Alone in the COVID Desert…

I have the utmost respect for our front-line providers. I’m talking about the healthcare providers and their support staff who are going out there every day in our EDs and ICUs taking care of patients with COVID-19. That’s a very hard, very high-risk job. This post is not about you guys. You guys keep doing what you’re doing, because the world loves you and we need you.

This post is aimed at physicians who primarily have an elective practice. Outpatient docs. Some specialist docs. Surgeons who can’t get any of their cases boarded in the OR because everything is so limited. This subset of physicians, and our dental/adjunctive healthcare colleagues, are faced with a huge problem: How do you keep the doors open when the current healthcare crisis mandates that you keep them essentially shut? There’s rent to pay. There are staff members who need to be maintained. And whoo! Don’t get me started on malpractice insurance… The clock continues to tick on all of these practicalities even though the elective medical world is at a standstill.

And to my colleagues in the employed or multispecialty models who are not able to do front-line work: How do you fill your time? Many groups have the expectation that all hands are on deck here… How will you justify your salary? What can you do to remain productive in a COVID world?

Like Clark Griswold in that first National Lampoon’s Vacation that we all love so dearly, you might be feeling like your car has broken down somewhere on the desert highway. Now you have to tie a shirt around your head while hiking over boulders to find help for your family…

A FEW OPTIONS…

We’ve spent some time over the last few posts talking about shifting your practice to a virtual setting just to maintain order and to keep the care flow going. Hopefully, that’s helped to jumpstart things a bit. But a number of physicians have asked, “What else can I do? And how can I keep my practice afloat until things normalize again?”

There are some good options. It all depends on which direction suits you the best. Some are more clinical. Some are more academic/industry-based. Permit me to throw out a few suggestions that I’ve discussed with my fellow physicians just even in the past few days:

  • Front Line Work — Our physician friends in the ED and ICU are really struggling. If you have an MD/DO and are willing to help out on the front line, I would be surprised if anyone would turn you down. Are you trained in the ICU? Do you vaguely remember ventilator management? If so, you have a valuable skill that is in high demand right now. If critical care isn’t your thing, I’ll bet that the ED would be happy if you could even help out with the mundane things. COVID notwithstanding, people still need help for a variety of ailments. Stitches, heart attacks, slip-and-falls… These things still happen. Even if you’re not a pulmonary expert, you have skills that count.
  • Academic — With this sudden switch to virtual classrooms, many professors are struggling to get content up quickly so as to keep their semesters going. Any friends teaching at your local university or medical school? I would be that if you offered to contribute something to their online curricula, they would be most appreciative.
  • Industry/Tech Commercialization — [Warning: I’m super-passionate about this!] So we as physicians always complain that industry needs to build a better whatever-thing because the whatever-thing we are currently using in the OR just doesn’t work right. And you’re absolutely right! There are a lot of young companies or proto-companies out there who are trying to do exactly this! The problem? Very few of them are actually run by physicians with clinical experience. We take our doctors’ lounge conversations about patient care for granted. Clever people are spinning their wheels designing stuff that we don’t want simply because we never get to tell them what we really need. You don’t have to give away your health system’s secret sauce or reveal any patient information. Your years of experience and your board certification are enough. And you don’t have to commit a huge chunk of time to helping these small groups out. Thirty minutes of your time will be immensely helpful, and it may make the next generation of healthcare better. [If you’re not sure where to start, contact me. There are lots of great ways to get involved.]
  • Side Gigs — Do you have a small business selling real estate or something akin to that? Do you do any consulting work for legal or payor entities? Nisha Mehta, MD has a popular website called Physician Side Gigs. I am not affiliated with them in any way, but I have found them to have some great discussions and resources. If you haven’t taken a look, it may be worth your time. Just remember a great quote an ED friend once told me: “Be careful before you say yes to anything. There are a lot of people out there who want to make money off of your hard-earned MD.” Wise words, my friends. Vet things out thoroughly before you jump into any new projects.
  • Volunteer Your Network — Do you have a friend who manufactures PPE [personal protective equipment]? Those N95 masks are more valuable than gold these days, and our healthcare systems in some parts of the country are struggling to keep up with demand. How about your buddy in that non-medical industry who might have access to some resources that are in short supply right now? Have you reached out to your non-MD/DO friends to see if they are protected? Chiropractors? Home health nurses? Many large health systems are saying that they have pretty much found PPE resources that should start coming through in the next several days, but our small-business colleagues who are vital to maintaining patient health during this crisis may be vulnerable. Spend some time connecting those dots if you can! It may not be glamorous or billable, but helping others is a great way to spend your afternoon. Think about who you might know and pick up that cell phone! Send that email!

CLICKABLE GOODNESS

Finally, the Money Question needs to be addressed. As a small business owner, how are private practice physicians supposed to keep things running for the next several weeks? Well, there are no easy answers to that, I’m afraid… But there are some newer resources that are starting to pop up! I’ve pulled a few here just to get you started:

California Medical Association: Financial Assistance for Medical Practices During the COVID-19 Pandemic

CMS Newsroom: Trump Administration Provides Financial Relief for Medicare Providers [3/28/2020]

CMS Fact Sheet: Expansion of the Accelerated and Advanced Payments Program for Providers and Suppliers During COVID-19 Emergency

Small Business Association: Disaster Assistance

United Way: COVID-19 Community Response and Recovery Fund

And there are a few resources you might want to have handy in case your employees come to you with questions:

US Department of Labor: How Do I File For Unemployment Insurance?

US Department of Labor FAQ #70: Furloughs and Pay Reductions

Stay strong, my friends. We will reach a new normal eventually. And it won’t look the same as things did before this crisis. Adaptation and flexibility will be the keys to survival in the post-COVID age… but we will figure things out. That’s what humans do.

Until then…

— TLS

Photo Credit: Simon Matzinger / Pixabay

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