Hurricane's Impact Crippled My Medical Practice
Hurricane's Impact Crippled My Medical Practice
Let me first say that my fellow New Jerseyans who have been affected by Hurricane Sandy and the recent nor’easter are in my thoughts and prayers. While I am about to tell you of the recent inconveniences that I and my office have endured, we are well aware that they are exactly that — inconveniences — and they pale in comparison to the suffering that is going on today in other nearby towns.
Well, Mother Nature seems to have it in for New Jersey lately. I blame Snooki. We didn’t have earthquakes, tornadoes, and freak storms until she and "The Situation" came along.
We have experienced storms before. We have had patients cancel due to rain and snow. I have had to close the office due to weather. We have also had brief interruptions in power, phone, and Internet service. But we have never had such a shutdown as we did post-Sandy.
The week before Sandy, I tried to be optimistic. I kept hoping the storm would turn east and leave us alone. We discouraged patients from canceling their appointments, because there was no good place on the schedule to put them. Come Sunday morning, it was clear that she was still a-comin’ so I decided we had to close the office Monday.
So my associate and I called the patients ourselves from home. Most of them understood but there were a couple who gave me a hard time. Really? I didn’t invite Sandy, and a state of emergency had already been declared in our state and I wasn’t going to risk the safety of my patients or staff. Monday morning came and wasn’t too bad, but the worst was yet to come, so then we called Tuesday’s patients to cancel. Monday night we lost power.
Losing power meant losing access to the EHR. That meant no access to the schedule, to patient’s phone numbers, to anything. Losing power also meant no phone. Fortunately, we use our phone company’s voice mail service which gets forwarded to our cell phones. Well, I say fortunately, but guess what — my cell phone also wasn’t working; at least not consistently. I would briefly have signal, then lose it.
Our patients also had the problem of not being able to get prescriptions filled. The pharmacies were closed. They had no power, no phones, and no fax. Oh, and did you know that Medicare will only allow pharmacies to fill a prescription for diabetes testing supplies if there is a hard copy of the prescription? Phoned in prescriptions don’t cut it (neither do electronic prescriptions, but that wasn’t the issue last week). A faxed prescription will do, but you can’t fax if you don’t have power!
Patients wanted their lab results — and I couldn’t access them. I couldn’t call the lab for results either. Everything was at a complete standstill. Patients scheduled for outpatient tests couldn’t get them done.
After three days of no power and no patients (or patience), we hooked the office up to a generator. That let us use the phone, fax, and computers, but we were in the dark and it was cold. We saw whatever patients could make it in, which wasn’t many as they either had no power or no gas. That was Friday. We were going to do it all again on Monday, so Sunday morning we hooked everything back up in preparation, but, Hallelujah! Sunday afternoon we got power.
We were back up and running Monday. We are trying to reschedule everyone who couldn’t be seen last week. We are seeing patients before and after our usual hours.
There is still a lot to do. And many of our patients still have no power (or lost it again in the nor’easter). We can’t contact some of them, probably because they are not in their homes, or maybe it’s because they have no phone service. Many are just grateful that their homes are intact and their family is safe.
What would you say are the most important 'lessons learned' through this experience? What will you change, in order to be better prapared for the future?
(BTW, please also include a description of your practice - primary/specialty, # of providers, etc).
Thanks!
Pete
We have been there as our office flooded and was completely damaged from a broken sprinkler system 3yrs ago in February. Business interuption insurance is a MUST along with the other insurances on the building. We were closed for 3 months trying to get out office up and running. We lost most all of our computers except for 2 (the server and mine, it was up on a Box so the water didnt get to it). Life was tough but we survived. The next year was where we were hit the hardest since we didnt see patients during that 3 months the next year was almost as bad. There were no recks for that time period. We will be much smarter this year and pull appts from other months to fill those spots. Good Luck!!
I am praying for you all. I used to have a primary care practice for teens & young adults in the Chattanooga, TN region, and we tried EHR initially--but due to the system.s bogging us all down and taking a long time to enter data, we switched to paper charts but kept on with electronic patient registration and billing. Then after the practice had been steadily growing over 6 years, the cash flow issues created by insurance companies' denials in 2007-2008 just prior to the last Presidential election (when Obamacare was looming on the horizon) caused me to go bankrupt. No longer do I practice primary care--I cannot afford to, with no possibility of a business loan or line of credit after filing Chapter 7--and I have had to streamline my services to medication management for mostly ADD/ADHD, anxiety, and depression. I operate a private-pay-only sole proprietorship; use paper charts; and direct patients to get their primary care elsewhere. I make barely enough to pay basic bills and overhead (which is so much lower than previously!), but I am happier and have peace of mind that I am doing what God wants at this particular point in my life, even though I am double-boarded by the American Board of Pediatrics in general pediatrics and the subspecialty of adolescent medicine. Reading your stories make me realize that, no matter how great technology is, nothing is weather- or disaster-proof. I certainly can understand the problems with paying bills and your care and concern for your patients' well-being, though, and as I said, I am praying for you all. That is so hard, when we went to med school to take CARE of patients!!!
Pete, we are a 2 physician 1 NP endocrinology practice. In retrospect, I think we should have printed out the week's schedule along with the patient's contact info, although it may not have made a big difference since patient's didn't have phone service. We have a generator now, so I don't have to worry about meds going bad. Most of what I had was free samples, a waste but not a financial burden, but I did have about $7000's worth of patients' meds in there. I had to bring them home and put them in a cooler with ice.
Richard, fortunately, we have enough of a cushion in the bank account and on our credit card to deal with being closed for the week.
HI Mellisa,
Thanks. You story and comments are encouraging. It will benefit other practices as I use your story & learning to help raise their awareness and prompt them to action/preparedness.
It's a hard way to learn, but good to see the 'opportunities' that are brought to light through this difficult experience.
Best regards for a quick & full recovery!
Pete
Thank you Dr. Young for sharing your story. As a Managed Services IT firm based out of Northern NJ that specializes in healthcare, we certainly had our share of physician practices affected by Sandy. As news of the storm began to surface our team began to reach out to our physicians practices in preparedness. Not all of our clients had a Disaster recovery\business continuity (DR\BC) plan in place and as a result it impacted the practice in a negative way. For those practices that had some type of a plan in place it was less impacting because of the plan.
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Nelson Gomes
Ditto... but how do you pay your bills at the end of the month? when the vaccine companies come calling or you rent payment... or alimony?