• John V. Guiliana, DPM, MS

Coronavirus Blog #2....How Crisis Can Lead to Opportunity


The coronavirus news certainly has us all captivated. New phrases have suddenly been added to our daily vocabularies such as social distancing, community spread, flattening of the curve, pandemic, etc. Schools are closing, restaurants are empty, events are canceled, and we find ourselves in a time where toilet paper has actually become a sparse commodity. We try to go about our normal daily life but with the constant wonder of if, when, and who will pass this virus on to us or our loved ones.

Bloomberg Economics estimates that GDP growth in the first quarter of 2020 has slowed to 1.2% year over year... The weakest on record. Ultimately, the coronavirus could cost the global economy in excess of $3 trillion. There are so many things out of our control right now that we often forget to obsessively search and focus on things that are within our control.

Many of you know that I have been retired from private practice for 6 years now as I and others launched NEMO Health in 2013. I miss my practice every day. I miss my patients every day. I miss my partners and staff. But these past 6 years have given me the opportunity to learn and look at business strategies objectively in my quest to help my colleagues improve. So I think about the events of today and challenge myself with the question, “If I were still in practice, what would I be proactively doing right now to offset the challenges that are outside of my control and enhance the things that are within my control?”

At a recent conference, I spoke about business management strategies from the framework of a “chess game”. Aside from helping my patients be more comfortable, the challenge of the chess game was my favorite part about being in practice. A chess game necessitates skill, strategy, thoughtfulness, and predictability. So in practice, and during these challenging times, you have the choice of either reacting emotionally to the challenges or responding like a master chess player.

So what specific moves would I be making right now on my chessboard? Well... here’s a list that I suggest you consider, depending upon their applicability to you:

Chess Move #1. As I mentioned in my previous blog, pay very close attention to your practice data. Your fingers need to be on the pulse of how the real and perceived fear of this pandemic is affecting your practice. Being reactive as opposed to proactive will hurt you. Reacting emotionally and not intellectually will hurt even more.

Your patient visit volume and charges can decline without you even realizing it. Monitor it weekly. Do you need to initiate a marketing plan? Do you need to have more social media presence?

It could be inevitable that patients are going to cancel based upon their decisions to socially distance themselves.

Monitor your cancellation rate and train your staff to attempt to get patients back on the schedule at a future date when they are comfortable. Avoid asking IF they wish to reschedule and instead, ask them WHEN they wish to reschedule.

Chess Move #2. With lower volume, take an objective and honest look at your visit comprehensiveness. We always have an obligation to look beyond merely the chief complaint of our patients to help preclude future foot ailments. Yet I frequently find that during a busy and jam-packed schedule, it’s very difficult to maintain that responsibility. Now might be the time to take a close look at your clinical protocols and how they may contribute not only to your patient outcomes but also to maintaining your production during this crisis. Are you using ancillary products and services which benefit your patients? Are you watching that child with the verruca walk to see if there are any gate or postural abnormalities? Are you screening your elderly patients for the risk of falls? Are you fully servicing your diabetic patients and wound care patients with screening for peripheral artery disease? The list goes on. You should be monitoring your per visit revenue (total revenue/total patients). With improved comprehensiveness, even though your visit volume may be down, your increased per visit revenue will make up for it, and then some.

Chess Move #3. Many opportunities exist outside of your practice. If you have years left on your home mortgage, now is the perfect time to take advantage of this crisis by considering refinancing. But in my opinion, refinancing should not only be about changing your rate. You should consider changing the terms as well during this time of historic low rates. For example, if you have 20 years left on your mortgage, maximize this opportunity by not only getting a lower rate but also by changing to a 15 year fixed term as well. In all likelihood, you might ultimately pay the same amount monthly that you are currently paying, but you will have shaved 5 years off of your mortgage term. That amounts to a lot of money saved in interest payments!

Chess Move #4. Look for opportunities to help people in your community. Try not to judge people who might be viewing and processing this crisis differently than you. Some might be more panic-stricken, and some might be more aloof. No matter how you process this, you will ultimately feel better by finding opportunities to help. Elderly people, for example, might need assistance with their social distancing and can benefit from your help with grocery shopping, picking up their medications, etc. Consider bringing back the ancient art of house calls for those in urgent need. Or consider having special isolated 1-1 office visit time for patients who are immunocompromised and in emergent need. We are all in this crisis together... and we will all emerge from this crisis by working together.

Chess Move #5. Monitor your own anxiety caused by this crisis. Stress has a funny way of sneaking up on you. You might be looking at your portfolio every day and seeing the ugly personal financial effect of this virus. You might be listening to the news too much and subconsciously soaking up the anxieties that are often created by the media. Before you wind up selling stocks or rushing out to buy cases of toilet paper, turn down the psychological volume a bit. Limit your exposure to the news. Watch a good movie. Turn on an old episode of Andy Griffith. Play a game with your children. Do anything to divert your attention without compromising your basic knowledge of what’s going on.

As long as you stay healthy, everything about this crisis will eventually be a thing of the past. Consider that the stress caused by the crisis, along with the long-lasting financial effect of business strategy aloofness, might be more lethal than the virus itself. Playing and winning the game of business and psychological chess will ultimately cause this virus to lead to a world that’s actually a better place. This crisis will have created an opportunity for us to learn how to work together, think together, help each other together, and plan together. We will have become better people and better entrepreneurs. Oh and we will have FINALLY learned how to properly wash our hands! 🎶Happy Birthday to you...🎶

John

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