During the COVID-19 lockdown, we are answering patient queries online and through WhatsApp: Dr Mohan Thomas

While the novel coronavirus takes centre stage, India is in its lockdown mode, which Dr Mohan Thomas, Senior Cosmetic Surgeon, Cosmetic Surgery Institute, refers to as “forced free time”. An American trained and board-certified cosmetic surgeon with a special interest in corrective cosmetic surgery, Dr Thomas is a Clinical Professor of Surgery at the Mount Sinai School of Medicine and a Visiting Scholar at the Mount Sinai Medical Center, New York. In an interview with Aesthetic Medicine, he shares ways in which he is coping with the current scenario of COVID-19, challenges involved in e-consultations, and precautionary measures he will implement at the clinic at the end of the lockdown.

Is your clinic still working? If yes, what are the precautions that you are taking for your
staff and patients?

Our clinic is now shut to follow the call given by our Prime Minister as intervention in planned surgeries can wait for a few weeks. When we had the office open, everyone took all universal precautions prescribed for viral infections, which can be transmitted by droplet infections. The precautions included:

• Consulting patients with prior schedules with sufficient time intervals between each patient. No patient is seen without an appointment (This has been followed by us since the inception of the clinic in 2003).
• All patients, visitors or employees entering the premises were provided with a disinfectant hand rub to sterilise the most exposed body part and prevent entry of viruses into the office.
• No patient having upper respiratory symptoms were examined and if their accompanying person was found to have the respiratory infection, they were provided with face masks and sent home.

How are you coping with the current situation of COVID-19?

Just like all other businesses, the cosmetic surgery and medicine business will be badly hit as it was just coming around a bend after a couple of years of bad time due to demonetisation and GST. The only way forward is stay safe to bring this business on track some other day in the future.

This forced free time is being used by me to pursue academic targets, which include writing research papers and chapters in books so that they are ready before the target date. Imparting knowledge and experience to the next generation through my writings in these chapters will go a long way in making cosmetic surgery and medicine safe.

Are you conducting online consultations? How are you maintaining communication with your patients?

We are answering patient queries online and through WhatsApp. However, we are not performing a full consultation, which I think is fundamentally inadequate and wrong given the nature of our work, which remains non-emergency. Furthermore, the Medical Council of India forbids any consultation and prescription online.

We have all details of the procedures and their indications on our website. People who are interested can write us an email enquiring about their requirement. They can then send photographs of their areas of concern and my team members get in touch with them and discuss about their options. They are required to have atleast one face-to-face discussion with the operating Surgeon (me) where they can discuss all possible concerns, risks, options and then take a decision about the treatment.

What are the challenges involved in e-consultations for doctors? Can any measures be taken to overcome these or control these?

The major challenge for doctors involves assessment of the Clinical features. In our line of work, this translates into assessing the skin looseness, movement, fat volume and skin tone. These cannot be assessed on photographs or videos and needs an in-person examination. The extent of skin oiliness, pores and the skin type and texture are some of the other factors that have to be assessed before advising any skin treatment whether surgical or non-surgical.

Since there is no major emergency treatment or intervention required for cosmetic concerns, my advise to people is to maintain their skin by using a mild face wash, use a sun screen once a day as most of you will not be moving out of their homes and finally a night lotion, serum or cream to allow in healing of the skin. Since you have got this special window to stay away from all make-ups and treatments carried out by parlours, let your skin heal naturally and regain the lost glow.

Do you have a plan in place, could be precautionary measures or any other, to implement at the clinic at the end of the lockdown?

It is my guess that by the end of the lockdown the COVID virus would have burnt out both in intensity and penetration, keeping in mind the incubation periods. Having said that, it would be wise to screen patients with a questionnaire prior to entry into the office or assessment of the online reply to our questionnaire. For a period of two weeks post opening of our clinic, we are planning to use a thermographic temperature assessment for all entering the office. Additionally, all entering the office would be required to sanitise their hands and wear a mask. All precautions in order to be successful must be universal.

With respect to COVID-19, Dr Thomas agrees that there is a global crisis, and he speaks on the importance to control and contain this coronavirus by adopting effective forms: https://youtu.be/8qs0-ag1q3U

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