And get ready to run like never before 

If you haven't heard yet, your organization just had its worst three months in history -- yet another COVID-19 driven contribution to physician burnout.

i) If you are a practice owner, this reality has been keeping you up at night for weeks.

ii) If you are an employee physician and you don't already know about the smoking crater that is your organization's financial statement, your leaders are hiding the financials from you in a fine example of #badleadership.

iii) And if your organization somehow managed to avoid a massive loss in the last 90 days - either you are a full risk/capitated provider (Kaiser Permanente) or you got very, very lucky.

For healthcare delivery organizations relying on fee-for-service payment contracts, things have never been this bad.

Their profit margin just went from single digit positive to a giant sucking sound. Even the Mayo Clinic is projecting a 3 BILLION dollar loss in 2020.

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This is Blog Post #335
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Now we have some potential GOOD NEWS !

Now we are seeing a little flicker of light at the end of the COVID-19 tunnel. 

As we begin to reopen society, data released this week shows physician visit volumes have rebounded slightly from the bottom out in the month of April.

The burning question is will the recovery happen quickly enough to avoid an extinction event in smaller private practices?

Fee for service private practice has been hammered by declines of visit volumes of 50 - 70%. No business can withstand an assault on its top line income of this magnitude for any significant period of time.

New research shows outpatient visits appear to have bottomed out in early April and are on the rebound. The curve is upward with volumes still 30-40% below baseline volumes from January and February of this year.

Given the US healthcare system's addiction to fee for service payments, the recovery in visit volumes and income must come quickly.

If the curve does not quickly assume a V or U shape, smaller physician owned groups who cannot survived a prolonged income drop will go out of business en masse before the end of the year. Unfortunately that does not look like a U or V to me. 

Here is the latest data on US Visit volumes from a unique source that tells the whole story.

As healthcare workers, we learn, "the patient comes first" as our Prime Directive.

Tragically, this reflex impulse to dive in and help without thinking, can get us killed - especially here in the Covid19 Pandemic.

We tend to dive in where the need is the greatest, never questioning our “the patient comes first” programming.

There is a huge and necessary barrier between COVID-19 patients and their caregivers - Personal Protective Equipment - PPE

The mask, face shield, gown and gloves are completely necessary to protect the caregiver and the other patients on the ward AND they block a powerful component of a therapeutic relationship ... seeing the faces of your care team.

No smiles, frowns, looks of empathy or concern except what words and the corners of the eyes can convey ... and that is if the light is not reflecting off your visor at the time.

What can be done to humanize this life saving connection between caregiver and patient?

COVID-19 is a Worthy Adversary - We count 13 Layers of Impact that will spool out over time.

VIDEO TRAINING:

It is easy to focus on the impact of the acute disease and the early economic effects, but just wait, there is more.

Those are just two of the 13 separate layers of negative impact from this crisis. The long tail of the pandemic's impact will last several years at a minimum and only if there is no wave two - please!

This mornings headlines in my InBox were dominated by a pair of suicides - one ER Doctor and one newly graduated EMT

Dr. Lorna M. Breen, the medical director of the emergency department at NewYork-Presbyterian Allen Hospital.

FDNY EMT John Mondello, 23, graduated from the EMS academy in early February and worked with the Tactical Response Group in the Bronx

This is a heartbreaking loss. Tragic to an extreme.

It is one thing to die doing what you love ...

It is another to die from your own hand, because the pain of doing what you love is too much to bear.

A Lightworker's burden ... may they both rest in peace.

This highlights the need raise our "I've got your back" caring for team mates to a whole new level. Time to step up.

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We know three things for sure:

Once we have released the beast of Coronavirus, under what circumstances would you expect local/state/federal officials to re-institute social distancing??

Governors all over the USA are relaxing social distancing restrictions and definitions of what is and is not an essential business. The biggest fear is reigniting the pandemic and flooding the local healthcare system with critically ill patients.

Fee For Service Payment Dark Side = Massive Healthcare Industry Financial Losses in the COVID-19 Pandemic

The Perfect Storm - is this the Beginning of the End of Fee-For-Service Medicine in the USA?

There are MASSIVE LOSSES across the board for every healthcare delivery organization I am talking with - for weeks now.

The Mayo Clinic announcement of a projected $3 Billion 2020 loss was the first specific warning from an otherwise stable provider organization.

$100M in bailout payments to Baylor Scott and White and other Texas hospital systems is just the next in a long line of bad news for healthcare over the next 18 months.

Will this catastrophe force significant changes in the way healthcare is paid for in the USA?

The worldwide pandemic of coronavirus is a disaster with multiple layers of crushing impact

It is nearly impossible to fathom the magnitude of the devastation. BAD on top of BAD on top of BAD, like a layer cake made of fresh manure -- and you and I and everyone else has to chew and swallow a nice big slice every week for long as it takes to reach the other side.

Hey Physicians! How much do you LOVE seeing patients in virtual visits from your HOME Computer - rather than from your office/hospital work station??

In our monthly Physicians on Purpose community support call last night, we brainstormed our list of positives.

Here's what we have so far:

• No commute
• Sleep in later 
• Get outside
• Pets stopping by to say hello
• Eat better
• Have time for short meditation
• Less interruptions by staff
• Able to think in complete thoughts and sentences
• Better control over your home environment