Dear ones,

In recent weeks I’ve suggested that we face a “new normal” and are in a situation that requires a change of culture. Let me review what I am doing personally and what we plan to do here in our office in the weeks ahead.

As I confessed last week, though I would not have labeled myself necessarily as a germaphobe, I’ve certainly been conscious of the nature of my day to day exposures. Whether we like it or not, we all need to be conscious of places and things that allow for the spread of infectious particles. Objects that get frequently touched by more than one individual need to be understood for the risks they carry. Also, we need to differentiate between home, work and the public sphere and alter choices accordingly. My husband pointed out that we are not sterilizing surfaces in our house daily, and I pointed out that neither of us us has been worried about getting sick from the other. We isolate together and take the same precautions going outside the home. If one of us became ill that would change what we do. For the last two months, we’ve gone to work and met with the same two staff who themselves are isolating at home. At work we keep our distance from each other, disinfect the counters and doorknobs etc. daily and after every new visitor, and wear mask and gloves for each person coming through our door. For everything else outside our home, Jim and I go out with gloves and masks, and I stay conscious of what I have touched after I have touched something outside. Once home, I disinfect my car door handles and steering wheel. Mostly we just have to get into the habit of being mindful of what we touch, and what we contaminate before we wash up. Then we can make disinfecting afterwards a habit. There need to be levels of care we practice for ourselves, work and the public, and these practices need to become second nature. By the way, with Lysol still in short supply, remember that bleach and alcohol are both plentiful and effective in destroying virus-just watch where you actually slosh bleach and perhaps rely on alcohol to disinfect.

One big change for going forward will be how I dress for work. For many of you my habits may have made a more subtle impression; for others the difference may have been more obvious. However, what you might not have known is that how I present myself has been shaped by infection control! When I worked for other people prior to opening my practice, I wore the standard “white coat.” If you have only known me since I’ve been working for myself, you likely have NEVER seen me in a white lab coat. On one level, I always rejected the idea of the white coat as a status symbol and a marker of a hierarchy that suggested a power relationship where the person wearing the uniform is in control. This has always been counter to my philosophy of PARTNERING with my patients as an educator and adviser on health matters. But if it was more hygienic to wear a lab coat I would. The truth is, unless you work in an institutional setting where you are provided almost daily with a freshly laundered coat, the same coat worn day to day withOUT laundering becomes a disgusting carrier of germs, from one patient encounter to the next! So for me in private practice, it has made personal and professional sense to wear freshly laundered clothes as I see my daily patients.

Then there was the necktie issue. Most of you have never seen me in a tie, so it may come as a huge shock to know that I used to be a rather formal person. From the seventh grade on through my undergraduate years and then medical school and post graduate training, I wore a tie EVERY DAY. Yes, as a teenager. Yes, to daily classes at the University of Michigan (it was the 80’s, so many of the ties were skinny). I love my collection of ties. But when you are no longer wearing a white coat, leaning over to examine a patient risks a tie brushing up against the other person. There have been studies that found doctors’ ties to have as many germs as toilet seats! So once the white coat went out, so did the ties. To know me though is to know that I value art and fashion and self expression, and I’ve had a nice run “being me” and each day wearing an outfit (and sometimes a beard color) that reflected my mood, and hopefully made you happy or smile at times.

That all changes effective immediately. If I am to continue to serve your medical and aesthetic needs in face to face encounters, I now have to consider heightened infection control measures in the office, and how NOT to bring germs home with me from work. Not only will all of us here at Springer Wellness be wearing masks during all patient encounters, I too will now be wearing freshly laundered scrubs every day. On one level I regret giving up my individual presentation; but health is paramount and its a simple decision to wear a fresh daily uniform while infection control is the first order of business.

So Monday the 1st of June we will resume our normal hours: Monday and Tuesday from 8am to 5pm with a noon hour break; Wednesday and Friday straight thru from 8am to 1pm, and Thursday from 11am to 5PM. We will try to cluster aesthetic procedures on Thursdays, but ALL appointments can be had on any day with advanced scheduling.

Here is what will be different:

ALL SERVICES WILL BE STRICTLY BY APPOINTMENT, whether it is visiting me or getting a shot, blood draw or other treatment from Natalie. There are NO EXCEPTIONS and walk-ins will face a locked door. This is so that each person can be seen one at a time and proper disinfection of surfaces can happen between patient visits. In the past it was possible to ask “can I come by anytime this afternoon and get a shot?’ Or “can I come tomorrow morning for a blood draw,” and just wait a moment to be fit in with the scheduled appointments. This will no longer happen, and for your safety, you will need to pick an appointment time for these services. Walking up to the front office window to say “I was just in the neighborhood and…” won’t happen because the front door will be locked. Calling from the parking lot will not make your care “urgent” or get you scheduled any faster. Save yourself the trip and call.
Please arrive with your own protective gear in place, meaning a mask. Be aware that there is a kind of mask with a circular valve in it. This type of mask protects ONLY the wearer, not not other people, as the valve makes breathing easier by directing UNFILTERED air right out of the mask. If you use one of these, you will handed another mask to wear over it or instead of. We’re all in this together; let’s make infection control a two way street.
Please come for your appointment ALONE and have partners/drivers wait for you in the car. Also, schedule your appointment for when child care can be arranged.
When you arrive for your appointment, call us from your car. We will instruct when to come straight back to your treatment room. You will not have to touch any door handles except when coming out fo the bathroom.
If you need a cup of coffee simply ask for it; staff only should touch the coffee maker.
We are changing how we are handling medication refill appointments. During the last two months, we have simply refilled medications that have not required any discussion of changes without requiring a doctor’s visit. Going forward we will expedite refill needs in the following way: if you need refills of one or more controlled substances that require intermittent drug screens, we will arrange for your refills to be made and make an appointment for you to simply stop in for the urine specimen-no prolonged face to face contact necessary.
Where possible, we will be doing appointments by phone. These last two months have proved the efficiency for me and patients both of having phone contact. Some of you have known from even before this year that we can accomplish a lot by just sharing texted or emailed smartphone photos of rashes and bumps. However, what has often interfered with the phone appointments in the past was that they often got “bumped” by something urgent happening in the office with other patients. This has not occurred during April and May because there were no other patients in the office! Going forward I’d like to reserve two half days or ONLY phone appointments, perhaps half of Tuesday and the Friday morning. Give us your feedback if you have a preference for the days for this.
All our treatment rooms are now SINGLE PURPOSE. There is ONE “sick room” for seeing people that are not feeling well. There are two rooms for medical visits that do not involve infection. Our other aesthetic treatment rooms remain separate from our medical rooms and are single purpose. EVERY room will be carefully wiped down after EVERY patient, but you can rest assured that your non urgent medical or aesthetic treatment will occur in a room that has never seen the new virus. So Stay Calm And Botox!

Lastly, don’t be in any hurry to come back in to the office right now. Let’s balance need against risk and where possible err on the side of less contact. I have to say there is one new efficiency of “seeing” you remotely. Back in the olden days, when I had paper chart on my lap, I made near constant eye contact with you in the room while making chicken scratches at the paper. There were times where later even I did not know what I had written down. But maintaining eye contact was SO important for communicating that I really do CARE and that I really do HEAR you. For almost a decade now, it has been a kind of torture to have to look down at a computer while having a conversation with a patient in a room, yet it is unavoidable, as the only way to know if I was documenting correctly was to look at the screen. In contrast, with the phone visits I have discovered that talking with you all has been a real joy, in part because with you on speaker phone, I can LISTEN and really process what you are saying, but at the same time, I can look at the computer and be searching your medical record while you speak. My multitasking brain is very suited to looking at your chart while listening to you and interacting, but without the distraction of feeling obligated to make eye contact. It has been a weird “better” thing to come of the recent changes. And we surely oughta look for the little blessings and silver linings in all that has occurred.

Give us your thoughts on all of the above; be patient with us and yourselves as we all get used to the new way of doing things. Trust me, it will take less energy once certain things just become habit, and it will all be worth it if we develop routines that keep the new virus impact to a minimum. I want to ensure a future where I know that I can embrace and cuddle my grandchildren withOUT protective gear, and not have to worry that I’m putting them at risk because I work as a doctor. You too I’m sure do not want to question the safety of your family for having gone to work or out to run errands. Let’s all DO more so that ultimately we can worry LESS.

Stay safe, and always hugs (virtual for the foreseeable future).

Dr. Bob