The pandemic games: A halftime review
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“The most insignificant score is the score at halftime.”
– Gresham Barrett
“Cross country: No halftimes, no timeouts, no substitutions. Must be the only true sport.”
– Chuck Norris
In football they have “halftime,” an opportunity for the players to take a break and fans on the losing side to forget their troubles with some precision marching and pop rock.
In baseball, they have the “seventh-inning stretch,” between the top and bottom halves of the seventh inning. (Must be that baseball fans are more patient, delaying relief until 72% of the game is over.)
Of course, the biggest national and global “game” at present is the contest to beat back COVID-19. Given the human, financial and emotional weariness of the last year — and with a prayer that at least half of this dire game is behind us — we could all use a pause.
Let’s use this pause to reflect on what has been learned and what it is going to take practices, owners and managers to be winners over the next many quarters before the pandemic recedes and we can all go home winners.
I have had a chance to see the winning second half of a pandemic through my past work with ophthalmic clients in Singapore who have had to deal with the many predecessors of this coronavirus for years. This experience, combined with running a national “emergency room” for COVID-struck practices over the last year, reveals the following truths.
1. Leadership tops the list of pandemic game winners. The best-restored practices today are those with physician and lay managers who stepped up early and carried the flag for the rest of their organization. And they did so together. The most impressive practices we have seen are those in which there was a preexisting, strong bond between administrator and managing partner. Together, they have secured all of the other resources to speed a return to high and safe patient volumes, and fostered the spirit needed to rally the staff to adopt new moves. If you and your administrator travel in different orbits, it is time to get aligned.
2. Right behind leadership comes money. Almost every practice took a financial hit in 2020 and will take a hopefully smaller hit in 2021, even under the best vaccination and treatment scenarios. Practices and owners with good capital access have not been losing much sleep in the last year. Even a wipeout year, with frank business losses, embedded in an abundant 30-year career is an irritation, not an existential threat. Check now to make sure you have ready access to at least three times your monthly operating costs.
3. We should assume that the game is nowhere near over. The more infectious COVID-19 variants now coming out of Brazil, South Africa and Great Britain as this column goes to press are in a race with vaccine rollouts and masking. And this is not the end of virulence. It appears we will be rolling our sleeves up for booster shots and influenza adjuvants for the rest of our lives. Public health investments are billions of dollars and decades behind where they would ideally be to stamp out each new bug that will continue to surface with depressing regularity. Think of it this way: You have had to become your own public health officer.
4. Now is the time for abundant empathy. For the direct health care victims, obviously. But also for staff, whose extended family members are probably struggling to find work or pay the rent. For imperfect local and national officials on both sides of the political divide, who are dealing as best they can with something they have never seen before. For undereducated patients who struggle with their COVID fears to the point of spraying volatile disinfectants on the inside of their masks before wearing (true story). For those who still think the pandemic is a hoax. From your position as a learned professional, humbly and compassionately continuing to care for others.
5. Calamity changes everything. The Great Depression and World War II reset life expectations for more than a generation. My mother, a gal of that era, worked two jobs into her 80s and saved every penny. It is not just today’s youth who will be affected. The most thoughtful mid-career eye surgeons will be more cautious in their business dealings going forward. Some will accelerate their retirement, while others will end up working longer than they imagined to restore savings depleted during the pandemic. And who isn’t planning their fantasy post-COVID vacation? Have your own professional and personal plans changed? Write them down. Discuss them with your family.
6. COVID-19 has driven home the value of contingency planning in both large and small ways. Newly hired doctors and excess staff were furloughed to preserve cash. Satellites were shuttered. The parking lot became the waiting room. Patient encounters went virtual. Nobody I know had a pregame plan for the pandemic. But going forward, consider your playbook for all the calamities that have much higher odds: a personal disability, loss of a key staffer, a fire or tornado. Let the pandemic be your reminder to always try to think a couple of steps ahead.
7. COVID has also been a reminder that you have to go against your perfectionistic grain from time to time. Surgeons seeking perfect personal and patient safety abruptly quit practice in March, and some have still not returned. Perfect sanitary measures are unrealistic. Those who have bounced back safely have aimed for a reasonable balance of community needs, economic survival and risk reduction — not perfection.
8. Do not disband your COVID-19 task force. Rename it. Like many practices, when the pandemic took hold, you may have mustered a group of senior staff to coordinate a response to the emergency. This same group should continue as an “operations management committee,” meeting as often as is appropriate to stay on top of the urgencies of the day, even if there are no further emergencies.
9. Think for yourself. National societies provide a great service to the profession and are indispensable at many levels. But they are not regulatory agencies. Their best dictates represent thoughtful, sincere guidelines. But in the early days of COVID-19, and in an abundance of caution, their guidelines were read by many providers as a bright red stop sign. Accordingly, for much of March and April, most ophthalmologists stopped in their tracks, while dermatologists — another high-volume, close-contact profession with arguably fewer urgent patients — motored on through to May and beyond. Take in all of the data, and then let your own professional training drive your patient care actions.
10. Balance boldness with preparation. The more aggressive you were about the number of patients you started seeing after the first COVID alarm, the more aggressive you needed to be in applying scrupulous safety standards to staff and patients alike. But this is nothing new. The cataract surgeon who transits four or five cases per hour instead of two or three has to be more meticulous — and have a more meticulous team. As pilots learn, boldly flying acrobatic patterns takes extra caution, experience and preparation.
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- John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. He is the author of several books on ophthalmic practice management, including John Pinto’s Little Green Book of Ophthalmology: Strategies, Tips, and Pearls to Help You Grow and Manage a Practice of Distinction, UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction (with Corinne Wohl), Simple: The Inner Game of Ophthalmic Practice Success, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at healio.com/books. Receive 20% off with promo code PINTO20. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.