Welcome to the Double Your Production podcast with the Team Training Institute, the one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it, who are in the trenches, who know exactly what you're going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.
Hey, podcasts listeners. This is Katie, your host, here with the Double Your Production podcast. We just wanted to give you a quick update amidst the chaos that's going on right now within our country and within the world and the dental industry. Wendy and Dr. John have been filming updates on their Facebook, whether it's live or Zoom daily, so there have been quite a few updates since this. This is the original recording that Wendy and Dr. John have done. It has a ton of good pointers, a ton of good information on how to go from panic to prosperity, what to do now during this time of the COVID-19 virus. So I wanted to just give you that intro and let you know that all of those videos are available on our Facebook page. So if you look up the Team Training Institute on Facebook or if you head to our podcast homepage, the www.theteamtraininginstitute.com/podcast. I will put a link to that Facebook page there as well. So hopefully you find this information awesome and helpful. Let us know. Give us some feedback on what's going on in your area and how we can better help assist you during this crisis. So here is Dr. John. Thanks.
Hey everybody, this is Dr. John Meis from the Team Training Institute, and we are going to do a series of recording and communications about COVID-19. So we want to be looking at the strategies from panic to prosperity. So each day we'll have the latest information and we'll also be talking about different strategies on how to manage this crisis. So the information is rapidly evolving, and every few hours we get more information. We get more and different recommendations, and so this video will be out of date very, very quickly. I can promise you that, which is why we're going to do it daily so that we keep everybody informed. So the dental organizations are a pretty good source. The American Dental Association recommended yesterday that all dental practices do only emergency service for the next three weeks. The state dental associations have followed suit. The state dental boards have not necessarily followed suit. So some have. Some haven't. But these are good resources for recommendations. The ADA has a good frequently asked question website that you can find by going to ada.org. Check with your dental board and make sure that you're compliant with the state.
So the disease, let's talk about that for a bit. And the big thing is that much unknown. We just don't know everything we need to know about this disease. The lack of test kits, particularly in the United States, has given us a very confusing picture. Because of the lack of test kits, the only people that are getting tested are those people who are very, very sick or have passed away. So we really don't know a lot about the disease. Some of the things that we would like to know is, are there asymptomatic infections? There probably are. There are with most viral infections. And so are there people walking around who feel good that are passing the disease to others? We don't know for sure, but probably so. We don't know the difference between the onset of virility, meaning the onset of when you can pass it to someone else, and the onset of symptoms. So it's possible that we can be spreading it for days or weeks before we have any symptoms of the disease, which leads to greater spread, of course. The mortality rate, we have no idea. But if we look at other countries, countries that have tested far better than the United States, the range is still quite large, 0.1 to as much as 4 percent in a general population. So this may be worse than the seasonal flu. It's really yet unknown, but it may be. The seasonal flu is bad enough. So looking at what happened in China, so in the city of Hubei, the cases started picking up, the grey bars. You can see the disease has been around a while. December 8th is the first time, in retrospect in looking at it, that the disease was there, but it really didn't take hold until mid-January, and then it was a very rapid ascent and then a very rapid decline. And from the beginning of the ascent to kind of the end of the decline was about four weeks. So here is some of the things that we can see. Here's another graph that shows what's happening in China. We can see mid-February we started to see cases in other parts of the world. We can see it was up and down in China. So we know now that there is very little coronavirus in China, and there are people who are traveling there or trying to travel there in order to have the relative safety there. So from start to finish in Hubei, the length of the contagion was about four weeks, and there were 3,216 deaths in the entire country of China. So just as a reminder, there's 1.36 billion people there and 3,200 deaths.
I mentioned the flu earlier. The flu is no small threat. Last year was a particularly bad year. The flu vaccines did not match the flus that came through, and 61 thousand people passed away last year from the flu. As of this morning, there's been 85 that have passed away from coronavirus so far. One of the challenges that we have is that human brains think linearly, not exponentially. But we can see by the graphs that it's an exponential, not a linear growth. So this is the number of new cases of coronavirus and with China excluded. And the kind of turquoise-ish bar is Iran, and the reddish bar is Italy, so two of the hardest-hit places. And you can see Iran continues to have exponential growth in the number of new cases. Italy, it's stabled off. So there's not that many new cases. So on the bottom right hand of this graph, the orange represents the United States. So it looks as though there's not exponential growth in new cases, but we frankly don't know because we're not testing enough people, and we're only testing the very sickest and those that have passed away. So we don't really know what it looks like in this country. From this graph, it doesn't look like we're having the exponential growth in other places, but that very well may be related to the fact that we're not testing enough people. So despite the picture, this is what we're seeing in the media. 1.7 million dead. This one says 480 thousand Americans would be killed. So if this virus does spread exponentially and act in the way that these people think it might, it will be a very devastating blow. We just don't know. And logic is useless when the world is in panic, right, because people, our patients, our teams are going to react in a way that is aligned with what they're seeing on television and what they're hearing in the media and what they're seeing on social media, etc.
So we have two options, really, see patients or don't see patients. See patients, we have a decision about what kind of care to provide. Now, if your state has mandated a certain kind of thing, you obviously have to follow that to be in compliance with state law. So if you're going to be open, and if you're not going to be open, same thing. Prepare a frequently asked question list. So write down every question that you're getting from patients and team and script out the answers. That way you can have a united and consistent message for your patients, a consistent message for your teams. And this doesn't take long to do and can be adjusted as more information is gained. In fact, you probably should refresh the FAQ list every day because the information is changing so very rapidly. If you're going to be open, another strategy is to screen patients when doing appointment reminders. So when calling patients to remind them of their appointment, you may want to ask some questions. So the CDC has recommended these. That is, "Have you traveled internationally in the last 15 days? Have you come in contact with anyone who has tested positive for coronavirus? And then do you have cold and respiratory flu or fever in the last 14 days?" Those are great screening questions. Anybody who answers yes to any of those, obviously we're going to reschedule them for at least two weeks in the future. If the answer is yes, here we go. Reschedule the patient at least 14 days. We're going to be asking those same questions of our team, obviously, right? And if the answer is yes to any of those, the team member should not report to the office. They'll work from home if they feel well enough, but they shouldn't report to the office for 14 days. Best practices, everyone washes or sanitizes their hands as they enter the office, patients and team both. Each person's temperature is taken. If over 91.1, consider delaying treatment or sending the employee home. Now obviously if you have a patient that has acute infection, having a elevated temperature would be normal for that, and so that's not necessarily a sign that they are suffering from coronavirus or another flu. It could be related to the dental infection. So we want to make sure that we clean not only our [office?], but clean the waiting room surface, doorknobs, handles, etc. between patients to minimize the chance of spread from one person to the next. Let's remove all the magazines, toys, and patient entertainment items. Those are places that could get contaminated and spread this disease. It appears as though the disease does not last very long on surfaces, though, which is a very good thing. The last I read was about three hours on a surface that the virus becomes inactive. So consider having a virtual waiting room where patients come into the office, they are screened with the questions, their temperature is taken, and if they're fine to have their appointment, you send them back to their car and text them when you're ready to take them directly to the team treatment room. That keeps from having a pooling of patients in the waiting room.
Next thing to remember is we got to be flexible with the schedule, right? It's going to be chaotic. We're going to have a lot of cancellations. We're going to have a lot of fails, and you're just going to have to be flexible. And those of you who are schedule watchers, this is a good opportunity to get over that. It's highly distractive to productivity in general, but particularly now in this very chaotic time. So mastering the phones, if you are open and if you are seeing patients after your screening questions, the great question is, "How soon can you get here?" Most practices will have significant open time, significant excess capacity, and so we would want to get people in there now to take care of their care now that we have all this excess capacity. And second question I would ask, as always, is, "Is there anyone else in your family that needs an appointment?" When we have patients that are in the office that have dental care aids, right, we want to maximize same-day treatment. So if anything is diagnosed in hygiene, any restorative treatment is diagnosed, or any hygiene treatment, any preventive treatment or [for all?] treatment, we're going to start that same day. We're going to take advantage of everything that's in our office every single day. We have someone comes in that needs restorative treatment and also is overdue for hygiene, we're obviously going to see if we can get hygiene taken care of that day. So maximize everything that comes in. Rescale out as little as you possibly can in order to use your capacity as best as possible. So team members may be protected from any kind of discipline or being fired if they refuse to come to work because they feel it's not safe. So if you have a situation like that, make sure you get competent legal advice. Call your HR consultant or your HR attorney to identify what's legal in your state and your locality. The laws vary dramatically from place to place. And so if you're running into these issues, make sure you [get?] legal advice before you make decisions.
So if you're going to be closed, inform team members with as much information as you can. It's going to be confusing to them, and the picture is going to be changing rapidly. And so make sure that you tell them what you can, but frankly, there's so much that's unknown. There is going to be limited information. Obviously, some office functions can continue even if you're not seeing patients. You can work on rescheduling the patients that you had scheduled. You can be working on a [inaudible], so the ones that I would focus on would be reactivation and recall so that when this three-week period passes, that we are ready to go. And obviously, all the revenue cycle activity, so making sure that we're following up on insurance claims, making sure that we are depositing checks and keeping people's accounts up to date. That activity can go on. But this is a great time for training, and so coming up with things that aren't working in the office and train. If technology allows, much of that can be done from home. Now, some of the video conferencing sites are suffering from the amount of volume, and so the video technology sites are a little bit spotty right now, but I think that'll level out over the next few days. So training, training, training. This is a great time to do it. And of course our Team Training Institute members have access to our online learning system, and this is a great time to look through what's there and decide what is going to be the biggest bang for the buck for your team to get training done. So you can, as an employer, require employees to work from home, but if we have anything going on with questions about compensation, vacation, [inaudible]. Like I said, get competent legal advice as the laws vary dramatically from place to place.
So we are going to have daily, not Monday, Wednesday, Friday updates. We're going to have daily updates through this COVID-19 crisis. Our next one is going to be-- our next update will be the current information that has come about today. So tomorrow, we will send out another opportunity to get the update, and we'll also talk about the first step of our financial survival toolkit. How do we manage cash flow disruption that most practices are going to have? And then later in the week and early next week, we're going to be talking about strategies to accelerate our ramp back up so that we go from crisis to prosperity. So I hope this was helpful for everybody, and we're all going to get through this, and money's not disappeared from the world. People have money. People have dental needs. This is a minor disruption, and when the disruption is over, we want to be prepared to take advantage of the uptick in demand that's going to happen when this passes. And so let's get prepared for that. Let's do what we can to make the best of the situation now, and let's work on getting prepared for the ramp back up. Thanks, everyone.
