to ensure two weeks have passed after their symptoms end.]

If confirming an appointment reschedule due to illness and leaving recording message:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• To protect our patients and staff, we are taking additional precautions during the coronavirus outbreak. This includes being more aggressive with daily cleaning in the waiting and clinical areas. If you are experiencing symptoms such as fever, coughing, shortness of breath or body aches, please reschedule your appointment at least two weeks after your symptoms end. You will not be charged a cancellation fee for any appointments canceled due to illness until further notice. We are monitoring the situation at the national and local levels, and we will keep you updated with any changes.

In the office – Consider screening patients upon arrival by taking their temperature and asking if they have experienced fever, cough, shortness of breath or body aches. Attempt to screen them before they sit down in the chair. {Some practices are doing curbside or parking lot screening to reduce exposure to other patients}. If they have a fever, reschedule the appointment and sanitize anything they came in contact with. Consider mentioning this in your phone calls so they won’t be surprised by this additional step.

In waiting area (have a nurse stationed to assist with patient check in):
Good morning/afternoon, how have you been feeling? Within the last 14 days, have you experienced a fever? Cough? Shortness of breath? Let's go ahead and take your temperature. Do you have any concerns to share with the doctor before your visit?

• [If patient appears ill]
  • Be empathetic. "Are you feeling okay?"
    • If they mention they have experienced symptoms or if they have a temperature, ask them to reschedule their appointment with no penalty.

Appointment follow-up – Patients may be contagious before they present with symptoms. These patients may be harder to track down. Use patient follow-up to find out if they were satisfied with their appointment and to check on their coronavirus status.

If patient answers:
Good morning/afternoon, this is Dr. _____'s office following up on your appointment with us on [insert date/time].

• Was everything to your satisfaction? [pause for response] How are you feeling? Have you experienced any fever, cough, shortness of breath or body aches since leaving our office?

[If they have experienced symptoms]

• I hope you feel better soon. Have you visited a doctor about your symptoms? What did they say?

[If no symptoms]

• Wonderful. We look forward to seeing you next time. Have a great day!

If leaving a message/automated system:
"Good morning/afternoon, [insert patient name]. This is Dr. ____'s office confirming your appointment for [insert date and time].

• We hope everything was to your satisfaction. Since leaving our office, if you have experienced any fever, cough, shortness of breath or body aches, or been diagnosed with any illness by a doctor, please call our office back at xxx.xxx.xxxx and let us know so we can keep our patients and staff safe. We look forward to seeing you next time. Have a great day!

Talking points to help you answer potential questions before, during and after appointments

• Are you cleaning the office more than usual? Has the waiting room been cleaned lately]
  • Before the outbreak began, we cleaned our waiting area every night. Now, we're even cleaning it through out the day and paying special attention to wiping down chairs, armrests, and the coffee station and other things patients frequently touch.
    *This could change practice by practice. Please adjust according to your unique cleaning practices.
• Have any of your patients tested positive for the coronavirus?
  • If you have had a positive case: "We did have a positive case, and the office has been thoroughly disinfected, local health authorities contacted and we are following their guidelines, and other patients alerted who visited on the same day."
  • If you have not had a positive case: We have not. We are screening each patient before treating them. If anyone tests positive for the virus in our office, we will follow WHO guidelines, which could include entering quarantine.
• Do any of your staff members have the virus? Are any of them sick?
  • No staff member presently in the office is ill and, as a rule, if a staff member is ever ill, we require that individual to stay home, in keeping with WHO guidelines. Now, we’re being especially careful and recommending that anyone with fever, cough, shortness of breath or body aches and chills sees their doctor as soon as possible and stays home for the WHO-recommended time, which could be up to 14 days after symptoms subside.
• My kids are sick, but I'm not. Can I still come in? OR I'm sick but my kids aren't, and they have an appointment.
  • Out of an abundance of caution to protect the welfare of patients and staff, we would prefer to reschedule your and/or your children's appointments. Thanks so much for your understanding. When are you available in one month?
• How do you know what's going on?
  • We are monitoring the situation locally and nationally. We will strictly follow WHO guidelines to keep you and our employees healthy.

If your office must close because of local outbreaks or other WHO guidance, let patients know via email, social and phone calls.
Automated message:

Good morning/afternoon, this is Dr. ____'s office.

• We are calling to let you know that due to local outbreaks of COVID-19, the disease caused by the new coronavirus, our office will close until [insert date], at which point we will look at the local situation and evaluate reopening or extending our closure. Thank you for patience and understanding. We hope you and your family and friends stay healthy and safe during this outbreak.

Additional recommendations:

• Quarantine cities and towns may require additional or altered talking points and actions. WHO guidance should be considered to supercede these recommendations.
• Recommend adding sign to door: PLEASE STOP. To protect everyone’s health, please do not enter this office if you are experiencing fever, cough, shortness of breath or body aches. You will not be charged for missed appointments due to illness. Simply call the main office number [XXX.XXXX] to reschedule. Stay healthy and safe!
• Recommend no cancellation penalties due to any illness until further notice.
• Include COVID-19 screening questionnaires as part of paperwork to be filled out in waiting area. Ensure the questionnaire meets all HIPAA requirements.
• Remove pens from office so patients are encouraged to use their own. Provide one if asked.
• Remove magazines and toys from the waiting area. If patients ask why, let them know it's to prevent the spread of germs during the outbreak. The toys and reading materials will be sanitized and returned once it's safe to do so.
• Spread out the chairs or remove some so they are farther apart.
• Recommend doctors send email and social media messages that outline more aggressive cleaning methods during the outbreak.
• If a patient asks whether the doctor can spare any masks for personal use, recommend replying as follows: I'm sorry, but at the urging of the WHO, protective masks are only for use by health care professionals and those who are ill or caring for the ill.

For additional guidance, consult the World Health Organization World Health Organization and the Henry Schein Education Center