Coronavirus (Covid-19) and the chiropractor: Life in a Washington State clinic

Filed Under: Costs

Continuing our series of health care providers recounting their experiences during the era of coronavirus (Covid-19), we’re posting an essay by Frank Wen, who runs a chiropractic clinic in Kirkland, Wash. He’s a member of our community over on Patreon, and he sent this to us.

By FRANK WEN

I live in Bellevue, Wash., and practice as a chiropractor out of my clinic in Kirkland, Wash. The adult center that experienced the breakout in March of this year that brought this to national media is just a few minutes down the road from my clinic.

This pandemic has been a very weird time for me as this whole experience has created some very mixed feelings that I’ve had to work through as an Asian-American, a business owner working in health care, and a consumer. I’ll highlight the inner thoughts that I’ve had in the past several months.

Public Attitudes and Masks

I felt like many people were initially quick to dismiss the severity of COVID-19. It was being compared to the flu statistics but what concerned me most was the risk of developing pneumonia.

Maybe it was because of my radiographic training as a chiropractor where I’ve seen so many old images of cloudy lungs on x-ray that biased me, but I know I don’t want that. I know people who have gotten pneumonia and often don’t think it’s a big deal, but damage to cells and a build up of fluid in your lungs is never good.

Also, this is a viral pneumonia which is not something that can be treated with antibiotics even if you aren’t in a high risk group for developing that complication. Instead of just dismissing it as a minor illness, I wished people would acknowledge the possible danger of what could happen if you do get it even if the majority of people only develop minor symptoms.

Like many people in the states, I initially felt like masks were probably limited in their efficacy. Because the viruses are so small, I figured they can probably be inhaled through the sides of the mask during inhalation even if they are rated high for filtering capability.

However, my family in Taiwan nagged me incessantly about getting masks and being sure to wear them on a weekly basis. My mother-in-law and uncle called numerous times to check to see if we got the masks they sent to us from Taiwan. The fear is very real for them.

But as we started to learn more about transmission, I changed my stance that masks may be a good risk mitigation strategy only if every single person wears them- to reduce droplets making their way into the air and maybe help make it more difficult to inhale droplets from the air. We are wearing them for each other and ourselves. It’s why we do things like wash our hands after using the bathroom, cover our mouth when we sneeze or cough, wear gloves, use protection during sex; you know, the basic stuff. Of course none of those things are always perfect, but we do these things… I hope.

Why would you not take the advantage?

Masks are (were) cheap and even if it reduces your chance of catching it by any percentage; why would you not take the advantage if you can have it? I felt it was strange that the C.D.C. was initially saying to not wear them because they were not proven to be effective although surgeons wear them all the time. I think that sent a confusing message, and probably caused the public to question the masks and even the competency of experts after they changed positions on wearing one.

With the U.S. having been shielded from dealing with some other viral outbreaks, mask wearing has never been adopted here and we weren’t prepared to supply our entire population so quickly which is why I can understand why it was important initially trying to preserve it for the frontline workers. But now as we are able to import them and produce them, I think everyone should wear them in public.

It’s funny hearing people call our elected officials dictators for wearing a mask. There are people who have fled countries from far worse atrocities than being made to wear a mask. Yes, they can be uncomfortable, and breathing in them can feel gross, but I wear one all day at work to be considerate of my patients as much as for my benefit.

But forget about me, I’m not even a frontline medical worker who is treating positively diagnosed patients. If you value their lives as a fellow human and American, then it’s not a big ask that you put one on for the couple hours that you go outside to do your errands or walk around the neighborhood to help keep you or your neighbor out of the hospital.

It’s very possible that we may find out masks aren’t effective, but I’d rather be more careful and wrong than be regretful.

Doing Business and Navigating the Future

At the current moment, there is no better way to prevent the spread of this thing unless we all just stay home. But unless the powers that be can put the brakes on the entire economy, pay our bills and other debt obligations, and keep the food production system running- no one can stay home forever. Ignoring quarantine fatigue, I think a large amount of the population is feeling the pressure to return to work — especially business owners.

As a healthcare worker I support initiatives to improve public health, but as a business owner I also have bills that must be paid even if I don’t get paid so I understand both sides of the issue well. Trust me, I’d love nothing more than for all of us to have a paid sabbatical.

When the outbreak first occurred in Kirkland mid-March, I voluntarily shut my office down for 2 weeks to assess the situation. Business was already starting to drop off significantly toward the end of February. I transitioned my team to the state’s workshare program so that I can keep them on the payroll part time while the state helps to cover the difference.

Making videos and other content for home treatments

I kept us occupied by doing internal office projects and making videos and content to help our patients, community, and anyone who was paying attention to us treat themselves at home.

At this point I figured, life is short and uncertain. If the world falls apart or if I end up catching and succumbing to this thing somehow, at least I tried to do something good. Also, if we stayed busy and worked to improve the business, we would be on better footing if and when things start to open back up.

My wife was actually excited that she might get to see me more during this time, but I worked my tail off making and editing videos for the next several weeks staying up to 3 A.M. on several days in a row so she got to see a lot of the back of my head unfortunately. She’s always been very supportive of my endeavor to develop the type of clinic I would want to go to; so I definitely appreciate her understanding and support.

Being deemed an essential business, I did choose to re-open on April 1, continuing to work on content and seeing patients in person at a very limited capacity. I knew we have to accept that things would be different going forward so I started to develop and change my clinic processes to operate in what will be the new normal until we get a vaccine because people will be concerned of coming for care even as the states open up more and more. Obviously there’s no perfect process other than staying home but these are the things we have implemented or changed over several weeks to mitigate risk with doing business in this environment.

Some of the things I’m doing might be considered overkill such as changing clothes between patients, but my wife has been making me change and go shower immediately when I get home so I figured I can try to implement part of this practice at work too to give anyone that’s like her more peace of mind.

There’s no doubt in my mind that many of these changes I have adopted will remain for a long time, and that health care as a whole is going to have to adapt as well. While inconvenient, this is probably going to make health care facilities cleaner and safer than before. I’ve always been a one- patient-at- a- time doctor, so the operational impact to me is not quite as severe as clinics that operate with open floor policies where there are multiple patients/practitioners. The fear of visiting establishments is probably what is going to create headwinds more than operational challenges going forward.

One thing that really surprised me in this whole situation was I’ve always used alcohol and disinfectant wipes in my clinic since day one and have always purchased them in bulk. Never had I thought I would be competing with the rest of America for them now. Aside from the extra cost of obtaining some of these items now, managing these resources over the next several months is going to be very important.

A Better Way of Living?

In our personal lives, I think the pandemic has been helping us enjoy much simpler ways of living, which I have to admit has been nice. I’ve enjoyed eating home-cooked meals more and have been having a lot of pleasant conversations about cooking at home with my patients. People seem to be saving money cooking at home too!

More recently I’ve been able to spend more time with my wife and catch up with friends over the phone I haven’t been able to chat with in a while. I’ve also enjoyed walking around and observing nature in my office park and neighborhood. It’s easy to practice mindfulness when some of the busy-ness has been removed. I also found the decreased traffic in the neighborhoods and on the freeway refreshing, but that’s quickly returning as the state has been reopening. I even picked up my guitar again recently.

In business, I think if this pandemic is showing us anything is that we need to slow down and check greed at the door. Will a form of conservative capitalism emerge from this thing? I don’t know, but there are so many businesses that have enjoyed success by relying on high volume operations and taking on excessive debt to grow and expand. It’s crazy to see businesses across different sectors that have tanked because of the way they have operated.

Whatever happens, I’m hopeful that life will be better at the other end of this pandemic.