I’m with you. 💙The world is changing literally hour over hour. It feels like everyone is scrambling to figure out how to respond in this crisis - personally, physically, professionally.
I’m writing this from our Rupa HQ* here in San Francisco - one of the first areas in the US to rush to sweeping action in response to the outbreak. As of today, March 15, 2020 - almost all tech companies are working from home, schools are closed (Stanford, my alma mater, moved classes virtual over a week ago). The city is deserted, many people are out of work / a job, and the 2nd and 3rd order effects of self-quarantine are starting to be felt around the city.
Here’s the thing - we (the community, your patients, the world) need you more than ever right now. You, our trusted healthcare practitioners, are a source of stability for us in this truly chaotic time.
Our goal with Rupa is to support you in running your practice, so you can do what you do best - taking care of patients. I took some time this weekend to read, listen, and observe what’s happening in the world around us, so we can understand how to best respond in our world (the functional and integrative medicine world). My hope is that this post is practical and useful for you as you navigate the next few months. Here we go! :)
Here’s what you can expect over the next few months (or more).
- Telemedicine is not a nice to have - it’s a necessity for survival in this time.
- An epidemic of stress, anxiety, and loneliness will hit the globe.
- Learning to create community and build trust virtually will be imperative.
- The increased stress, anxiety, loneliness, social isolation will have negative downstream health consequences - creating and exacerbating chronic conditions.
- Patients are going to continue booking appointments, even in an economic downturn. Chronic and lifestyle based illnesses are not going away anytime soon (unfortunately) - and the patients who need it the most will still need your help.
- Patients will increasingly seek your “quick” advice outside of visits (social media, email, text, phone call, etc) on things like immunity, protection, testing, health support.
The silver lining in all of the chaos and devastation in the world right now - is that you, as integrative healthcare practitioners, have a unique opportunity to step up right now.
This is the time to build trust with your patients, create community digitally with your team, and stay sane & healthy yourself. Here’s how to do that, and come out even stronger on the other end.
Part 1: Taking Care of Your Patients
- The basic tools you need: Zoom, Google Drive, Rupa :)
- If you’re not using an EMR that has this built in, you can easily set up a system in 10 mins or less - I recommend using Zoom & Google Calendar. If you do this, you can add the zoom chrome plugin to create a video meeting with one link in google calendar.
- Important Tips: When moving to virtual & working from home, it’s tempting to turn off video and do a voice call in your PJs. This is a MISTAKE. Always turn on your video - not just voice. This is especially critical in times of social isolation, where people are craving face-to-face connection.
- Lighting can make a big difference - try to face a window so the light comes on your face and you’re not backlit.
- As tempting as it can be to take notes during the visit - try to at least begin and end the visit with human connection & talking to the patient directly, without distraction.
- Small things like text messaging / checking in can make a huge difference. People remember those who were there for them in times of need.
Over-Index on Emotional & Spiritual Health
Chances are, most physician advice is focusing on physical health right now with this highly contagious infectious disease gaining momentum (rightfully so). You, however, are uniquely trained to care for patient’s emotional & spiritual health. Do this.
Spend more time talking to patients about the things affecting them the most right now:
- Stress and Anxiety - How are you feeling in response to this outbreak?
- Social Isolation & Relationships - What is it like working from home with your family?
- Change in Daily Routine - What does the shift feel like? How does this affect your meals & nutrition?
- Immune System - How are you supporting your immune system? What supplements are you on?
- Movement - How is decreased movement affecting your mental health?
- Taking Care of Loved Ones - Who are you responsible for and how can I support you with that?
If you haven’t done so already, send patients an email about COVID-19. They want to hear from you. Here’s an example outline you can use:
- Personal words & how you’re feeling & doing. What steps you have taken to stay safe and healthy. (Patients want to know what you are doing!)
- Resources & links to trusted information about COVID-19 (email me at email@example.com if you need a list here. I can forward a great email I received.)
- A link to supplements & other products you recommend during this time.
- A link to sign up to your virtual office hours (see below).
- Signing off with a (non staged) photo of you - selfies are great because they come across as personal and authentic.
Virtual Office Hours: Send your patients a message that you are hosting a virtual office hours where they can ask you questions live. This doesn’t need to be staged or planned - the more casual and authentic - the better! It can be a simple zoom call or google hangout that others can join.
Here’s the steps to take to get it done:
- Prep: Send a note in your COVID-19 email (above), post on social media, and message individual patients you know would want this. Pro Tip: Ask for questions beforehand and also seed some questions (have your own list) so you can go through them.
- Use: Zoom or google hangouts. Record the office hours. Make it as causal as possible. You don’t need to have answers to everything - it’s ok to say “I don’t know, I will look into it.” to questions!
- Follow Up: Follow up with an email with what was discussed & a copy of the recording. Host another one if more people are interested or as the situation unfolds in the upcoming weeks.
Pro Tip: As you’re doing more telehealth - these virtual office hours are something you can actually do on a weekly or biweekly basis. If you offer packages or a membership, it’s a great perk to add in, and doesn’t need to take more than 1 hr total (including admin time) per week!
Part 2: Taking Care of Your Team
(note: this section is mainly for small & medium size clinics, but can be helpful if you have a team of 2 or 3!)
So much can get lost in moving from in person communication to digital. There’s a TON written on this (google or go to Medium!) but the best advice?
Video Chat > Phone > Text > Email.
Avoid email as much as possible. If you don’t already have an internal communication tool, use Slack. It’s what we all use over here in SF! And it’s free :). Here’s their resources for remote work as well.
As mentioned, there’s an epidemic of stress, anxiety, and uncertainty. People are not only worried about their health, they are worried about their paycheck and livelihood as well. Here’s what you need to do: communicate transparently - even if it’s bad news.
The worst thing is not knowing & living with uncertainty. Eliminate the fear in your staff & teammates by telling them exactly what is going on. e.g. “We will be out of the office for the next 1 month, and then it is TBD. We will be paying 1/2 time salary during this time.”
It can be painful short term, but better in the long run and builds trust amongst your team.
Set Clear Expectations
When working remotely - the line between work and life can blur. This is ok & don’t fight it. It will happen, especially if schools are out and your teammate is juggling work with making sure her kids are taken care of. Here’s what to do instead: be clear about what the rules are. e.g. “We’re online from 9AM - 2PM, then can be in and out of work - as long as we get our work done, and then close out with a daily sync in the evening at 6.” People operate well with structure - let your team know how they can be successful while working remote.
One important thing we do at Rupa is set check-in times with our team. We call this “daily stand-up” in the tech world. It can be as simple as a slack message (see above) or phone call with answers to these questions:
- What’s on my docket for today? What do I want to get done / what’s on my calendar.
- What’s blocking me from getting this done?
- Is there anything I need help with? (If so, ask for it)
We do a morning standup, communicate via slack throughout the day, jump on video calls when we need them, and set 30 minute weekly 1:1 times for us to catch up with one another 1 on 1 via zoom video.
Part 3: Taking Care of Yourself
This is possibly the most important list on here. You can’t take care of others without taking care of yourself first - you know this!! :) Here are my quick tips.
Socialize: FaceTime Coffee / Lunch with Friends
During this period of self-quarantine, I’m scheduling FaceTime catch ups with friends where we both grab a cup of coffee or lunch and enjoy a meal together - virtually! Is it the same as in person? No. Is it effective and fun? Yes!
(P.S. This is also something you can do with your team & staff.)
Get Therapy: BetterHelp
I’ve said it before, and I’ll say it again - I love this virtual mental health service! I do a 50 minute video call with my therapist every week….for $35 / week. And unlimited texting, resources, worksheets, etc. And you don’t have to leave your couch. Perfect for not going crazy in self-quarantine. :)
Workout: Down Dog
Being at home doesn’t mean you need to give up workouts. Instead, you can now workout in between meetings! (No one will know you’re in yoga pants on video calls :)
This app has changed my relationship with yoga because it actually allows me to do yoga every single day. And I’ve found 15 mins / day is so much better than the 1 hour every two weeks I’d actually make it out to a yoga class. Don’t worry - you can do any length you like - from 5 mins to over 2 hours! The fact that I can just pull out my yoga mat at home, have a fantastic session (that’s extremely customizable) that is different every single time and paired with great music - it’s incredible and they didn’t pay me to write this. :D It will be a huge source of relief for me while all the gyms in San Francisco are closing their doors.
P.S. It’s FREE until April 1, 2020 (due to COVID-19). And an annual membership is only around $50.
Meditate: Insight Timer
While most people like calm, I love insight timer for meditation. Check it out if you haven’t already. Totally free!
Eliminate Distractions: Customize Do Not Disturb “driving”
Here’s a fun hack if you have an iPhone. Your iPhone has a Do Not Disturb Driving setting - where you can actually customize the response. It’s basically an auto-response for your text messages! Go to Settings —> Do Not Disturb —> scroll to the bottom. You can update the message to something like, “I’m working right now, and will respond to your message as soon as I get a chance”, and then turn it on during your “heads down” work time. This gives me SO much peace of mind during the day.
Lastly - have fun! My partner and I are self-isolating at home right now, and we’re realizing we have such a unique opportunity to actually be near each other during the day! This so rarely happens.
For the majority of our life, we spend our days away from the people we care about the most - our partners, spouses, kids. Our families. One positive way to look at self-quarantining is actually increased family time! Enjoy it. (I’ve had more than a few dance parties in the last few days. :)
Ok - coming up for air here, because I know that was a lot! 😅
I hope this can be a helpful resource as you navigate the change in the world right now. I’m extremely optimistic for the opportunity we, the integrative medicine world, have in supporting people in need all over the globe. And of course, I’m grateful that Rupa - the telehealth platform for functional and specialty labwork - can have a small supporting role in this. ☺️
Would love to hear how you are handling this pandemic in your practice. Please email me if I can be helpful at all! firstname.lastname@example.org
Most importantly, please take care of yourselves!
P.S. To support practitioners who are moving their practices to telehealth in light of this pandemic, we’re doing free office hours and answering your questions on how to make the switch. Send me an email if you’d like to join! email@example.com
*ok, truth is I’m actually in PJs on my couch since it’s Sunday morning! 😂