Leading your medical practice through crisis

The conversations we’ve had with physicians this week confirmed that the primal fight-or-flight response has kicked in as physicians across the nation recognize the COVID-19 pandemic as an imminent threat to the survival of their practices. Some are reacting from a place of fear, while others are proactively evaluating options and making strategic moves.

In surgery, there exists a time-honored adage: all bleeding stops eventually. When a patient has unexpected severe bleeding in the OR, confident and decisive measures must be taken to save their life. Conversely, paralyzing fear can have detrimental consequences. Apply the same skills ingrained in you to manage an event in the OR to navigating this economic crisis.

1. Check your own pulse. It is normal to feel afraid, but allowing fear to take over will impede your judgment. Acknowledge how you’re feeling and re-center yourself so that you can respond with a clear head.

2. Turn down the music. Like music in the OR, during a crisis the noise becomes distracting and contributes to anxiety. With the viral pandemic, it’s important to stay informed about what’s going on in your city and state, throughout the country and across the globe, but the constant updates, incessant scrolling, and intrusive news alerts add to the fear and distract you from taking real action. Turn it down and focus.

3. Assess the situation. What is your financial situation? Compare your typical monthly expenses with the balance of your cash reserves. How long can you go before you have to reduce wages and hours or lay people off? What expenses should you hold back on paying? And which ones should you prioritize? Asking the bank and credit card company for an extension is advisable. Failing to pay the third-party billing company (that is likely a small business, too) would be short-sighted. You need them to continue working the accounts receivable, which may be your only source of revenue for now.

4. Call for backup. You are not alone in this crisis. Call on your colleagues, consultants, advisors, and specialty societies. Across the health care industry, people are reaching out, sharing ideas, and providing support. Webinars, blogs, and articles are by now filling your inbox. Tap into your social and faith network, recognize your support system, and use them. Everyone is saying, “We’re all in this together,” and it’s true.

5. Develop your plan and act. Steve Jobs said, “Deciding what not to do is as important as deciding what to do.” Involve the manager(s) in developing an immediate action plan. They likely have helpful ideas and may offer a perspective you hadn’t considered. Get their input and engage them in the process, because you likely need their help executing the changes. Write down the plan and make it exceedingly clear what changes are happening and when.

6. Communicate with your team. In the OR and in your practice, you are the captain, and your team is waiting for you to lead them. They look to you to solve problems, and now more than ever, they need to hear clear directives from you. In author Michael Hyatt’s free webinar Confident in Crisis, he said something that deeply resonated: “Nature abhors a vacuum. If you don’t supply the narrative, they will make something up.”

Be honest and direct with your team, no matter how difficult it is. For staff whose hours are reduced or the teams that are working remotely, stay in regular contact using phone, video chats, texts, or one of the countless forms of technology that allow us to stay connected. This is not the time to go radio silent. The situation will likely continue to evolve, and regular, frequent contact will help staff abate their own anxiety.

7. Communicate with your patients. You most likely will reduce office hours and availability to some degree. Some physicians will even close their offices. Use email, letters, and social media to keep patients updated on appointment and phone hours and how to best contact you when the office is closed. Encourage patients to stay home when possible, stay healthy, and remain positive.

A reminder to all who are feeling a bit helpless – though our current situation is tragic, remember that you’ve come through other setbacks in life. On your most difficult days, remind yourself that thus far, you have a 100% success rate at surviving difficult times. You can survive this, too.

You have an extraordinary opportunity right now to serve your patients and staff, neighbors, and colleagues. Serve them well.

Thank you to Dr. Sidhbh Gallagher for her explanation to a layperson of how a surgeon manages a crisis in the OR.