Although the COVID era is often referred to as the “New Normal,” life in public with a mask and fearing personal contact will never be acceptable as “normal” for me. COVID will run its course, albeit on its own time. Still, for the duration of the pandemic, we must accept and take necessary precautions as we continue to care for our patients and be with our family and friends.

COVID is one of two life-changing upheavals — watershed moments — that I have experienced in both my professional and personal life. The other was Hurricane Katrina while I lived in New Orleans. Both of these events have taught me a lot about responding to an unexpected and life-changing event.

In this article, I will share with you how I responded to these events, the challenges that I faced in my practice, how I overcame them and the lessons I learned.

THINK CLEARLY IN A CRISIS

When faced with a crisis, try your best to think clearly, make a thoughtful decision and act swiftly on it. Thinking clearly is extremely difficult during a crisis, especially when you have suffered a great personal loss.

At the start of the COVID lockdown, on March 17, 2020, our practice in Long Island immediately furloughed a majority of the staff and doctors — I was notified that my office hours and surgeries had been cancelled. This swift and decisive move no doubt helped to keep the practice afloat.

When I worked in New Orleans, some of my patients died as a result of Hurricane Katrina; some employees were missing and presumed dead. The devastation to the city was tremendous. I realized that the New Orleans economy had crashed and would take years to recover, which turned out to be the case.

I had been doing primarily refractive surgery — an elective procedure — at my own laser center. We evacuated from the storm to a hotel room in Birmingham, Ala. From there, I closed the practice and laser center just 3 days after Katrina hit; I gave my employees good termination packages and closed the doors. It was important to avoid the paralysis of grief, to prevent waiting many weeks or months to close my practice. This would have been financially ruinous.

HAVE A PLAN TO DEAL WITH EMERGENCY PATIENTS

Whether you close your practice temporarily or permanently, you must have a plan to deal with emergency patients. At the start of the COVID pandemic, our practice’s youngest doctors were tapped to deal with vision-threatening emergencies. They were selected because it was feared that our older doctors were more at risk; these young doctors graciously stepped up to the plate.

Back in 2005, communication technology was much more primitive. After Hurricane Katrina, we set up a phone answering system that told my patients that the practice had closed and that they should go to an emergency room if they had a vision-threatening emergency. Back then, all medical records were still on paper. Later, I did my best to deal with my mold-ridden charts. My clinical practice office building was off limits for an extended period. Ten months later, only people wearing hazmat suits who would sign a waiver were permitted entry.

For months, I kept two employees on the payroll to help me copy and send record copies to patients who requested them. Eventually, I moved the charts to the Tulane Medical Center, where I had referred the bulk of my patients; Tulane kept the charts in a separate facility due to their condition.

UTILIZE TECHNOLOGY

In 2005, the technology didn’t exist for me to offer telemedicine visits to my patients after Hurricane Katrina, though that wouldn’t have prevented me from closing the office if it did; one cannot provide laser vision correction via telemedicine. However, our Long Island practice did set up a telemedicine system quickly after the COVID pandemic.

I participated, as we all did, and there was a schedule for the days one was assigned to telemedicine duty. As we continued to use telemedicine, I learned three things:

1. Our patients loved it.
2. Unless the procedures are efficiently developed, it is difficult to support financially.
3. The incredibly high quality of the images I saw from our patients’ smartphones or laptops was a revelation to me. I was able to diagnose more conditions than I had ever thought possible, thanks to modern digital device cameras — conjunctivitis, subconjunctival hemorrhages, episcleritis and even the larger abrasions, to name a few.

Other diagnoses could be inferred from the patient’s history, such as corneal graft rejection episodes. I have stopped doing telemedicine now that we are all pretty much back to a normal schedule, but it was a great way to stay in contact with my patients during the early phase of the pandemic.

THE PIVOT FROM IN-PERSON TO ONLINE MEETINGS

During the aftermath of Hurricane Katrina, which affected a swath of the South/Southeast, the meetings outside the affected zones continued as usual. During COVID, which affected the entire globe, technology platforms such as Zoom helped us to morph from in-person to online meetings.

At first it was strange; we all had to learn how to position our cameras, light our faces adequately, and mute/unmute our microphones at the appropriate times. These online meetings and educational vehicles provided an invaluable service: we continued to communicate with each other, to teach and to learn.

However, nothing will ever replace in-person meetings, with their innumerable opportunities to interact on a personal level with others. Having said that, online meetings and educational vehicles will not disappear. The savings in time and money are enormous; more meetings are actually possible, now that we can meet online — after clinical hours have ended — and with minimal expense. Going forward, we will have a hybrid existence: a mixture of in-person and online experiences.

IT HELPS TO HAVE A ‘SIDE HUSTLE’

Grandma was right; don’t put all your eggs in one basket. As ophthalmologists, our overarching concern is the health of our patients and our practice, but it helps to have another income stream. I was fortunate to be doing some consulting during the Katrina crisis; that definitely helped us, especially as I had to keep two employees for months (to wrap up the books and copy charts for patients) after the practice officially closed.

Some doctors invest in real estate, do voice overs for commercials or take an active role in their investments. If you have a side interest that could be profitable, consider developing it into a business. Plan B: Support your spouse’s efforts in this regard.

FINAL THOUGHTS

Don’t get too attached to your things; they may all be gone tomorrow. What matters is your health, your family and your friends. If you suffer a catastrophe and lose a lot of your possessions, you realize that the stuff wasn’t really that important.

Your home? It is where your spouse or partner is. Every day on this side of the grass is a gift, especially when you can continue to share it with the people you care about. OM

Marguerite McDonald, MD, FACS, is a cornea/refractive/cataract specialist with Ophthalmic Consultants of Long Island in Long Island, N.Y., and a clinical professor of ophthalmology at NYU Langone Medical Center in Manhattan and Tulane University Health Sciences Center in New Orleans.