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Covid-19 toolkit
Reopening your dermatology practice
Tips and guidance on staying safe

As a healthcare professional, ensuring the well-being of your patients has always been your primary goal. As practices reopen, the safety of you, your staff, and your patients will remain the highest priority.

The following suggestions may help you adhere to the guidance from the American Medical Association (AMA) and American Academy of Dermatology (AAD) as you prepare to reopen your practice.
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First, consider the prevalence of COVID-19 in your community. The date that your practice can reopen will depend on the incidence of COVID-19 in your practice area/patient population, and whether that rate is increasing or decreasing.

Please consider the following steps when reopening your practice1

Step 1

The federal government has noted that a downward trajectory of documented cases over a 14-day period must occur before opening practices to elective visits and procedures. Consult with your local and state public health department for additional requirements. The AMA has developed a helpful chart summarizing each state’s directives on elective, non-urgent, or non-essential procedures.

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Step 2

Keep track of local and state public health department updates on transmission of COVID-19 cases. If cases begin to increase in your community, have a strategy in place to determine whether your practice will need to temporarily close or reduce services again.

Step 3

Have a plan in place for patients who present with COVID-19 symptoms and who may require testing. Identify testing locations in your area to where you can refer patients for testing, or refer patients to their primary care provider.

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Last updated 06/11/2020

You may be able to help reduce the spread of the virus by making some changes to your physical space.2

  • Clean and disinfect your entire practice every day before opening and regularly throughout the day
  • Re-organize your practice space to minimize patient contact and proximity
  • Place a sign on the front door to notify patients: “If you have had any respiratory symptoms in the past 14 days, please do not enter. Call and reschedule once the symptoms have passed.”
  • Provide multiple hand sanitizing stations in the waiting area along with receptacles
  • Remove magazines, TV remotes, bottled water, coffee machines, and any other items patients may touch from the reception area
  • Make sure bathrooms are stocked with soap and paper towels to support hand hygiene. Increase frequency of cleanings throughout the day
  • Place a sign in the reception area to educate patients on coughing/sneezing etiquette and other topics related to personal hygiene/safety
  • Consider having all team members complete OSHA Infection Control Training
  • Position air purifiers throughout the office to provide active sanitation against aerosols

To prepare your team, develop guidelines to identify if a patient is at high or low risk for serious COVID-19 infection. High-risk patients are those who tested positive for COVID-19 or who have one of the following:

  • A heart condition
  • A respiratory condition
  • Diabetes

High-risk patients may require your staff to use different personal protective equipment (PPE).3

The AAD has gathered evidence from dermatologists regarding skin manifestations of COVID-19. A summary of this evidence is available at AAD.org4

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Last updated 06/11/2020

Before your patients return to the office, let them know about the precautions you are taking. They may feel more at ease about coming in if they know what to expect when they arrive.

  • Consider sending a letter/email notifying patients of changes they may see, and anything they should be aware of before making an appointment
  • If possible, schedule appointments with enough time in between for minimal overlap of patients in the office

When confirming appointments with patients over the phone, mention your updated health screening practices. Also:

  • Inform patients that people accompanying adults should not wait in the reception area and that no food is allowed inside
  • Ask patients to wear a mask and to bring their own pen so they do not have to share
In addition to your normal screening questions, ask your patients if:
  • They have had a fever of ≥100.4° degrees in the past 14 days. (If the answer is “yes,” reschedule the appointment and refer the patient to their primary care provider for assessment)3
  • They have tested positive or been in close contact with someone who has tested positive for COVID-19 (If the answer is “yes,” reschedule unless the patient has an emergency need)
  • They will have traveled within 14 days of their appointment (If the answer is “yes,” reschedule unless the patient has an emergency need)5
  • Their health history has changed
  • There are any changes in their medication
  • They use tobacco or have diabetes
  • Their stress level is higher than normal
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Last updated 06/11/2020

Once patients enter the office, consider screening at the first point of contact for:

  • Fever ≥100.4°
  • Cough
  • Difficulty breathing
  • Flu-like symptoms
Reschedule if they exhibit any of these symptoms.

Also consider incorporating these precautionary steps in your routine:

  • When treating patients, your team should use PPE including N95 masks (which seal around the nose and mouth) plus full-face shields, safety glasses with side shields, gowns, and gloves6
  • Provide face masks for patients as well. If N95 masks are not available, surgical FDA-approved masks must be worn by each patient and not reused6
  • Do not perform any procedure without the minimally acceptable combination of a surgical mask and a full-face shield. If these are unavailable, refer the patient to a clinician who has the appropriate PPE3
  • Isolate high-risk patients while they wait for their appointment in an empty operatory or room2
  • Limit access within 6 feet of the evaluation/treatment area to the attending HCP and/or assistant6
  • Clean, disinfect, or discard surfaces, supplies, or equipment located within 6 feet of symptomatic patients3
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Last updated 06/11/2020

REFERENCES: 1. American Academy of Dermatology. Reopening your dermatology practice. https://www.aad.org/member/practice/coronavirus/reopening-your-dermatology-practice. Accessed May 18, 2020. 2. Cuny E, Ecklund K. COVID-19 Infection Control Protocols and Procedures Webinar; March 20, 2020; American Dental Association website. https://success.ada.org/en/practice-management/patients/digital-events/covid-19-infectioncontrol-protocols-and-procedures-webinar?utm_source=sucessadaorg&utm_medium=covid-resources-lp&utm_content=cv-safety-osapwebinar&utm_campaign=covid-19. Accessed April 22, 2020. 3. Centers for Disease Control and Prevention. Interim infection prevention and control guidance for dental settings during the COVID-19 response. https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html. Accessed April 22, 2020. 4. American Academy of Dermatology. Dermatological manifestations of COVID-19. https://www.aad.org/member/practice/coronavirus/clinical-guidance/dermatological-manifestations-covid-19. Accessed May 18, 2020. 5. Centers for Disease Control and Prevention. Returning from international travel. https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html. Accessed May 18, 2020. 6. The American Dental Association. Summary of ADA guidance during the COVID-19 crisis. https://success.ada.org/~/media/CPS/Files/COVID/COVID-19_Int_Guidance_Summary.pdf?utm_source=adaorg&utm_medium=covid-resources-lp&utm_content=cv-pm-summary-guidance&utm_campaign=covid-19. Accessed April 22, 2020.

Last updated 06/11/2020

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