After COVID-19 – Reopening Your Medical Practice

As this is being written the state and county restrictions on conducting business, including medical practices, are being lifted. Everyone wants to return to their lives and businesses prior to COVID-19. For a physician, this period of “ramping up” his/her medical practice offers an opportunity to reassess past habits, routines and procedures; identify those that may need to be revised in order to conduct business in a post-COVID-19 world, and make those revisions.

 

For the sake of simplicity, this article divides these habits, routines, and procedures into three categories- structural, operational, and clinical. NOTE: These categories are neither exclusive nor exhaustive. Rather, they provide one way to categorize, identify, and address the changes a medical practice should consider making in the wake of COVID-19.

 

This category focuses on the legal documents that address how the practice operates and with whom it does business. These include the practice’s basic organizational documents, that is the practice’s bylaws, partnership, and physician employment/retention agreements, as well as its relationships with key vendor agreements, referral sources, and insurance policies.

 

One question to ask is whether there was some event that was not adequately addressed in these documents, or that needs to be considered if of a similar future event occurs. For example:

– What happens if an important physician-owner becomes ill; is there insurance that will indemnify the practice for the loss of that physician’s revenue?

– What happens if a vendor, who supplies a critical item or service, is not able to do so; can the practice seek that item or service from another vendor and is it entitled to indemnification if there is a higher cost?

– Did the practice have sufficient business interruption coverage to meet its ongoing obligations?

 

After all, the likelihood of another event that will disrupt the practice’s business substantially (for example, another pandemic or the damage caused by a major hurricane) is something that should be anticipated.

 

The need to retain, furlough, or terminate employees because business during the pandemic was poor is best addressed before another pandemic, hurricane, etc., strikes. These questions include whether the practice

– has adopted sufficient policies and procedures, incorporated them into an employee handbook, and made sure every employee receives a copy of that handbook; and

– what to do if an employee needs to be treated for a medical condition, like COVID-19, or as the result of an injury suffered while working. If limited to an employee’s accrued sick leave. he or she can quickly exhaust that allowance, even when the recovery period for a condition such as COVID-19 is measured in weeks.

 

Another operational issue is determining whether the practice’s compliance plan was robust enough to ensure the businesses’ compliance with all relevant state and federal requirements.

 

Probably the category generating the most attention involves the clinical habits, routines and procedures medical practices will need to consider as their practices begin reviving. For example, before COVID-19 the use of face masks and gloves during an office visit was limited. Now, patients expect to see their physicians and staff using these items. A question now is whether additional patient protective equipment (“PPE”) should be worn each time a patient is seen?

 

From a patient’s perspective, one of the few benefits of this pandemic is the absence of long waiting times when they see a physician in-person. Will medical practices abandon double booking and adopt scheduling protocols carrying this situation forward? Similarly, will practices adopt telemedicine as a mechanism for delivering health care services and/or, like some other businesses, begin providing home services to patients?

 

The physicians in a medical practice (owners and employees) should begin reviewing how and addressing what changes need to be made to their business. If they have not begun this process already, there is an increasing likelihood their medical practice will not adapt to the changes we are beginning to see in a post-COVID-19 medical industry. So, begin now. Assemble the practice’s governing body and trusted advisors (these professionals should include its attorney, accountant, insurance broker, banker, billing consultant, and asset manager) to begin this review process. When the next business interruption happens, the owners will be glad they are proactive.