RetinaLink continues its new Staying the Course series with Dr. Rishi P. Singh. Dr. Singh is a staff surgeon at the Cole Eye Institute, Cleveland Clinic and Associate Professor of Ophthalmology at the Lerner College of Medicine in Cleveland, Ohio. He also currently serves as the medical director of informatics at the Cleveland Clinic. He is Past President of Retina World Congress and on the Board of the American Society of Retina Specialists (ASRS).

Today, Dr. Singh discusses his new clinical protocol, virtual patient visits, diagnostics, PPE and stress relief during the COVID-19 pandemic.

Rishi P. Singh, MD

RetinaLink (RL): Please outline your new patient protocol at Cole Eye Institute?

Rishi P. Singh, MD (RPS): We adopted a very stringent patient protocol early on. No family members (unless the patient needs an advocate or is disabled), No talking during the slit lamp exam, temperature is taken upon entry into the clinic, masks are available (however, not required) and we placed signage on waiting room seats to ensure the 6’ social distance is maintained. This is basically every other seat. The other change is diagnostic decisions. Does this patient need this imaging test today? I’m deferring diagnostics for some patients. There’s no reason to keep them at the clinic longer than needed.

I applaud the Cleveland Clinic leadership and our Cole Eye departmental leadership. They have been remarkable and responsive. We have all worked together since the start of the COVID-19 pandemic.

RL: What is the decrease in patient volume?

RPS: My clinical volume is down 70% and my surgical volume is down the same amount.

RL: Please describe Cole Eye Institute’s new virtual telephone visits.  

RPS: The ACA, Affordable Care Act, provided physician/patient discussions with no reimbursement. COVID-19 has been the catalyst to change this and provide the opportunity to do this better. Physicians now receive reimbursement for virtual and telephone visits.

RL: Please outline your PPE for your clinic and surgery days.

RPS: I wear a traditional surgical mask, not an N95 in clinic. The purpose is to prevent droplet transfer and importantly to prevent me from touching my face with the virus for entry. I ensure I have eye protection and wear a hat, too.

Dr. Singh’s PPE includes goggles,
hat and mask

RL: How do you spend your evenings and what’s optimal for you to decompress?

RPS: The number one positive of sheltering in place is that I never spent more time with my family. I realized just how much I enjoy being home. My wife is a physician, too, so dinner together with all of us was rare until this happened. Now, we have dinner together and go for a walk, my wife, son and our dog.

Dr. Rishi Singh can be reached via e-mail – drrishisingh@gmail.com