How has the coronavirus pandemic affected your practice?
During the coronavirus (COVID-19) pandemic, the NHS have controlled the intake of patients in private hospitals. As a result, patients who are not a priority have been denied access to the hospital for elective procedures. Therefore our capability of doing operations at Rhinoplasty London by East & Badia private hospital has been greatly reduced – essentially stopped. As of the end of June 2020, we know that this control from the NHS will continue until the end of August. Unfortunately, all private patients have been momentarily disadvantaged because it’s not possible to pay for access to care in private hospitals – everyone must go through the filtering system in terms of priority.
What extra measures have you taken to protect staff and patients?
We have really changed our way of engaging with patients. Any new patient needing a consultation – or existing patients with concerns, follow-ups or any other questions – is spoken to via video consultation. This has actually been surprisingly amazing – not only is it feasible, but it’s also very efficient in keeping all patients happy, with less travelling and less waiting. There are some changes that COVID has brought in which I think are here to stay, and the use of video consultations is one of them.
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There are many new measures that we’ve put in place to protect staff and patients. We’re seeing very few patients face to face, but those that we do see must sign a specific consent form that includes several key messages, some of which are:
- They understand that they are having an elective treatment during a time in which there is a worldwide pandemic
- It’s an extremely contagious virus spread by person to person contact
- They understand that if they are unwell, they need to isolate at home. Patients cannot enter the practice if they have had COVID-19 symptoms in the previous weeks (fever, shortness of breath, dry cough, runny nose, sore throat and/or loss of sense of smell or taste)
Patients who arrive at our clinic will have their temperature checked and they need to wear a mask and gloves. Doctors do exactly the same – we have our temperatures checked every morning and wear full PPE including masks with visors and gloves.
Another thing that we do is change and wash our clothing frequently. Before the pandemic, we would always change clothes for operations but now, we also change from normal wear to scrubs as soon as we arrive at the hospital clinic. We take the scrubs off again at the end of the day and wash them for the next day.
What has changed big time is that, in between patients, every single surface, doorknob, laptop, couch etc. – everything in the office – is wiped and cleaned with alcohol. We can also only allow one patient in the office at a time, with no relative or friends. These factors have greatly minimised the number of patients who can attend in one day.
In terms of patients who need an operation, they must receive a negative COVID-19 test result within three days before the procedure. This is to minimise the risk of operating on a patient who might develop severe COVID-19 symptoms around the operation or after surgery – the risks are very high and there is even a risk of death.
In Rhinoplasty London, before COVID-19, we used to have lots of patients travelling from abroad to have treatment, but at the moment (the end of June 2020), anyone having a consultation and/or operation needs to have not travelled and if they have, they must isolate for 14 days prior to any consultation.
Can patients have face-to-face appointments now?
Due to the cleaning in between patients and only having one patient in at a time, there is a reduced number of patients we can see: anyone who does not require an internal examination will have a video consultation. During a video call, we can’t examine inside the nose or mouth and in the cases where this is necessary, patients are invited to have a face-to-face appointment. We can still of course order all the necessary investigations eg scans.
The changes of the last three to four months are relatively new, including the reality of not seeing a doctor face-to-face. Some patients would rather have a face-to-face consultation because for them, it’s easier and quicker to explain their symptoms and thoughts. But, with the appearance of the virus, it’s unrealistic to see everyone face-to-face. While video calls are prone to issues such as slow internet or the internet becoming disconnected, there are benefits of e-consultation such as not travelling and being able to greatly reduce the risk of contamination.
What about surgery? What is the standard process now?
As mentioned previously, everyone that must undergo an operation has to be isolated for 14 days before the procedure. They must also isolate for one week after. During surgery, nurses, doctors, surgeons and anaesthetists wear full PPE and they must each have a negative COVID test results.
Only the most urgent cases can have surgery. In our particular situation at Rhinoplasty London, an urgent case is someone with nasal trauma due to injury or an accident. This could be a broken nose, infection in the nose or sometimes a completely blocked nose. These are not urgent in terms of being immediately life-threatening, but they are urgent in the sense that they must be resolved within three months.
If someone is interested in cosmetic surgery, where do they start?
If I was a patient looking to have cosmetic surgery right now, I would spend a lot of time looking at different social media pages and websites to get to know as much as possible about the procedure before arranging a video consultation. By doing this, you can fully educate yourself about what the procedure you want involves, what’s expected from risks and recovery – all this information is available out there.
Once you have this foundation of knowledge, the surgeon can build on it during your video call by explaining what applies to your particular case, resulting in further research that will be more targeted.
Look for a specialist who routinely performs the procedure you want. I think that in this day and age, having an operation by someone who is not a specialist in the procedure you want is particularly dangerous. Surgeons who are used to doing the same operation in their routine have the best experience and knowledge to correct any unforeseen issue during the procedure. They are also likely to achieve the best result.
Should patients expect any delays?
Yes, delays are to be expected but as of July 2020, we don’t know exactly when the private practice can return to normal. Currently, we think elective procedures can resume at the end of August, but this could be later. Guidelines are constantly changing and we will know in the following weeks if there will be a surge of cases and if the availability of elective procedures in the private sector can resume in August or later.
If you’re considering rhinoplasty and facial surgery, don’t hesitate to get in touch with Ms Badia. Through e-Consultation, you can receive her leading professional advice via a secure video call from your own home – visit her profile to get started.