Monday marks start of Phase 1 of Re-Open Saskatchewan Plan

Phase 1 of the Re-Open Saskatchewan Plan begins on Monday.

Part of Phase 1 includes a return of some medical services like physical therapy, chiropractic care, optometry and dentistry.

Returning to the clinic will look a little different during the COVID-19 pandemic. Here’s what’s about to change:

Physical Therapy

PhysioYoga founder Linda Boryski always thought sneeze protectors were meant for buffet lines. Yet there she was installing the Plexiglas pieces at the front desk of her clinic after the province announced its reopening plan on April 23.

She admits she wasn’t thrilled to see she would be one of the first people heading back to work during the coronavirus pandemic.

“I was fearful,” Boryski said of her immediate reaction to the reopening plan. “I didn’t know that this was the right thing for us to be doing. After I sat and processed it for a while, I kept coming back to what Mom and Dad taught me growing up: ‘Just because you can do something, does that mean you should do something?’

“There was a lot of hesitation for sure.”

A lot has changed at the clinic. Cotton chairs have been swapped out for vinyl chairs to ensure easier cleaning and disinfecting. There will be fewer people in the clinic, done to discourage interaction and maintain distancing.

All patients will be staggered and  pre-screened in advance of their appointment in addition to a screening upon entry into the clinic. Some clinics, like PhysioYoga, ask patients to wear masks upon arrival in addition to staff wearing masks at all times.

Many of those protocols are part of the new normal for health-care services moving forward. Boryski is doing her best to adjust and continue helping the backlog of patients whose ailments are getting worse without any in-person treatment.

“I almost feel like a guinea pig sometimes, too. There’s this excitement, fear and trepidation as well. As it comes closer and we’re working and problem-solving … our confidence builds,” she said.

Boryski has been able to secure supplies that should last her for two weeks at a time.

Wooden chairs were brought in and spaced far apart at this clinic. (Chiropractors’ Association of Saskatchewan)

All those measures come with some added financial burden for clinic owners, and those costs could be enough to prevent some physical therapists from returning to work when they would have wanted.

“That has to be taken under consideration by our clinic owners when they consider if they’re going to reopen or not,” said Brandy Green, the interim executive director of the Saskatchewan College of Physical Therapists.

Boryski said she has spent somewhere between $700 and $1,000 for the two clinicians at PhysioYoga to meet all the new guidelines.

Acting as the governing body for physical therapists in the province, the college held plenty of meetings with its medical counterparts, the Saskatchewan Health Authority and the province prior to the launch of Phase 1 to map out a framework for people returning to work.

Green admitted some members weren’t thrilled at the prospect of returning to work, but as more equipment was acquired, and rules and guidelines implemented, slowly more and more members were confident in opening Monday.

“They were concerned about their patients’ well-being and not being able to provide services that might be helpful and continuing to improve their patients’ quality of life,” Green said.

There’s nothing stopping clinics from adding any measures to ensure safety, like temperature checks upon entry — something that has been recommended by the college but is not required.

While more services are being offered, clinics can still offer help via video or the TeleHealth line.

“If people aren’t feeling safe and confident in coming in for treatment, they can still get the help they need through video conferencing,” Boryski said.

Like all industries included in Phase 1, clinics across the province will open in the coming weeks rather than all at once as personal protective equipment (PPE) and other needs are acquired.

Optometry

Dr. Nathan Knezacek is taking added precaution when he begins offering a full array of services on Monday.

Knezacek has been wearing an N95 mask while he offered emergency services at the Family Eye Care Centre in Regina since the province banned non-emergency work in March.

“We might not know who has coronavirus or not. For myself, who will be close to a patient, or for my technicians, they’ll have an N95 mask to keep themselves safe and the patient safe,” Knezacek said. “Also my staff will have face shields, glasses and scrubs. There’s not much more we could do at this point.”

Dr. Nathan Knezacek poses for a photo to display some of the personal protective equipment he will be wearing at his optometry clinic during Phase 1 of the province’s reopening plan. (Submitted/Nathan Knezacek)

The president of the Saskatchewan Association of Optometrists said plenty of work has been done from the association to create PPE packages which can be sent out to clinics upon request.

Emergency treatments like retinal detachments, infections or any problems that could lead to vision loss if not treated immediately already were being done. Now with eye exams and more minor issues like glasses fittings returning, optometrists are expecting to be busy once again.

Knezacek said you could get a wide range of replies depending who you ask about returning to work.

“I know there are people that are nervous to get back to work, but I know that there are people that never wanted to shut down,” he said, adding he is fully booked on Monday.

Fine details of the policies will vary across the province as each clinic does its part to return to work safely. Patience will be needed as the added safety measures could create longer than usual stays, Knezacek warned.

Chiropractic

Dr. Jennifer Beggs was pleased to see the province’s first phase of reopening included chiropractors.

The vice-president of the Chiropractors’ Association of Saskatchewan said nagging issues or concerns have grown worse since the province restricted all practices outside of emergency treatment on March 23.

“That’s exactly what we noticed at our clinic,” she said of the emergency appointments she has been taking at the East Quance Chiropractic Clinic in Regina.

“Initially we were screening over the phone and seeing lower numbers. As the time went on, things that started off as minor and that people were managing at home, now two and three weeks into having their back problem or neck problem it’s now at the point where they’re calling in because they can’t go to work.”

The other issue Beggs noticed was a lack of emergency clinics operating since March 23. What started with phone calls from her own patients soon started to include people from outside the community as people attempted to reach any chiropractor who was open.

“People are putting things off and are now in need of coming in,” Beggs said.

For some people, whether they want to return to work or not, there are some added factors in coming to a decision like their patients’ access to services.

“Situations change, too. I’m lucky enough I’m in a clinic with two other chiropractors. You may be a sole practitioner in a small community and you’re the only option for people,” Beggs said.

Dentistry

A lack of PPE could delay more dentist offices from opening.

At least that’s the case for one dentist in Prince Albert.

The local dentist, speaking on the condition of anonymity, told paNOW their supply company could not say if they could provide them with the PPE required to return to service.

“Why would I open my business back up when I can’t even place an order for more masks?” they said. “So if we run out of masks we have to close again while keeping the bare minimum of masks for real emergencies.”

The College of Dental Surgeons of Saskatchewan denied an interview request, but was able to send a media release.

“Dental care will be at a different pace and your dental office will look a little different. But rest assured that those people under all that personal protective equipment are still the same people you have come to trust for safe, quality dental care for you and your family,” associate registrar Dr. Mitch Taillon said in the release. “During this time of world-wide shortage, your Saskatchewan dentists are working diligently to source the required PPE as described in the member alert.”

While dentists must be outfitted with masks, gloves and glasses, more complex procedures will require a respirator, face shield, gown or lab coat and surgical bonnet for the dentist and their assistant.

A document outlining interim protocols for dentists in the province said some health-care providers are wearing an N95 mask and covering it with a surgical mask and face shield to further protect the N95 from droplets and splatter so the N95 mask can be used for multiple patients.

Other health professionals returning to work on Monday include opticians, podiatrists and occupational therapists.

— With files from paNOW’s Glenn Hicks.