COVID-19 is affecting businesses of all industries and sizes, and private practice is certainly not exempt.
We’re in the midst of an unprecedented event with no clarity on the best path forward. There are a lot of unknowns, particularly concerning the long-term impact of the coronavirus and how owners can start planning now to mitigate any negative effects on their business.
Private practice owner Mike Lewis (whose PT practice is located in Seattle where the first cases of coronavirus were confirmed in the US) joined us recently to share some insights for other owners regarding how we can deal with COVID-19’s impact on business. Here are the answers to the most pressing questions we tackled.
How can I best plan for ensuring my business can survive the financial impact?
First and foremost, practice owners should plan on keeping their marketing alive. Many owners make the mistake of pulling back on marketing when money is tight because it’s a cost they can control (unlike overhead, for example). But the fact remains that you still need new patients coming in, you still need to hold onto current patients, and people still need PT. Pain doesn’t take a holiday when a crisis emerges, and you need to be there during times of need.
The situation isn’t going away in two weeks, and it’s anyone’s guess as to how long it will last. Regardless, you need to put on your own oxygen mask first. Take care of yourself and your family. Get enough sleep, go outside for a walk, eat well, and stay vigilant of any changes every day. This is going to be a marathon, not a sprint, so it’s best to prepare mentally and financially for the long term.
You also need to think about how you’re going to take care of your practice. This might mean cutting expenses at some point. Dialing back payroll and operating hours, reducing staff, and cutting any unnecessary spending can help you make up for any potential loss of revenue if your phones aren’t ringing as often or patients are missing appointments.
I recommend using our Gray-to-Black planning methodology. I go into more detail at our Facebook PT group, but this plan focuses on less-than-ideal scenarios: what would happen if you had a 50% reduction in income over the next 60-90 days?
Mike recommends talking with vendors or creditors to see if you can get some leeway on payments or pursuing lines of credit to keep business going. Also, make sure you’re reaching out to current patients to see how they’re doing to encourage them to continue with their plan of care. Now is a critical time to engage with them and show them you’re invested in their progress and are here for them.
What are the best practices for continuing to treat patients safely?
We don’t want to put patients or staff in a compromised position, so it’s important to respect boundaries. It’s not our job to convince or coerce staff or patients to come in, so be respectful if they decide not to come into the practice.
Follow reliable guidelines from the WHO, CDC, and local authorities to ensure you’re taking all the right precautions – we have put together a COVID Physical Therapy Guide to help PT Therapists and practice owners here. Look at how your clinic is set up to make sure clients can safely distance themselves from other patients. Consider steps like installing a hand-washing station, putting out hand sanitizers, and propping open the front door so people don’t have to touch it to open it. Limit visitors that accompany patients.
Anything you can do in accordance with expert recommendations will help create a safer environment and instill confidence in your patients and staff.
How would you go about implementing telehealth as an option?
Telehealth in PT (and the medical industry at large) is an extremely hot topic at the moment. Telehealth isn’t a new concept, but it’s also not widely implemented just yet. During COVID-19, many PT practice owners have expressed interest in offering telehealth as an option to keep patients safe and continue to provide care to their patients.
Here’s the reality: several years ago, we actually offered telehealth as a cash-pay option. We ended up shutting the program down because, at the time, the rules and laws around telehealth were very grey. The laws are better defined now, but there are still misconceptions surrounding the service.
One question that’s come up many times recently is whether you can use telehealth to replace income loss. What I recommend is looking at the codes that CMS just put out. You might be surprised to learn that the reimbursement rate is considerably low—anywhere from $15 to $37 per visit. If you’re getting $90 per visit in the clinic, you’re not likely to replace that loss with telehealth.
Another thing to consider is that patients may not be able to adapt as quickly as you. This is a drastic change, and you may not be able to get your older patients to hop on a Zoom call.
The way you might consider using telemedicine is with no expectation of reimbursement from the insurance company. You can use it for a check-in or follow-up with a patient (which is what we do at Madden PT) or if someone wants to hop on a call because they took themselves out of care.
Ideally, only take advice from PTs who had done telehealth before the COVID-19 crisis. There’s too much misinformation out there right now to dive in head-first with the wrong expectations.
How do you work through the decision as an owner to close or remain open?
There are two sides to this: first, you want to realistically look at your practice to see if you’re set up to provide a safe environment for your patients and staff. And second, you should follow the directives of your state authorities. Every state is a little different at this point, so make sure you’re tracking updates as they become available.
Even if the decision is made for you, and you’re forced to close temporarily, doing so isn’t easy. You worry about the well-being of your patients and employees and have no time frame to give them as to when you will reopen. But remember that it’s essential for you to keep their safety (and your own) as a top priority.
We’re all finding our way through these strange times. For more support, join our free Facebook community—Private PT Practices: Standing Up Through Crisis.