Greetings From Wisconsin!

This is the first of a series looking at different practices of all sizes and locations, and how we are all dealing with issues during this pandemic. It’s modeled after the round table discussions during UR’s recent national videoconference.

By Mark E. Pearson, MD, FACR

We have a four physician practice in between Milwaukee and Madison WI. Recently we added a PA and also have an NP starting next week to help with infusions. We closed down March 16th completely for two weeks, using just telemedicine – doxy.me. Like most, we do not feel this is an adequate replacement for an office visit. When we did start back up, it was for new infusions only. We have limited PPE like most. We are finding that most of our infusion patients are flaring now, and we plan to open further May 4th. Our infusions have started to take over the office using various areas while continuing to practice proper distancing. At the same time, we plan to start back seeing patients, but only one, maybe two doctors at a time, and cutting our usual 20 plus patients/day to maybe 10 in order to practice distancing. We have a backlog of new patients who are being screened via telemedicine by our PA. We plan on seeing just those established patients that need a visit while trying to hold off on elderly and high-risk people as long as possible. Our lab will open to draw those people in for a visit or infusion. Elective lab visits will be drawn only at times that the docs are not seeing patients. We now have weekly meetings between departments – it’s impossible to plan further out.

We decided early on to keep all of our 25 employees on the payroll, even before the HHS funding came and the filing of our PPP application. We did not get our loan yet despite early filing and need the government to increase funding for Chase to make our payment. A significant benefit of keeping all of our staff was the loyalty that’s developed — everyone pitches in. Med techs are cleaning rooms, our x-ray tech is screening patients before they enter the building, our US tech is working at home due to her daycare closing, but she’s canceling and scheduling patient and lab appointments. Other staff are sitting near a displaced infusion patient that’s not in the direct vision of our infusion nurse anymore. We hope to grow back week by week as situations change. Other than a couple of secretaries to answer the phones, most of our front office is working from home. Another major benefit of having EMR that we didn’t anticipate!

Just recently, we started looking at our infusion patients with the hope of some benefiting from a medication change that would require less time in the office, such as Simponi-Aria instead of Remicade. Some may also benefit and welcome switching to an SQ at this time. With the help of United Rheumatology, we will continue to look for ways to improve our practice.

Mark E. Pearson, MD, FACR
West Suburban Center For Arthritis
Brookfield, WI
Member-Medical Policy Committee
United Rheumatology

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