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.
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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- If you offer health insurance as fringe benefits, call your health insurance carrier to check coverage options for the employees.
- 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.
- Take advantage of many complementary or low-cost CEs that are available online.
- Continue to follow up with insurance companies on your outstanding claims. Although payout has slowed down significantly, payments are still being processed.
- 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.
- 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.
- Don’t forget to cancel monthly paid subscriptions such as water delivery.
- 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.