By EWA MATUSZEWSKI
Did you catch the oxymoron in the headline? Reactive disaster planning – or reactive planning of any sort – of course is not planning. But writing this so close to what we can only hope was and is the worst disaster of our lifetime, we mut be honest and admit that our responses to the myriad disasters wrought by the pandemic were rarely planned. Some of us may have been quicker to act than others, more willing to admit that indeed a crisis of heretofore unknown proportions was upon us. But still, we reacted. We had not adequately planned.
In Michigan, we were at the epicenter of our nation’s outbreak, and primary care practices in particular – with their normally busy offices of over-scheduled patient visits – were in a tizzy as the degree of the severity of this crisis came to be understood. While most primary care physicians and their practice teams did not have a basic emergency preparedness plan in place there is no excuse not to have create one now for future disasters.
First, understand that disasters take many forms beyond public health. They can be an electric grid failure, or weather-related, such as a tornado or a dam break (like the one we had in mid-Michigan amid the pandemic), with flooding that displaces people and businesses, forces a boil water advisory, and otherwise brings chaos to small communities. Fire obviously devastates, as can the impact of a trusted physician partner who leaves a practice under dubious circumstances which may or may not bring legal scrutiny or practice reputation risks.
Other practice-specific disasters can be identified, but focus instead on an effective disaster plan, with its four pillars:
The following basic tips provide steps you can take now to be prepared for – and recover from – what may lie ahead. They also provide general business advice. Despite the unique nature of a physician practice, business and operational aspects must also be prioritized. Making wise business decisions is good for patients, practice teams, and the physician’s livelihood.
Consider tackling a disaster recovery plan month by month, with the toughest topics handled early on. Regardless of how you approach your planning, identify a coordinator and planning team and charge them with conducting a needs assessment to identify gaps and vulnerabilities. Establish a chain of command. In the case of another pandemic or health crisis, assign a staff member to interact with the local health department and monitor CDC guidelines for infection control. Assign another staff member to inventory items such as PPE, determining what levels are considered at least adequate in a crisis; put a re-supply policy is in place.
Identify the key contacts authorized to speak on behalf of the practice. The physician may be focused on patient care; identify a second source who can ably communicate with patients, team members, vendors, and other external audiences. Depending on the situation, a communications professional may be necessary.
This can’t be overemphasized: build a network. Join the local chamber of commerce and other affinity groups, connect with the local school district, know your local elected officials. Be an active member of professional organizations such as the MGMA, Michigan Osteopathic Association, the Michigan State Medical Society, and the Michigan Association of Family Physicians, or join a physician organization. Associations are rich information sources, with webinars, informational websites, newsletters, and other communication vehicles, not to mention access to decision makers that can help mitigate a crisis through their own broader networks and resources.
Engage with your local health department year-round. Be a resource for them and they will do the same for you. Participate in community drills for stockpiling, distribution, and dispensing or supplies.
Training and education: Keep office policies and procedures up to date. Cross train all members of the practice so they can step in when a gap is identified. Train the medical practice team on the disaster plan and do a dry run at least annually.
Crises are expensive. Establish an annual budget. Review the most recent fiscal years’ budgets and set a goal to save for a minimum of 4-7 months of operating expenses. Also, plan for future capital expenditures to grow your practice.
Balance the books. Prioritize the reconciliation of bank statements at least monthly for full knowledge of your cash flow situation.
Find a trusted CPA and establish regular touchpoints.
Develop a relationship with a financial institution. Your local banker can be an excellent resource in times of financial uncertainty.
If your practice is already bouncing back, you were doing enough right all along to sustain it. But when the next disaster strikes, there will be much less sympathy and assistance for those who chose to waste this crisis by not immediately planning for the next one.