Immediate planning needed for personal, practice financial survival
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The coronavirus pandemic is a new experience for everyone in the United States today. SARS, MERS and Ebola were rapidly contained, with no impact on the U.S. economy or our ophthalmology practices. None of us lived through the 1918 Spanish flu pandemic. So, we are all in uncharted territory.
A great source to follow regarding what is happening globally and even city by city in the U.S. is the website Worldometer. In your browser, type Worldometer-coronavirus/USA to follow what is happening. If you want to look at any other country, just replace USA with the desired country.
China was first into this pandemic, and it is currently reporting no new cases. Many patients are still recovering and a few even dying, and much can be learned from the Chinese experience. It looks like the number of actively infected cases increases for 4 to 6 weeks and then declines if proper social distancing is achieved. If we experience a similar course in the U.S., we will see an increase in new cases for 4 to 6 weeks and then decreasing new cases for another 4 to 6 weeks. Those recovering and sadly those dying continue for at least 1 month after new cases stop being reported.
Because the new cases started in the U.S. in late February/early March, we can expect a peak in late April/early May and hope for no new cases by mid to late June. That suggests to me that our practice in Minnesota will be restricted and only seeing emergency cases though April and much of May. I anticipate we may start doing more elective surgery as early as late May or early June and be back to business as usual in July. There will be a backlog of elective surgery to do, so I expect our clinics and ASCs to be busier than average from July through October. This will represent a mini-boom for us and should extend for at least 4 months.
Many are concerned that we will experience a return of COVID-19 in the winter months, as occurred with the Spanish flu in 1918-1919. It is unlikely that we will have a vaccine by this fall, but we will be more experienced in dealing with this virulent virus by then and hopefully better able to mange it.
Today we are seeing only urgent patients at Minnesota Eye Consultants and performing only non-elective emergency surgeries in our ASCs. We have furloughed or separated many employees. We doctors are learning to perform telemedicine, and third-party payers including CMS have agreed to relax payment restrictions for telemedicine services. I encourage every doctor to study the American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery guidelines regarding telemedicine and proper coding and billing.
Most of us are experiencing significant financial challenges, and careful planning will be necessary to survive this unexpected tragedy. The core business principles are to develop an expected-case and worst-case scenario business plan that includes expected revenues and expenditures for the next 3, 6 and 12 months. This business plan should be both personal and professional. Then it is important, especially if you are a practice owner, to cut costs and delay payments as much as possible. Finally, every individual and business should strive to accumulate a “war chest” of cash to ensure solvency and financial survival. In many cases, that includes drawing on any available lines of credit. If you have great value in your home, consider getting a home equity line of credit and draw on it to ensure access.
Fortune favors the prepared mind, so follow Worldometer to increase your accuracy of predicting when this pandemic will resolve in the U.S. Every 2 weeks update your plan for personal and practice financial survival. Expect to stay home and work very hard through the summer months to make up for the lost revenue between now and July 1. At present, social distance, stay home and stay well, as survival is the first goal. Expect it to take a year or two for financial recovery, personally, in your practice and globally. We have more challenges ahead, and all of us will experience some damage from this unanticipated pandemic. Good planning and good plan execution will diminish the pain. Ocular Surgery News will be there to help keep you educated and informed. I wish you well.
Disclosure: Lindstrom reports he is a shareholder in Minnesota Eye Consultants/Unifeye Vision Partners.
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