The Executive Suite: Can, and Should, You Keep Your Practice Open Through the Pandemic?

Never before have we faced such an extensive global health risk and economic disruption. Amid stay at home orders, social distancing guidelines, and overwhelming fear, countless businesses are closing, including many medical practices. Some do not know when or if they will reopen.

Keeping the doors open: is it possible and feasible?

There is no question that the crisis will affect your practice. The question is how severe the impact will be, and how you can stay afloat in these uncertain times.To some extent, the decision may be out of your hands. At the time of this writing, cosmetic, elective, and non-urgent medical treatments are currently prohibited in many areas across North America. However, some remain open and restrictions are expected to ease in coming weeks.

The situation is fluid, so it is essential that you stay up to date on the latest requirements and recommendations. Beyond legalities, there are several things to consider before deciding to (or not to) close your practice:

Assess the health risk: Can you reasonably protect clinicians, other staff members, and patients? This depends on your location, patient demographic, type of services you offer, and even the layout of your office. It will also change over time, as the rate of spread increases and decreases in your locality, so you should constantly re-assess.
Determine the need for services: It might not be financially feasible to keep your office open and staffed for emergencies if they are rare in your specialty. On the other hand, if you are likely to see a lot of emergency patients, it may be profitable to remain open, and it may alleviate some of the burden on local ER facilities.
Review your insurance: Of course, your policy will not explicitly say whether you are covered for Covid 19 related liability, because the disease did not exist when you purchased insurance. It will be included under some policies, but not all. If you are not sure, contact your insurance company or talk to your lawyer. You need to understand your liability before deciding.

Plan for success

Maybe you have decided to stay open, but it certainly is not business as usual. The situation can change on a daily — sometimes hourly – basis. Do not let your office devolve into chaos!

Instead, expect the unexpected. Be prepared and keep your team prepared:

Take stock of supplies: The worldwide shortage of personal protective equipment (PPE) and other medical supplies is unprecedented. What is available today might not be tomorrow. Take inventory of what you have in your office and estimate how long it will last. If you expect to run out quickly, it may be prudent to limit services to the most serious emergencies. Some practices have been forced to close due to lack of supplies.
Create tentative plans: No one knows what to expect, but we can make a good guess, at least for the immediate future. Rather than postponing decisions until you have solid answers, make a detailed plan based on current information. It can be adjusted as things change, but at least you will have a starting point. Also try to anticipate possible “what if” scenarios. What if a clinician or staff member contacts Covid 19? What if a patient displayed possible symptoms? What if you run low on PPE supplies?
Establish a clear chain of command: Despite your best efforts, unexpected issues can and probably will arise. Who has the final word in important decisions? What if that person is not available and the situation is urgent? Do several people need to discuss important matters? If so, how will you call a virtual meeting? You want to answer these and similar questions before they arise.
Keep staff informed: Do not just plan ahead in your mind. Document the appropriate process for handling various situations and discuss your plans with your team. Make sure everyone knows the chain of command, and that they have applicable contact information. The last thing you want is an employee faced with an unexpected problem and no idea what to do or who to call.

Keep your revenue stream flowing

Unless you specialize in infectious diseases or operate an urgent care facility, you can expect a reduction in patients. That means a reduction in income, at a time when you and your employees can least afford it. However, there are steps you can take to minimize the impact:

Explore telehealth options: Online appointments are a great way to conduct post-treatment follow ups, initial consultations, discuss future elective treatments, and in some cases even preliminary visual diagnostics. This can expand your range of services, increase your income stream during the crisis, and reduce the number of people physically present in your office. Even if you must close your doors for a time, you can remain open for virtual business.
Consider alternate services: If your practice focuses on aesthetic or other “nonessential” services, you might have to close for a time. However, you may be able to temporarily transform into an essential facility. For example instead of smile makeovers, offer emergency dentistry. Instead of Botox, offer treatment for wounds, burns, and other dermatological emergencies.
Be financially proactive: Do not wait until you are confronted with a bill you cannot pay. Crunch the numbers. See what your projected revenue looks like and compare that to your financial obligations. Start contacting vendors to inquire about potential discounts or options for delayed payment. Look into loans. Explore ways to reduce expenses if needed. Make a contingency plan and be prepared.
Adjust your marketing strategy: First and foremost, if you are limited to emergency patients make sure you have paused any advertisements for elective procedures. Running these ads is not only a waste of money but it will give people the impression that you are not following local mandates. Secondly, optimize your marketing for emergency services, post on social media to let people know you are available, and use other applicable channels to get the word out.

Conclusion

The loss of human life is unquestionably the greatest tragedy of this pandemic. However, it is far from the only effect. An unknown number of businesses will not recover, and countless jobs will be lost. With some careful planning and smart decisions, you can make sure that your practice does not succumb to the economic fallout.