One lesson outside observers can learn from how Juniper Clinic handled the Covid-19 pandemic is that crises can become opportunities for those who are prepared.
Like all businesses, the chiropractic and naturopathic medicine clinic was hit hard after the pandemic lockdown began last March.
“We were 100-per-cent shut down for most of our practices that couldn't be done by telehealth, like massage therapy and chiropractor. Half of our providers were off work for six or eight weeks,” said clinic owner and chiropractor Dr. Michael Bokor.
Juniper was among several health care providers who experienced an increase in telemedicine appointments in the spring after non-urgent and in-person appointments were discouraged in the lockdown.
But the halt in business activity at the clinic didn't compare to the anxiety of being unable to help patients who were in pain, Bokor explained.
“We were getting emails every day from people ... and we had to say no or send them to the hospital. Sometimes with musculoskeletal problems, medicine doesn't work. Sometimes you need someone to massage your back. And we couldn't do that. People were trying really hard to convince us to come back to work and we just couldn't.”
Things slowly began moving back towards normalcy in the first week of May.
“We went back for urgent care I believe on May 7, which I think was about two weeks prior to being able to return to a reduced capacity in phase one (of Emerging Wisely). We did have a lot of patients who contacted their MLAs asking if we could get the urgent care clinic back. I think that allowed us to do urgent care again,” Bokor said.
Juniper was prepared and patients started coming back right away, though under modified conditions and at volumes lower than before Covid.
“(The GNWT) told us not to have a waiting room, which meant it was hard to cycle patients in and out,” said Bokor. “We had to put more time between patients. We reduced capacity by 40 to 50 per cent. We continued offering Telehealth and that's ongoing. We have a sign outside with a QR code that people can scan so that we can manage them so they don't have to wait inside.”
For 2020 overall, Bokor estimates the clinic lost about 25 per cent of its business. Some of his staff were affected more than others, such as the chiropractors and massage therapists whose regular patient load took longer to return to normal.
All of Juniper's 14 practitioners are back seeing patients. One counsellor sees patients exclusively by Telehealth.
The clinic applied for an exemption to the waiting room prohibition, which it received after some back and forth with the GNWT. It spread out the seating area of the waiting room and added another one.
Wearing of PPE and frequent sanitizing have become part of the daily routine at Juniper.
“The cleaning has been a big part of our job. I clean whenever someone is in my office. I can spend an hour per day wiping things down. Anything people touch is constantly being cleaned. We don't allow people to hang jackets in the lobby. We don't want anyone using the same coat hook after them. They have to take them with them into the offices,” Bokor said.
Clearing the backlog of delayed appointments took some time and with some complications for patients.
“Our wait lists have never been so big as they were last year. So many people couldn't see practitioners. When people are in pain like that it switches from acute to chronic. Chronic is harder to treat than acute. You have more people needing more care. That increases backlogs and makes it harder for people to get in. But we eventually caught up.”
The difficult times brought their own benefits to the clinic.
“The word 'pivot' comes to mind,” Bokor said. “I had downtime to focus on the next logical step of our business. We have a physiotherapist in now. We have more products. We've been working on updating offices. Over time things have been getting cleaner and fresher. Our protocols are more solidified now because we had to be on the same page with rules that we developed for Covid.”
It had been slowly developing its online store Juniper Supply Co of Canadian-made vitamins, beverages and gifts since late 2019 and once Covid hit the NWT sales ramped up.
“We brought in 40 more brands. I was shipping across Canada and the United States. Our online clinic has more than our clinic boutique. I was delivering to people in Yellowknife, too. It took off quite a bit. We're still selling across Canada but not as much as during the lockdown phase.”
With the NWT's vaccination campaign about to enter its fourth week, Bokor is feeling optimistic about being able to move forward.
“Our practice has a high level of stress because we make close contact with people. The risk of exposure to Covid is high. But if we all get vaccinated it will reduce that stress.”