Practicing Dentistry in a Quarantine Economy

I recently spoke with Dr. Gerry Curatola, a dentist, wellness expert, entrepreneur, author, and international speaker on my Small Business Edge podcast. Dr. Curatola and I talked about his experience running a dental practice and an entrepreneurial company during a global pandemic. He also gave a stern warning about the unhealthy lifestyles of Americans and some advice on how we can change our ways. Below are excerpts from our podcast show.

Brian Moran: What has it been like to run a dental practice in the epicenter of a global pandemic?

Gerry Curatola: There are aspects of dental practices that obviously require the patient; the mechanical aspect of dentistry. Every dentist is dealing with 95-100% drop off in seeing patients only in an emergency. However, over the last two years we have been practicing something called tele dentistry or telemedicine; virtual consults with patients. For example, we see a lot of problems with people's ability to breathe (and COVID-19 is a respiratory virus). We are sending patients a disposable home sleep study that connects to their iPhone or Android device, and uploads to the cloud. We get their results and then design and make appliances for them based on the study’s results. We also do video calls with patients which has grown tremendously even before the pandemic. I would take a day out of my office every week just to do teleconferencing.

In Dentistry, much of the information we obtain diagnostically is on a digital format. It enables us to discuss and share online in a safe, HIPAA compliant platform with the patient. Given that most state governments have deemed us to be operational up to a point because we have to be available for emergency patients and to provide essential dental services, we are helping to keep patients from going to an emergency room, which is the last place they want to go.

Brian: The home study that you just spoke about checks on and monitors a patient’s respiratory breathing; did you start it as a result of the Coronavirus or was it something you had been doing in your practice?

Gerry: We started doing home studies several years ago. When sleep apnea started to be much more actively diagnosed, we realized that it puts patients at risk for heart attack, stroke, sudden death, dementia, hypertension, diabetes and many other diseases and chronic conditions.

When I hear about younger, perfectly healthy people dying from COVID-19, I know that they probably had an undiagnosed disease. The disposable home sleep study, which costs a few hundred dollars, came out a few months before the coronavirus hit. We saw it back then as an opportunity to measure a patient’s heart rate, blood saturation, respiratory rate, how many times they stop breathing, what their breathing is like, and how much they are snoring. It gives us an accurate picture of their airway health which is critical for a respiratory virus like COVID-19.

Brian: Other than the sleep study, what have you done to help your business in the last two months?

Gerry: It is important for businesses to stay in touch with their clients right now. Every week I reach out to my patients just to connect with them. People need encouragement. Our patients want to know that we are ok, that we are for them in case they need us. We reassure them that we are maintaining a healthy, sterile environment in the event they need to come see us.

The coronavirus pandemic will be the catalyst for a new normal in healthcare industry – which will make things better. For example, we have UV filters on our centralized air systems. We have ionized positive pressure air in the operating rooms. We have been doing these things long before the current pandemic, and we will elevate our safety conditions to an even higher level now because the safety of our employees and patients is paramount in our practice.

Brian: Your response brings up several questions – and possibly a whole new podcast. Is the cost of the additional safety equipment expensive? Do you finance the purchases? And do you think what you are doing new will be the standard for most, if not all industries in a post COVID-19 world?

Gerry: As we adjust to the new normal, we need to actively look at how to create the safest environment in healthcare offices, especially dentists who create a lot of dental and respiratory aerosols in the treatment rooms.

There is good equipment that many dentists will need and are currently not aware of mainly because they didn’t need to be…this will change. The equipment ranges from more use of UV-C light to sanitize personal items and personal protection equipment like N-95 masks, better air filtration systems, and equipment that can create more positive pressure in treatment rooms that prevents the spread of viruses, bacteria and other heavy metal vapors. The equipment cost ranges from a few hundred dollars for the UV-C light boxes to $1500-$5000 per treatment room for the air filtration systems and installed air ionization systems.

I see a need for “Respiratory Pathogen Protection Equipment Packages” in a post COVID-19 world in addition to the standard sterilization, and these packages will need to be financed to be affordable to the dentist. The costs will probably be passed onto the patient for the dentist to recoup this necessary investment. It happened after the HIV/AIDS crisis when a nominal "OSHA fee” was added to the patient visit to cover the costs of additional personal protection equipment (PPE) at that time. But that virus transmitted as blood-borne; COVID-19 is respiratory inhalation which is a whole different story.

Brian: Looking at COVID-19, is there anything that you wish that you knew in January that you know now?

Gerry: The biggest thing that I wish I knew in January was more emergency preparedness. I would have had a greater stock of personal protection equipment. There are vulnerabilities when you are not prepared. My brother always says, “Prepare for the worst, and pray for the best.”

Brian: Great advice from your brother, and from you Gerry. Thanks for your time today and we look forward to talking with you again later this year.

You can listen to the full podcast here.

Brian Moran, Small Business Edge and Pitney Bowes content contributor

Back to The Way Forward for Small Business content