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My Office Versus COVID

Zainab Abdurrahman

Last year, I proudly opened my own clinic with a colleague. We wanted to open a community-based centre of excellence in allergy and clinical immunology. It took us a long time to make our vision a reality. That reality is now at risk.

As with any new business we started small and are working on building our referral base and our practice. There are many steps or phases you expect to go through as a new business, which we had prepared for.  

Then the unexpected hit, a pandemic not quite out of nowhere but certainly out of left field. All of a sudden I was no longer working in a health-care system that I was familiar with. As physicians had to rapidly change the way we practice, most of us in the community moving to a nearly entirely virtual practice.  

As per public health recommendations, we were cancelling all our elective procedures such as allergy skin testing, food challenges, and drug challenges. Some patients decline virtual appointments as they think this situation will only last a few weeks while we are hearing about long term implications and reviewing new practice guidelines for working during a pandemic from our various societies.

Our number of patients started to drop significantly each day. We try to educate our patients and explain that this is not a short-term issue but rather a long-term situation. When restrictions are lifted we do not want to return to crowded waiting rooms and risk a second surge so I know we need to think creatively for when we have patients in office again.

We chose our clinic location based on the need of the community and the lack of similar specialists in the area. If our clinic is unable to weather this difficult time, then this will lead to even longer wait times for patients. As a full-service allergy clinic we also provide specialized testing focused on penicillin allergy and stinging insect anaphylaxis which is not always routinely available. Other clinic owners are in the same predicament and if a large number of clinics cannot remain open this will significantly impact patient care within and beyond our specialty. 

Then another blow hits, the codes we are billing for these telephone visits as of March 14 when released will NOT be able to be submitted and there is no date in sight. It seems the earliest time we will be paid is mid-June but fixed costs such as rent are paid monthly.

As a new business, we do not qualify for the government supports. So, with reduced patients, minimal patients eligible to come into the office, and being unable to bill the virtual patients we are seeing, we were forced to make difficult decisions. We are forced to reduce our staff, which is heartbreaking. 

We are doing our part to reduce community spread by not bringing patients into the office but with reduced patients and lack of remuneration this puts us in an awkward position. We are thankful that we did not get the anticipated surge in the last 1-2 weeks but this also means that we were not required by our hospitals to provide care on the front lines.  

So now like many others we are scrambling trying to find ways to be able to pay our rent, as it is likely we do not have any income coming in next month. At the end of this pandemic we need to still have offices to see patients and provide care but how can I do this without support from my provincial government?