Protecting your practice in the time of COVID-19

One month ago, I was doing my weekend readings at Barnes and Noble, writing, and sipping on my favorite mango dragon fruit lemonade. Little did I know that two weeks later, I would be sitting at home, on the phone with my bank to negotiate for a deferred loan payment because of an emergency shut down. My patients were cancelled or rescheduled indefinitely.  Schools were closed. Never-before-seen memes about toilet paper shortage have gone viral: toilet paper rolls used as gambling tokens or college tuition payment, toilet paper zombies, and images of empty shelves. There is endless discussion about N-95 masks, surgical versus industrial, real masks versus fake masks, cloth masks, diaper masks, or 3D DIY masks.  We have gone mask-frenzy as a nation.

Photo of Dr. Hung

Dr. Hung

Media is flooded with COVID-19 news. New COVID-19 discussion groups are being formed on social media. We receive daily e-mail reminders that the number of positive cases and deaths continue to rise. Each day, I am torn between turning on the informational funnel to keep myself educated, or shutting it down to lessen panic.

As a solo practice owner, I performed a practice scan in the past two weeks to protect and in hope to preserve my reserve. These are some of the steps you might have already taken, or are planning to work on:

  1. Call all the creditors, loaners and vendors. This will include calling personal and business credit card companies to ask for reduced monthly payments, credit of interests paid, reduced interest rate, and no late payment penalty for 90 days. You might need to call each month during this time of crisis. Discuss with your loan lender deferring payment for 90 days. Call your vendors to discuss similar terms. With practice loans or equipment loans, you might be able to negotiate a 90-day deferred balloon payment at the end of your term or extension of the maturation date, with no interest and no prepayment penalty.
  2. Call your landlord to discuss for deferring payment for up to 90 days. Bear in mind this is not forgiven and would need to be caught up later.
  3. Open a line of credit if necessary or advance money on your existing line of credit. The advantage of a line of credit is that when the market goes down, the interest rate also drops.
  4. Call your malpractice insurance carrier to see options to reduce your premium if you have reduced your work hours. My carrier, OMSNIC, has offered a 50% reduction on the premium as “part-time” status, or 85% reduction as “suspension” status, if there is no patient interaction, until June. Contact your carrier to find out your options.
  5. Call your other insurance carriers, that includes general liability insurance, workers compensation insurance, and overhead insurance policy, to see if deferred payment is possible. Typically, these are smaller costs compared to other fixed expenses.  This is also a good time to review your coverage to make sure you are properly covered.
  6. Calculate your monthly cost that is required to carry you through the next three to six months, whether you receive relief or not. Have back up plans.
  7. Look into Small Business Loan, or SBA, if needed. There are differences between the Economy Injury Business Loan, or EIBL, which is not forgiven, and Paycheck Protection Loan Program, or PPP, which has forgiveness provisions when applied to certain operating costs such as payroll, rent and utilities, for example, in order to encourage employee retention. However, if you decide to roll your EIDL loan into your PPP loan those EIDL dollars could be included in the forgiveness provisions under certain circumstances.  These loans are applied for separately and can be transferred if one is granted before the other, and that you decide one suits your need better than the other. Be advised that traffic is extremely high on sba.gov at this time. EIDL loans are only available through SBA, and PPP loans will be administered by outside lenders such as banks and other financial institutions. Also please remember that this law and its implementation has moved at an unprecedented speed and we implore you to work with your own financial advisors to determine what might be best for your practice.
  8. Decide furlough or layoff. Consult your employment law attorney for the federal and specific state regulations. Be ready to have uncomfortable but necessary conversations. Make sure your decisions can help to preserve practice’s reserve for the months to come.
  9. If you offer health insurance as fringe benefits, call your health insurance carrier to check coverage options for the employees.
  10. Many people are considering teledentistry. Bear in mind that HIPAA still applies. Check with your malpractice insurance carrier to see if teledentistry is covered under your policy and comply with your state laws.
  11. Take advantage of many complementary or low-cost CEs that are available online.
  12. Continue to follow up with insurance companies on your outstanding claims. Although payout has slowed down significantly, payments are still being processed.
  13. I recommend designating specific time daily for media, including TV news and social media, to keep up with updates. However, make sure to shut off from all media after a while and have downtime from being overstimulated. Too much exposure leads to anxiety, fear and depression.
  14. Make sure your IT network is protected. Check with a reputable cybersecurity company to scan your practice. This is a vulnerable time for ransomware attack.
  15. Don’t forget to cancel monthly paid subscriptions such as water delivery.
  16. Support organizations on grass-root campaigns and petitions that can affect us as a profession in general. Your voice counts.

If you are an associate, make sure to take care of your personal finances and have necessary conversations with your employer.  Uncertainty can be scary, however, keep in mind that we are all in this together.

Love in the time of COVID-19 is to self-preserve and connect with close friends and family. Patience is difficult but necessary.  Share your thoughts with your circle of friends and family. Find activities that can trigger happiness and serenity: finish your garage project, cook, listening to music, or do arts and crafts. For example, my recent project is a composition of a trio including euphonium baritone which my older son plays; trombone, which my younger son plays and my part, piano. It has been my dream to write a piece that the three of us can play together. Eat healthy food and drink lots of fluid. Keep a healthy immune system. Make sure to designate time in the day to stay away from all media. Protect your mental health.  Crisis can be scary, but this too, shall pass.

Dr. Cathy Hung is a board-certified oral and maxillofacial surgeon.  She is the owner of Prospect Oral Surgery Center in Monroe Township, New Jersey. She enjoys writing posts, blogs and articles on clincal topics and practice management. Her first book on cultural competency for healthcare professionals is expected to publish in May 2020. She is currently a participant of ADA’s Institute for Diversity in Leadership, Class 2019-2020.

20 comments

  • Historically, Dentists have been more technicians than business owners focused on sales. Now is the time for dentists learn sales management.

    • In this day and age, there are many practice management courses, many low-cost or complementary, that dental students may take and enrich themselves while learning the technical aspects of dentistry. It may be too late to start learning about business when crisis occurs. Business aspects of learning should parallel clinical and technical part of learning, and this can be practice management or marketing.

      • I totally agree with your reply. Like most white-collar professions, little no business development education is offered. It may too late for most dentists to recover, but moving forward, dentists still in business will need to jump in and get their feet wet with learning Visible, Logical and Repeatable sales systems. Practice Management courses unfortunately do not provide business development education. Stay well!

  • Yes, we must take this time to reflect and learn about the business strategy and design our own exclusive solutions to bounce back effectively when the corona shutdown ends.

  • Pingback: Protecting your practice in the time of COVID-19 – New Dentist Blog - Dental Jay

  • Dr. Jimmy Kayastha

    A great read, thanks Dr. Hung. For those who choose to do so, this read will make a difference going forward.

  • I thought the HIPPA reqs were relaxed during this time with regards to teledentistry?

    Great post, enjoyed the read and the easy to digest gameplan points. Full disclosure – I’m a marketer, not a clinician.

  • Thank you Dr. Hunag for your helpful reminders!

  • I totally agree with you, that media is flooded with COVID-19 news. All people are panicking, which is very bad. If we follow all the rules, we will manage to get rid of this virus sooner.

  • Right now “guidance” is requiring that banks actualize PPP loans within 10 days of approval. And then starts the 8 weeks of forgiveness audit.

    Florida dentists are closed by mandate until at least May 8, and patients are required to quarantine indefinitely as of today.

    Receiving the money today, or in ten days is de-facto forcing us to waste the money. We can’t practice. Patients can’t come.

    Even after the mandates lift we are sure to be off to a soft start.

    It makes sense that the money should be received as close to June 30 as possible, if it is to be used as intended by Congress.

    What is the FDA and ADA doing to fix this conundrum?

    • I am a solo practice owner in New Jersey sharing practice tips. My office is closed at this moment. I am not seeing patients and I am also waiting for the loan. I would suggest you reach out to the legislators directly. Major organizations have encouraged grass-root campaigns and petitions to help protecting dentists. Signing and giving your vote would be a great way to get involved. I have also seen individuals starting their own grass-root campaigns online. I am afraid I cannot answer these questions on behalf of FDA and ADA.

      • I recommend when dentists reopen their practices that they start marketing to businesses to add the majority of employees at companies instead of waiting for employees to select dentists from online or published dental provider directories.

  • I believe your interpretation of the EIDL loan is incorrect. These will supposedly be forgiven whether or not they are rolled into a PPP loan.

  • Great perspective in a time of this unprecedented situation. Thank you for the great post!

  • WOW. Great information. Because “Call all the creditors, loaners and vendors” is very helpful information.
    This will include calling personal and business credit card companies to ask for reduced monthly payments, credit of interests paid, reduced interest rate, and no late payment penalty for 90 days. You might need to call each month during this time of crisis. Discuss with your loan lender deferring payment for 90 days. Call your vendors to discuss similar terms. With practice loans or equipment loans, you might be able to negotiate a 90-day deferred balloon payment at the end of your term or extension of the maturation date, with no interest and no prepayment penalty. Thank you for update us.

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