Interview with Julie Buchanan

Dr. Julie Buchannan, DDS, was interviewed by Kennedy Cluff on April 14th, 2021 over the phone in St. George, Washington County, Utah. She talked about the effects the Covid-19 Pandemic had on her business, Apple a Day Dentistry.

KC:This is Kennedy Cluff. Today is April 14th, 2021 and I am interviewing Dr. Julie Buchanan for the DSU Pandemic Years Oral History Project.

Will you please state your full name, spell it, and then tell me the location that you live in and where you practice.

JB:Dr. Julie Buchanan, B-U-C-H-A-N-A-N. I live and practice in St. George, Utah.

KC:Okay, so we're just gonna-- I'm just gonna go into the questions and just start jumping into it.

So, what were you doing before the pandemic started? If you just want to give a little bit of, like, your daily life and things like that.

JB:So, I work as a dentist, and so four days a week I was in practice, and so we just treated patients. And then, usually after that, I'm a mom of two and I would go home and take care of my kids.

KC:Awesome. So, if you wanna go into how did you first hear about the pandemic?

JB:So, the first knowledge I had of the pandemic and it starting to hit close to home, I was actually on my way with my parents and brother to catch a flight to Scotland.

KC:That's crazy.

JB:So, we were actually traveling and we knew, we knew things were happening, but we didn't know what was happening. We'd heard a little bit about it, but as we were traveling to Las Vegas [Nevada], we started having text messages from family and friends saying, "Hey, they're closing the borders. And we don't know if you'll be able to go to, you know, catch your flight to Scotland." And so, when we got to the airport, they actually, we talked with British Air, and they said, yes, they're closing the borders, some of the borders are being closed 00:02:00because of the pandemic, to try to contain it, but the American citizens can still come freely and go freely. So, if you do get on your flight, and you need to change your flight, then you can come home at any point. So, that was the first time we realized, like, this could be kind of serious, like they're shutting down, you know, the flights and people coming and going into our country. So, I believe the foreign visitors were starting to be held out of the United States and other countries. So, that was interesting. But we ended up going, and that was an adventure in itself, being over in Scotland when everything was starting to happen.

KC:Yeah, I can only imagine. So, like, what was your first thought when you heard that they were going to be closing borders? Like, were you scared?

JB:That went through my mind, that I really wasn't sure what was happening. We didn't know how serious it was. We didn't know how contagious it was. And we 00:03:00were completely unprepared. I mean, we had, we had some antibacterial wipes and a couple of things, but we didn't have masks, or gloves, or, you know, anything like that. And so, it was a little scary because we just didn't know, really, what was happening and how serious it was. And then, we decided to get on the plane and we got on the plane and we landed in London Heathrow. And that's when I kind of realized that there was something serious going on. And we started looking around and there were people with makeshift masks and different things. There were people with gas masks on the airplanes, there were people draped and wrapped in garbage bags. I mean, everybody from everywhere in the London 00:04:00Heathrow Airport, you can imagine that there were, you know, people coming and going from various different countries. And so, I think it was just a mad grab to find anything you could, just protect yourself while you were traveling in the airport. So it was very, at that point, when we landed in Heathrow, I realized, we're gonna need masks, or we're gonna need something, 'cause something serious is going on.

KC:Yeah, for sure. So how, with the COVID pandemic, and then coming home and being faced with, like, your business to run and things like that, how has the pandemic affected your daily life? Has it changed a lot?

JB:Oh, it's changed a lot, yeah. It's changed the way I practice in dentistry for sure. Before we always used masks and gloves and glasses, because we always would treat people with the mindset of, you know, this person is carrying a 00:05:00disease. So, we always wore gloves, masks, you know, wear everything that we had. But when the pandemic happened, how it changed dentistry, when I came home, things significantly changed. They shut dentistry down for about a month, and all we could do was treat emergency care only. So, my practice closed for a month. And then, when it reopened, we were able to start treating patients. But with that, we were the highest, one of the highest-risk professions because we had saliva and everything in our face when we were working.

And so, from there, it was hard because there were so many people trying to get protective equipment. Through the hospitals and the healthcare workers and everything, everything was sold out. It was really hard to find N95 masks; it 00:06:00was hard to find shields, face shields, it was hard to find any surgical gowns or protective gear. And at that point, none of us really knew a lot about COVID, and how-- We just knew it was contagious, we knew it could be deadly, and we knew we were really high risk of catching it because of where we work in people's faces and with the saliva spray, and that it was transferred through saliva. And so, we were, you know, for that month while we were just treating emergency patients, I had some N95 masks in my storage, but not very many, not enough for my whole staff. But it definitely changed everything in dentistry because now we wear double masks. We double mask, and have a shield, and wear surgical gowns, and head coverings, like surgical caps, now. So we're very 00:07:00protected. And then, when we're finished, at the end of the day, we take off the surgical cap, the N95, and the regular mask, and the gowns, and the shield, and everything, and everything goes in the washer, so we don't carry anything home. And--

KC:Yeah.

JB:-- definitely different working with all of those layers now, it makes my job a lot more difficult.

KC:Oh, I can only imagine, 'cause you're quite literally, like, on the front line. And so, as a dentist, you are considered, like, they had to beco--, you guys had to become leaders in the healthcare community. And what were some examples of key decisions that you had to make to set yourself up for success later on? So like, how did you confidently make decisions and explore protocols?

JB:I think there was a lot of research that went into it. You know, I was following different Facebook groups. I was following the Utah and American Dental Associations. I was talking to a lot of colleagues. But it was just 00:08:00trying to gather information. I think that was the best way that we coped with it, was we were just trying to gather as much information as we could and then make the decisions that we felt were going to set us up for success long term. And the biggest thing was just making sure we had the protective gear into place and trying to locate that. And it was really nice because the Utah Dental Association and our colleagues, we all kind of came together and we helped each other find masks and equipment and different things. But it was just, literally, trying to gather all the information we could to make the best decision possible with the pandemic, because no one really has gone through this specific pandemic before; there's no protocol for it. So, we literally were trying to make decisions as we go, with the information we had.

KC:Yeah, for sure. Yeah, definitely, I feel like that is definitely new waters 00:09:00that you had to go through. And so, I kind of already touched on this, but how did you feel like your days were like, at first, like, did you-- Was it hard to get back into it, and things like that, and, like, stay positive throughout it? Or has it changed from the beginning of going back after your dentistry had closed? And now, how are they now?

JB:Yeah, when I first started back, I was really scared. I mean, I didn't want to contract COVID. And so, I literally was just, I would put my equipment on and my face mask and everything, and I would not take anything off or touch anything for the whole day. So I would literally be in a mask and gown for six or seven hours straight. And I just didn't wanna contaminate anything else. So, you know, we would work on one patient, sterilize everything, change our masks, and then move on to the next patient to work on people. And it's funny in dentistry, 00:10:00because a lot of times you run three or four different chairs, so you have hygiene going on, and then you'll have two patients in the chairs, and you'll numb a patient, and then you'll go do fillings. And then you'll come back when you're done with one patient and the other patient's numb and ready to be worked on. So a lot of times we were jumping from chair to chair, just depending on who was numb and who needed treatment. And we had to change all of those protocols to just working on one person at a time. You know, it slows down quite a bit. And so, it affected the production of the practice, because we were literally just treating one patient at a time instead of several patients at a time.

Our number of staff was reduced. We ended up having part of our staff laid off through the pandemic because we had so many patients that were choosing to stay home because they were scared to come in and get dental work because they didn't want to be exposed to the virus. And so, we had the number of patients lessen. 00:11:00But things have changed, through the last year we've gotten, you know, a lot of us have gotten a vaccine, which helps. It helps, you know, with our safety and our patients' safety. We've had a lot of our patients get the vaccine. And so, they're starting to come back in after being off for a year, and some of them have dental needs that needed to be treated. We've had a lot of toothaches that have needed to be treated because people have missed their checkups for a year. And so you know, it definitely increased our dentistry that needs to be done in emerging care, just because people were not able to come in routinely. But our protocols are still the same. We still wear double masks, and shields, and surgical caps and gowns. We still follow those protocols, but now we feel safer, just with the vaccine and more information. We're realizing, you know, we know 00:12:00more about the virus now and how it's transferred and different things. So, we've been able to relax a little bit as it has gone on, even though our protocols are still in place.

KC:One hundred percent. Have you been vaccinated directly, and how did you feel about that?

JB:I did, I had the choice. I gave my staff the choice. I didn't make it mandatory. It's their choice whether they wanted to do it. I chose to go ahead and get a vaccine. I received the Moderna vaccine. I did the two shots and I have done really well with it. I got really sick with the second shot, the first shot I had no problems whatsoever. The second one made me really sick for about twenty-four hours, but after that I've had no symptoms or problems.

KC:That's awesome. Do you feel like it was good-- did you feel finally hopeful 00:13:00about it? Like it was finally maybe an end to it?

JB:Yeah, like, I felt like when I got my vaccine, I felt like just a huge weight lifted where I felt like more and more people could relax a little bit. Like, you know, we could practice, I could practice in the same ways we were practicing, but I wasn't so worried that I would get it or I would bring it home to my kids or family.

KC:Yeah, for sure.

JB:It's been very helpful, very huge stress reliever.

KC:Yeah. So, you talked about having to lay off some of your employees and things like that. Can you talk a little bit about how the COVID-19 pandemic has affected your practice financially, and, like, what steps you had to take to secure your business and things like that?

JB:Yeah, so during that month, when we got home from Scotland, the UDA [Utah Dental Association], and ADA [American Dental Association], recommended to close practices to nothing more than emergency care, we knew that we would only be 00:14:00able to have just a few of the staff stay on because we just didn't know how many patients we would be treating. And so, we made the recommendation to keep three of the staff members on of the eleven. The other portion, we ended up having them, we laid them off, and they basically took a sabbatical, and they were on unemployment for that period of time for about a month, one to one and a half months, while we kind of reassessed the situation during that closure. And then, once they gave us the okay to open back up, we rehired everyone, or gave everyone the opportunity to come back to work. And then we reopened the doors as best we could, knowing that there were a lot of patients that just weren't ready 00:15:00to come back.

So definitely, I was down about thirty-five percent from my normal production as compared to the year before in that second quarter. The second quarter was down thirty-five percent, and then, after that, in the third and fourth quarters, we had a lot more people coming in and we were able to make up some of that production and income that we lost during that closure, and during, you know, three months after the closure. But overall, last year, I was down eleven percent from the year before. So, we were down thirty-five percent in the second quarter, and then, when everything was said and done, we were down eleven percent, which I felt really good about considering how many patients had stayed home and canceled their hygiene appointments, and being closed for that full 00:16:00month with only emergency care, only.

KC:Yeah, that's that-- I mean, it's still not ideal, but it is good for a pandemic.

JB:Yeah.

KC:Yes. So, have you had any unique challenges that your practice faced regarding the pandemic? Like, with patients and things like that, have you found yourself having to problem-solve a little bit?

JB:Yeah. I mean, our first challenge was trying to get protective gear. I think what happened with it was China kind of knew what was happening to, you know, in the beginning, and then they started ordering all the protective equipment. And then, when we started being faced with it, our hospitals needed N95s, and face shields, and protective equipment. And then, by the time we realized it, there was nothing left, like we couldn't get anything. And so, I think that that has been one of the major challenges that we faced, was even having, you know, in 00:17:00N95s and protective equipment for us to treat our patients and be protected ourselves. And even to this day, we still have glove shortages. We're only, sometimes we're only allowed to order three boxes of gloves at a time, or six boxes of masks at a time. Whereas before the pandemic, we could get as many gloves or masks as we wanted. But it's still limited and that's a huge factor for the dental industry. If I don't have masks and gloves, I'm not able to practice.

KC:Oh, 100 percent. And I bet that's like, I bet, it feels a little bit scary just knowing that you are kind of on a shortage.

JB:Yeah.

KC:So, how do you think it's, like, that we've been handling the pandemic? Whether that's like you talked about following the American Dental Association and Utah dental places, and things like that.

JB:It's hard for me to fault anyone. I mean, I've looked through what happened with President Trump and [Dr.] Fauci, and, you know, the closures were 00:18:00recommended by the ADA and the Utah Dental Association. And I just, I can't fault anyone. I felt like this was just one of those situations where I don't think anyone was trying to do a disservice or destroy the economy in that first month. I felt like it was just something that came up on us, and it happened so fast. Like I said, we were on our way to Scotland, and then all of a sudden, I was gone for a week and a half, and when I got home, things had completely turned around. Things were completely different when I got home a week and a half later. And then, I ended up going on a fourteen-day travel quarantine. So, I was literally out of my dental office for almost a month. And then, when I got back these were, you know, 180 degrees backwards from where I left them. And so, I can't fault people that first month. I think we were all just trying to figure things out. And--

KC:Yeah.

JB:-- you know, it's just hard to fault people for the decisions that were made. 00:19:00And, you know, I feel sorry for other people that have lost their jobs and the businesses that have closed and repercussions that have continued on. But in the beginning, I can't fault anyone.

Now looking back a year later, I think it's time though, to let the kids back in the schools, and to open things up, and let people just make the decision to stay safe themselves, and go from there. I'd like to see, you know, more autonomy given to individuals to decide whether they want to wear masks or not. But, as for our doctors, right now, we cater to, we keep wearing our masks, we keep our standards where we've had them a year ago. We still take temperatures at the doors, we still have barriers and protective shields on our, you know, heads. We still do everything we did a year ago, just because we like to cater 00:20:00to the most prone person that still may get COVID. And so, we still keep our standards pretty high at this point, because I'm choosing to go that route.

KC:Oh, 100 percent. I think that's a great route to take. I know, talking with you, that you travel quite a bit for dental conferences and things like that. Have you noticed, like, has there been good alternatives to that or has that been frustrating to get new resources?

JB:No, not at all. I have done more continuing education in the last year than I could possibly do previously because all of the continuing education centers have opened up online classes. And so, I've been able to take courses on a weekend or, you know, different days that I would have normally had to drop off to, you know, Scottsdale, Arizona, or Florida or Texas, or wherever, which is a great expense to take you or your staff or whomever to go do continuing 00:21:00education. So, it's actually been really awesome. They've opened up all online classes, they've done virtual meetings, we hold virtual study clubs. So, for me, the information flow has increased, you know, a thousand percent, and the opportunities have increased a thousand percent because now I can do everything at my fingertips on my laptop, whereas before I had to be there in person and have the expenses of the travel. So, it's actually been a great thing.

I think that's also changed for my kids and schooling. A lot of the parent-teacher conferences and meetings that we have with kids at school are done online. And as a working mom, I love that. I love doing a Zoom meeting rather than having to go meet at the school. It's so much more convenient and easy for us, too. For me, the online, you know, the transition over to more 00:22:00online stuff and more Zoom meetings, and stuff like that, has been great and it's given me more opportunity.

KC:Which is awesome, I think, especially as you are a working mom, that gives you a good bridge between your work and your kids. So, just as we close, how are you staying connected to family, friends, work, and school, and balancing it all, while still trying to go through this pandemic and things like that?

JB:You know, that's a good question. I feel like we're finally starting to see the cloud lift. I feel like all last year, it was very limited in contact. I felt like a lot of the contact that we had was just through Facebook, or social media, or texting. There wasn't a lot of individual in-person type meetings. And it's really sad. I feel like I kept everybody at a distance, family and friends. And I feel like our lives were almost on hold. So, this year has been much better with being able to see people and travel and do different things. You 00:23:00know, music is coming back into play, like concerts; and travel opportunities, like Hawaii just opened. And, you know, there's just, I feel like the cloud is lifting a little bit where we're able to do more of those social things. And I am so excited about that.

KC:Oh, for sure. And so, at the end of the day, do you feel like things are gonna continue to get better and that it's just going to keep going on the up?

JB:I feel hopeful that we've learned a lot over the last year. I think we're headed in the right direction, I feel hopeful that we're, you know, going to continue on this progress. But I still feel like we have a lot to learn, and to watch for, and to listen to. I think there are variants to COVID, and I don't know how those are gonna affect us. I think that's the one thing, and the one 00:24:00unknown is how the virus will change and mutate, and what kind of issues that will cause, and whether we need more and more vaccines, or different vaccines, or booster shots. This very well could be something we deal with for the rest of our lives, and our kids deal with. We just don't know, at this point, what longevity is. And I will tell you, a year ago when all of this went down, I never-- if you had asked me a year ago, if we'd still be dealing with it today, [I would've said,] "No." I never would have guessed that this would be an ongoing thing and we'd still be worrying about it now, a year ago.

KC:Yeah, 100 percent. So, if there was another surge in COVID-19, do you feel confident in your practice and things that you would be okay?

JB:Yeah. I don't think we would change anything. Right now, we have our protocols in place, and we've kept the protocols, even with the mask mandate being lifted in Utah. We still do everything we can to keep my patients, and my 00:25:00staff, and I safe. And so, if we do have, you know, anything else happening, we still have the protocols in place, we still have everything going. So, knock on wood, I feel we can still handle what comes our way and we're better prepared for it after experiencing this last year.

KC:Awesome. Well, I really appreciate getting to talk with you and getting to take your time to interview about this. And I really appreciate your input on this whole thing, especially as a dentist in Utah. So I appreciate it.

JB;Thank you.

KC:Yeah.

JB:No problem.

KC:Well, thank you so much, and I will talk to you another time.

JB:All right. Thanks, Kennedy.

[END OF RECORDING. END OF INTERVIEW.]