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How to Decide to Return to In-Person Care

Updated: Jun 27, 2020

This post was originally published on SimplePractice's blog and is reposted with permission from author Dr. Ben Caldwell. If you would like 2 free months of SimplePractice please look at our partnership page here.

Even with stay-at-home orders in place, a wide variety of healthcare workers have been deemed “essential workers” and are allowed to work from their offices—depending on their state and city regulations, of course. 

But as governors around the country prepare to ease stay-at-home orders, health and wellness professionals are facing difficult choices about returning to in-person care. As some practitioners are starting to be allowed to offer in-person care again, many have chosen to stick with telehealth sessions instead.

Should You Start Offering In-Person Appointments Again?

It was a difficult choice for many practitioners to close their (physical) doors, but deciding when to return poses an even greater challenge. And it’s a decision that will have to be made by each and every practitioner. As you try to decide when you’re ready to welcome clients back to your office, here are four factors to consider.

1. Your Risk Factors

Right now, age and health are the two identified risk factors for complications from COVID-19—the disease caused by a coronavirus infection. However, there’s no age or health category that’s risk-free. You should not only consider your own age and health, but also the age and health of those you make regular contact with. 

People who have coronavirus may be symptom-free even while they’re contagious. Just because you or your clients are not presently experiencing symptoms does not mean that you can be sure you’re not carrying—and transmitting—the virus. 

If you believe you’ve been exposed or are feeling sick, you shouldn’t take the risk of potentially exposing your clients, colleagues, and others. The CDC recommends self-monitoring, self-quarantine, or self-isolation—depending on the nature of your known exposure. 

2. Your Clients’ Wellbeing

Who you work with matters as well. If your clients want telehealth and can be effectively served via telehealth, that should help you sustain your practice without opening your clients to unnecessary risk. However, you may find it challenging to maintain virtual sessions with some clients—either because of their age, their specific symptoms, the technology available to them, or other reasons. 

Consider who your clients come in contact with. If they’re regularly in contact with high-risk individuals, then it may not be the right time to return to in-person care just yet.

Of course, reopening your office to clients doesn’t necessarily mean reopening your office to all clients. You may choose to initially limit in-person client contact to only individuals who can’t be served via telehealth for whatever reason.

3. Your Physical Space

It’s worth considering what your space allows in terms of both physical distancing and contact with shared surfaces. An individual practice in a larger office may be able to hold enough space between client and provider to reduce any risk of transmission. You can also stagger appointments to allow more time to clean any shared surfaces between appointments.

On the other hand, if your office space has a shared waiting area, small rooms, recirculated air, or other limiting factors, it can increase the likelihood of transmission. If your office space doesn’t allow you to use best practices, you may want to be more cautious about reopening. 

When you are ready to reopen, the CDC offers resources for businesses, including guidance for reducing infection risk in workspaces. It may also be useful to review the CDC guidelines for community facilities.

4. Your Community

As states and communities progress toward the designated milestones for reopening their economies, keep in mind that not every community will be moving at the same pace.  Just because in-person practice is technically allowed where you live and work doesn’t necessarily mean that it’s the right move for your practice. Part of your assessment may include community factors like population density and community norms, as assessed by what other providers are doing.

Ultimately, each practice will need to determine on its own when the conditions are right to reopen and at what pace. In addition to reviewing the most recent guidance from health officials, you may want to consult with your commercial landlord, your liability insurance provider, your co-workers, and your clients.

SimplePractice customers can access the COVID-19 screening questionnaire in their note template library to begin screening clients who would like to resume in-person care


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