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Pediatricians design a practice within a practice during pandemic :

April 28, 2020

Editor’s note:Pediatricians around the country have risen to the challenges posed by the coronavirus disease 2019 pandemic. Some are on the front lines battling the virus; others are connecting with patients while hunkered down at home. They are relying on creativity, ingenuity and tenacity to keep their patients healthy and their practices afloat. Here is one pediatrician’s story.

Stapleton Pediatrics in Denver has more than a waiting room for ill patients: It has a waiting office.

Last August, the six-pediatrician practice co-founded by Noah J. Makovsky, M.D., FAAP, and Brandon S. Davison-Tracy, M.D., FAAP, opened a second location, Pearl Street Pediatrics, about 20 minutes away. To prepare for possible COVID-19 patients, Pearl Street was used for well patient care, while the main office became the designated location for sick patients. A separate section is used for those who might have COVID-19.

“We put up different temporary walls in our practice so when people come in and out of our COVID section, they are completely separate … like a practice within a practice,” Dr. Makovsky (“Dr. Noah”) said. The arrangement helps protect staff and families.

The office also signed up for telehealth.

“The ones who have taken advantage have been ecstatic because they are in the comfort of their own homes,” Dr. Makovsky said. “They don’t have to feel nervous about coming in; they have the ability to see their provider and really get a chance to talk.”

In another first, Dr. Makovsky and Dr. Davison-Tracy created a Facebook video message that introduced office changes and how virtual visits work, with plans to continue weekly.

The office has seen an uptick in behavioral consults, primarily due to anxiety, in both young children and teens. Staff members also are anxious (when Dr. Makovsky spoke to AAP News, the office had no testing equipment and limited personal protective gear), but regular meetings help reassure employees. “They feel like they are in an environment where we are taking all the potential steps to keep the staff safe and other patients and families safe,” Dr. Makovsky said.

A big worry now is keeping the business afloat. There are 45 employees, including physician assistants and nurse practitioners. While the practice has seen some patients with flu and respiratory syncytial virus, those illnesses are decreasing rapidly or patients are not coming in to be diagnosed, he said.

The concern is shared by others in the area. Practice volumes in Denver and beyond are down by 40%-50%, Dr. Makovsky said.

“The foundation of primary care in the country in itself could be threatened by this crisis if we can’t make it to the other side,” Dr. Makovsky said. “That’s very much on our minds.”

To read other pediatricians’ stories, visit

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