Pediatricians know that during times of crisis, they’re the ones being looked to for help. Families, staff, and most importantly patients need resources, information, and reassurance to help them weather the storm. Taking advice from two physicians experienced in crisis management, we take a look at how pediatricians can be leaders in their communities, advocate for the underserved, and continue to affect positive change.
The advice and information offered in this article comes from the fifth in the Pediatric Management Institute’s Business Impact of COVID-19 webinar series, hosted by PMI’s Paulie Vanchiere and PCC’s Chip Hart. They were joined by physician-experts Dr. Nneka Unachuwku, FAAP, and Dr. Fernando Ysern, FAAP, who have practical advice to share from their own clinical experiences in Georgia and Puerto Rico, respectively.
Access to all of the Business Impact of COVID-19 webinars is available here. Sign up for the forum and join the conversation!
In previous articles, we encouraged pediatricians to apply for financial assistance offered by the U.S. federal government, in order to continue to pay expenses such as rent and payroll and to maintain revenue during a summer that could be severely affected by stay-at-home orders. This assistance included the Payment Protection Program (PPP) and the Economic Injury Disaster Loan (EIDL). As of mid-April, the first round of funding has been exhausted.
While new applications are not being accepted at the time of this writing, funding is expected to be replenished in another stimulus bill, which could allow the Small Business Administration to accept new PPP and EIDL applications. Here are Chip and Paulie’s latest recommendations for pediatricians navigating their finances:
If you have not applied for assistance, your best bet is to apply for or extend a line of credit with your bank. Applications may reopen for federal assistance at a future date, in which case we recommend that you apply for this low interest or free assistance.
If you have applied for PPP or EIDL assistance and have not received confirmation, your application may still be approved if and when the SBA is granted more funds from a second stimulus package.
If you have applied for PPP or EIDL assistance and have been approved, you may or may not have received your funds yet. Have back up plans, such as a line of credit, to account for 3 to 6 months of financial stress at your practice.
Are you advocating for your practice? As a small business, it deserves the same opportunity for assistance in an economic crisis as any other. Of course, providers are natural advocates for the health and well-being of families and patients.
Luckily, you can use these skills in patient advocacy to advocate for your practice. During this time when the national focus is on healthcare providers more than ever, you have the opportunity to reach out to your Senators and representatives to ask for the help you need, and demand the assistance that was promised. Advocating for your practice is a key step in caring for your community.
Here you can locate and contact your House representatives.
Here you can contact the U.S. Senate and speak to your Senator’s office directly.
“Great leaders know that adversity produces the greatest opportunities in life.” -- Brandon Webb
Dr. Nneka Unachuwku, affectionately known as Dr. Una by her patients, is a physician, entrepreneur, career coach, and podcaster. Her approach to addressing the obstacles of the COVID-19 pandemic are to seek the opportunities that present themselves. “They’re many,” she said in the April 17th webinar, “One of them is the opportunity for reinvention.”
Dr. Una posits that practices now have the time and in some cases, the incentive to pursue ideas and projects they never had time to do before, most prominently telemedicine. PCC has recommended that practices take the leap into telemedicine as quickly as possible, and Chip Hart, Director of Pediatric Solutions, suggests that providers may also now have the bandwidth to call patients and tidy up asthma, ADHD medication, or behavioral health action plans.
Dr. Una continued by explaining that telemedicine operations allow providers to take back the market share from telehealth provided by insurance payors, and even speculates that telemedicine’s reach could extend to a post-COVID-19 world, allowing providers to, for example, achieve better work/life balance.
She says that the pandemic has brought many providers to take on an “alternate MBA,” or a process of learning the essentials of their business in a way many hadn’t had reason or time to before. According to Dr. Una, this process empowers providers to be strong leaders, communicating efficiently and often with their teams and communities, solving problems, making plans for the future, and adapting to pressure with as much grace and flexibility as possible. Leadership skills, after all, are often learned in the moment.
While Puerto Rican pediatrician Dr. Fernando Ysern knows how to handle crisis situations such as hurricanes, economic strife, and insurance battles, he takes a philosophical approach to dealing with the fallout of the COVID-19 pandemic. “We are probably not going to go back to normal,” he says with a smile, “But what is normal?”
Recalling that the webinar's airing date of April 17th was the anniversary of the Apollo 13 mission’s safe return to Earth, Dr. Ysern reminded the audience that the current crisis could also be a vehicle for extreme coordination, efficient effort, and could produce “one of our greatest moments if we can come together, and work this out, and especially for pediatricians -- we have an advantage [in fighting for things like telemedicine in the future].”
Dr. Ysern spoke about his practice’s preparation well in advance for such natural disasters as Hurricane Maria, so that despite 3 months of widespread power outages and lack of water, his practice “did quite well”.
He recognizes that addressing the practical concerns of the pandemic -- financial, operational, logistical -- are important. He also encourages practices to prepare where they can for future, unknowable emergencies. This includes practicing flexibility in a way such that emergencies can be addressed operationally. “This is a sudden change we were not expecting,” he says. “But what if COVID hadn’t come at all? Things change anyway. If we do not work and try to find change, find quality improvement, some of you are going to end up doing wrong.”
Dr. Ysern also asks providers to remember the emotional aspect of the pandemic is important too. Patients, staff, and families are going through emotional turmoil many have never experienced, and providers have an opportunity to offer guidance, support, and reassurance in uncertain times. He continues his philosophic reassurance to providers in this way:
“When you’re drowning, there are two positive things. First, you haven’t drowned, you’re alive! Second, you know exactly what you need to do -- you only need to keep swimming.”
Check out the full webinar and the forum to join the conversation. You can also visit PCC Learn's resource page for our latest updates on COVID-19 related material, resources, and advice.