1. Make big groups smaller:  To allow maximum conversation and connection use break out rooms whenever possible so allow group of 2-4 people to converse at a time.

2. Give clear instructions be thoughtful of your words and directions. Breaking into small groups does not always allow for check-in and clarifying questions

3. Make visits shorter:  consider more frequent and shorter visits so as to keep every participants attention.

4. Use your mute button:  To help contain enthusiasm the careful use of mute buttons allow a more controlled conversation.

5. Use the right technology: ZOOM is a leader in the ability to have breakout rooms and HIPPA compliance especially for larger groups but can cost $200 a month or more.  Doxy.me is good for smaller groups of 10 or less, but does not have break out capabilities.  We are working on evaluating technology and hope to give a full report later.

5. Create a virtual room: We anticipate a future where only a small percentage of people will be able to have a visit in person.  A virtual room will allow a combination of in person and at home people to interact.

1. We have the infrastructure in place to communicate and handle a large number of people.  One clinician can see over 150 patients receiving services in a day and clinically bill for 30 or more.  This efficiency has us prepared for emergencies such as Covid19, gas explosions, and winter weather.

2. Our schedule has flexibility to accommodate changes.  Because a large number of our group visits are run as a drop in service there are fewer pre-scheduled appointments that would need cancellation in the event of a community emergency.

3. We have an enhanced relationship with our patients and community and thus are more effective in sending messages (such as social distancing).  By seeing large numbers of people consistently over months and years a mutual trust and understanding have developed so that communication is more effective.

1. We are offering on-line exercise and yoga classes.  We have had to cancel in person groups where it would be difficult to maintain social distancing of 6 feet.  Come join us on-line either on Youtube or Live streaming for a yoga class.

2. We are working with Kronos Health by offering more clinical hours by our providers and staff to help with increased medical activity at this time.  It is helpful to be able to switch our focus towards the medical practice.

3. We are offering our integrative medicine services (such as acupuncture) in a one-on-one manner using our space to keep people separated.  We have limited group sizes to 6 people at most and are staggering entry to our programs.