Continued Conversations: Experts share insights from the pandemic

The global pandemic has forced necessary adjustments to nearly every profession, and the professions Continued serves have not been exempt. 

Here are some of the lessons learned by an audiologist, a speech-language pathologist, an occupational therapist, and a physical therapist. See how they’ve made adjustments to their practices and how they are providing the best possible care in these unprecedented times. 

Our Continued conversations series highlights the experts behind our content. Meet the presenters, contributors, and guest editors who make a difference in their fields and inspire our learners to do the same.

AUDIOLOGY: Alicia D. D. Spoor, AuD

How has your practice changed during the pandemic? 

Like many, my private practice closed for approximately eight weeks, and during this time, revenue was down nearly 90%. The convenient walk-in hours that were offered three times a week were also temporarily paused. 

Initially, trying to manage staff members and navigate the financial landscape (e.g., PPP loans, cash flow) was very intimidating and worrisome. By being creative and open-minded, we introduced some unique service models, including non-contact, car-side appointments and telehealth hearing aid and cochlear implant programming.  Additionally, states of emergency allowed providers like us to care for patients in other states and to offer continuity of care whenever possible. 

The reduction in patient services afforded me some time for business development, involving insurance contract reviews, collecting accounts receivable, updating office policies, and more.

While this has certainly been a turbulent time, do you have any positive takeaways? 

Telehealth with devices such as hearing aids and cochlear implants has obviously changed during the pandemic. Although it was a learning process, with some creative thinking, audiologists can often provide patients with access to more diagnostic services and treatment (fitting and adjusting devices).  

Online methods to purchase over-the-counter products are now more accessible via e-stores, as well as drop shipments from supply companies and manufacturers. 

Additionally, many providers have realized that fulfilling the entire scope of practice is essential to audiology’s survival. Offering tinnitus, auditory processing, aural rehabilitation, industrial, and vestibular consultations and treatment can supplement a practice when diagnostic testing in a sound booth and hearing aid sales are limited.

The COVID-19 pandemic has also shown audiologists and patients that unbundling prices and charging for expertise and time is possible and effective.

How can we provide the best possible care during this time? 

Taking care of patients is different at this point in time, but it should still be the primary focus. Obviously safety and health in the practice have always been imperative, but there’s even more need for careful cleaning, disinfecting, and sterilizing all surfaces, corners, and doorknobs after each and every patient. Audiologists need to follow the CDC and WHO guidelines and check with state licensure and regulations on a regular (almost daily) basis to ensure all protocols are completed.  

It’s important to remember to be patient, as each person’s comfort level returning to public places is different.  Keeping in touch with patients using electronic media such as enewsletters or Facebook can let them know that care is still available. 

The age-old saying still applies: “If you take care of your patients, the rest will work itself out.”

“The age-old saying still applies: If you take care of your patients, the rest will work itself out.” — Alicia D. D. Spoor, AuD

OCCUPATIONAL THERAPY: Krista Covell-Pierson, OTR/L, BCB-PMD

How has your practice changed during the pandemic? 

We now provide telehealth and also have new practices in place to prevent infection. 

Another change we are seeing is that many of our clients are struggling with additional negative impacts indirect to the virus such as depression, loneliness, and decreased mobility and participation in activities of daily living.

While this has certainly been a turbulent time, do you have any positive takeaways? 

Our leadership team is stronger and wiser than before. We can now provide services to people in rural areas via telehealth. We have also added a whole new skill set to OT plans of care through infection prevention and helping patients set up telehealth with their doctors.

How can we provide the best possible care during this time? 

While this is a difficult time, therapists are creative and were already spending their workdays solving problems for people. Our trades are made for things like this. We help people overcome hardships every day. This is just a new kind of hardship, but we can do it.

“Our trades are made for things like this. We help people overcome hardships every day. This is just a new kind of hardship, but we can do it.” — Krista Covell-Pierson, OTR/L, BCB-PMD

SPEECH-LANGUAGE PATHOLOGY: Marva Mount, MA, CCC-SLP

How has your practice changed during the pandemic? 

We have all been forced to think outside the box with different “plans.” Virtual therapy is now the norm, and finding ways to get creative and reach our clients, patients, and students effectively without human contact has broadened our horizons and forced each one of us to find ways to close the distance with our imaginations.

While this has certainly been a turbulent time, do you have any positive takeaways? 

So many positives have grown from this troubled time. We have been able to collaborate more as a profession than ever before. We are able to work with parents and caregivers as better coaches and collaborators, with better and more meaningful interactions. We have been forced from our therapy rooms and into more real-world exchanges. It has been so difficult, but so rewarding and fulfilling to actually be a part of our clients', patients', and students' lives!

How can we provide the best possible care during this time?

First and foremost, we must show grace to our clients, patients, students, and their families. People are dealing with so much right now with food insecurity, job loss, closed schools, isolation, and depression. In order to provide the best possible services to those we serve, we must prioritize needs and make our therapies more meaningful and practical while understanding and respecting a person’s struggles and limitations. As we show grace to them (and ourselves), that bond of trust and understanding grows more and more each day, and in ways we never could have anticipated.  We now not only have the therapist–patient bond; we have the bond of humanity, and that is where true change begins—when there is mutual respect, trust, and empathy.

“We now not only have the therapist–patient bond; we have the bond of humanity, and that is where true change begins—when there is mutual respect, trust, and empathy.” — Marva Mount, MA, CCC-SLP

PHYSICAL THERAPY: Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST, FAPTA

How has your practice changed during the pandemic? 

Our practice has moved through a quite typical evolution for outpatient therapy in some ways. We started seeing patients that could be considered essential and low-risk; moved to quickly help the essential/high-risk patients that had both desire and capacity to adopt telehealth; then gradually resumed seeing other patients while obeying and exceeding in-person regulations. At present, we are in the space–time quandary of too many patients to see and not enough room or time in the day to see them. So, we evolve again. My wife and I are co-owners of the clinic. We lost hundreds of thousands of dollars to date yet still regularly count our blessings to date for the dramatically low incidence and few possible contaminations that have turned out to be of no avail. 

While this has certainly been a turbulent time, do you have any positive takeaways? 

My positives can be found in the fact that our state, region, and city have been much less affected than most. We have not lost any employees directly because of the financial impact. Our patients know that they have been well cared for, and they express their gratitude frequently for our consistent messaging, respect for precautions, respect for their individual perspectives, and the consideration of the community's health as a whole over an agenda of profiteering or “making up” for lost revenue. As a staff we have developed a keen resilience, the likes of which may still be tested. Future travails that are not of pandemic proportion will have a hard time testing our new reserve, which was strong pre-COVID. I am proud to be a part of this team.

How can we provide the best possible care during this time? 

Care does not change. Evidence-based, high-intensity, and personalized care will always be the best care. This persists. What can and should change are the latitudes that we afford one another, the patience and time to explain our plan of care through a facial covering, and the extra effort to communicate empathy, energy, and understanding, all while your main non-verbal gestures are hidden. Smile with your eyes if you cannot communicate this well through a facial covering.

“Evidence-based, high-intensity, and personalized care will always be the best care.” — Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST, FAPTA

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