Chris Mazzolini is the editorial director of Medical Economics

Ransomware has never been a more serious threat for health care organizations, even small medical practices. So what should be done about it? Is it possible to defend yourself? Are there insurance products that can help protect your business in the event of a breach? To discuss these issues, 

® sat down with Peter A. Halprin, Esq., a partner in Pasich LLP’s New York office who specializes in complex insurance coverage matters in relation to cybercrime. The transcript below was edited for length and clarity.

Let’s put the ransomware issue into context. How big of a problem is it in health care?

 It is a massive problem. We’re talking about billions of dollars in impacts. And I think the average cost of a breach tends to be around $2 million, with about 10% of that being ransomware payments, and the rest being recovery. As I said, the numbers are going up and up and up. So any number I’d give you is already stale. Unfortunately, the trend is only going to continue.

I think health care is a particularly risky sector in this regard for two reasons. One is there is lots of personal information. So data-rich target, if you will, and then the flip side being you’ve got a lot of proprietary systems, you’ve got a lot of older systems that haven’t been updated, don’t get regularly updated. I think in some ways, doctors, like lawyers — they’re focused on their craft. And they’re not necessarily focused on these other things, assuming, Why would anyone do this? Why would anyone target a medical facility or doctor’s office or anything else? And the answer is you’re a target-rich environment and (cybersecurity is) not a priority. So I think health care has continued to be a particularly fertile source for ransomware actors.

ME: How has the COVID-19 pandemic affected cybersecurity?

: Negatively, for sure. I think that the bad guys have taken advantage of people working from home, people being distracted. It’s very hard to stay focused on your tasks. All of a sudden, you get an email that comes in and it looks very convincing. And I’m telling you, the bad guys are bad. For example, people were getting emails in March of 2020 talking about the cure for COVID-19, or the email looked like it was coming from the World Health Organization or the CDC. So they took advantage of that. Cyber hygiene was definitely down.

I think the other side of it is that the bad actors are targeting specifically vulnerable institutions and organizations. So we saw attacks on vaccine research centers, hospitals, doctor’s offices. For those vulnerable sectors, part of their vulnerability is that it is a matter of life and death. The bad actors take advantage of that vulnerability.

ME: Is being targeted by hackers inevitable?

: I’m hesitant to say that it’s inevitable because I don’t want people to just throw their hands up, so I don’t love the word. But it is highly, highly probable that there will be an attack or there will be some form of cyber incident or cybercrime involving a health care institution.

So the question is, knowing that there’s that high probability, how do you address that? You really want to beef up your security, what I call cyber hygiene. It’s protecting your business, it’s making sure that people don’t click those bad links, it’s making sure that you clearly identify when an email comes from an outside source, it’s making sure that sensitive areas in a business are closed off so that people can’t penetrate security.

The second instance can come in the form of limiting access. If someone’s able to access your account, then they can get no further than what you can access. It’s that kind of internal security.

ME: What about cyber liability insurance?

Halprin: Yes, the third layer is cyber insurance. So you get insurance for when things go wrong. This is the same kind of product. Once you have that in place, remember, it’s not a fail-safe; it’s not a defensive system. That’s why I say it’s the third and final resort. But it offers two things. It offers bottom-line protection: Let’s say you have $10 million worth of coverage, and then the bad thing happens. You know that you can be restored up to the $10 million that hit your bottom line.

The other thing that cyber insurance often entails is breach response services. So they can help you build out a program to protect yourself when something happens. They can provide you with vendors, they can provide you with legal counsel, they can provide you with public relations experts, and so they can help build that suite of services around you and your business that are needed to deal with an incident.

Now, most businesses have their own cybersecurity plans and their own incident response plans. One of the biggest flaws that I see in incident response planning is that a company will have its own incident response plan, and then it will also have these cyber insurance resources, but they won’t be integrated. And so the problem there is if you use your own people, and you don’t get consent to use them, the insurance company might say, Hey, we’re not paying for that. So the best thing that you can do is work to get insurance involved on the front end working to make sure the insurance company signed off on the plan so that seamlessly integrates. So when something bad happens, you can bring all those resources to bear.

ME: Should health care organizations ever pay the ransom?

: This is probably one of the trickiest moral and ethical dilemmas for businesses. As a lawyer, I can’t advise anyone to break the law. And if you speak to law enforcement, the overwhelming suggestion is don’t pay. The reason they don’t want you to pay is they don’t want the criminals to be incentivized to continue doing what they’re doing. There are also sometimes actors that are on the sanctions list, right? They’re people that we as a country do not permit our citizens to engage with. So there are a lot of considerations as to why it’s not a good idea to pay.

One other consideration about not paying is sometimes you pay and the actor stays in your system and continues to extort. So you’re not even promised that you’ll get free and clear access from paying. And then even the worst part is, you could get free and clear access, but everything’s corrupted now that they’ve left. And so you get very little for what you pay. Those are all the reasons not to.

But what I think businesses often do practically, especially those in the health care space, is they just pay. I can’t give you a number or a statistic. But overwhelmingly when clients are hiring me and they’re fighting with their insurer; oftentimes it’s because they want to get the insurer to cover the ransom. And I would say if you have a cyber policy that covers ransomware, insurers are amenable to you making those payments and to reimbursing those payments.

ME: Something we often hear from physicians at small or solo practices is they don’t believe they are really being targeted. How true is that?

: It’s not true at all. It’s more kind of a buckshot and goes in a lot of different directions. I don’t think (hackers) are necessarily saying, I want to hit small practices in the Midwest, but it may necessarily end up being that way. There are targeted attacks, for sure, which do end up hitting the larger organizations, but I think that for the smaller medical practices, it’s not necessarily because they picked you. It was more that you happen to have a vulnerability that’s not patched.

ME: Is there anything else that’s important for physicians to know about the subject that we haven’t discussed?

: Just to take this seriously. Some of the questions that physicians have: If I’m going to get hit with this anyway, what’s the point? Why bother? I think the answer is you still want to be prepared. And you still want to take precautions. Because if you’re too nonchalant about it, it could end your business.

Articles

As ransomware attacks continue to strike practices across the country, is your practice prepared to defend against them?

Is your practice ready for a ransomware attack?

Tired of administrative burdens bogging you down? Are you feeling burned out and need a career reset? Does remote patient monitoring sound interesting but you don’t know where to start? And have you gotten your financials in order to minimize your taxes this year?

These are questions that many physicians ponder, but at 

Beyond the Classroom Business Training for Physicians

Reducing administrative burdens at your practice through clinical-first technology

Physician burnout tipping point: How membership-based primary care could be your career reset

Top 10 tax planning ideas in 2022 for physicians

Register now for this important free online event 

Also, be sure to check out our most recent 

 from the spring, where we touched on the following topics:

Addressing patient needs with a membership-based model

All the content is available online for you to review at any time. Take a moment to learn more about these important topics and don’t forget to register for the summer event. See you there!

This is your last chance to sign up to learn strategies that will take your practice to the next level.

It's your last chance to sign up for the Summer Boot Camp

Associate Editor for Medical Economics, Physicians Practice

Compensation for health care management and nurses is on the rise, despite persisting staffing issues across the industry.

According to a news release, the 2022 edition of the 

MGMA DataDive Management and Staff Compensation

 across all management levels rose between 2019 and 2021. Executive positions saw the largest increase, rising 19.73 percent, while senior 

 saw a more modest 5.07 percent increase. General management saw their compensation increase 4.28 percent over the same period.

The western region of the U.S. saw the largest increase in management pay with executive management positions in that region receiving more than a $23,000 pay raise compared to the eastern region of the country, the lowest increase measured for the position. Meanwhile senior management received more than a $31,000 increase and general management saw a more than $23,000 increase in the western region compared to the southern region, the lowest region for increases for those positions.

The increase wasn’t limited to managers, with some fields of nursing also seeing rises in compensation. Triage nurses saw the largest increase of 13.91 percent between 2019 and 2021 and licensed practical nurses seeing the second largest jump with 7.09 percent over the same time period, the release says.

Meanwhile, productivity continues to suffer as the health care industry experiences a lingering 

 even as the COVID-19 pandemic continues to subside. As of November, 30 percent of medical groups saw themselves coming in below their 2021 productivity goals for 2021, according to the release.

"Today's surge in demand for workers has created a compensation arms race forcing medical practices to revisit the ways in which they recruit, engage and nurture staff," Halee Fischer-Wright, MD, MMM, FAAP, FACMPE, president and chief executive officer at Medical Group Management Association, said in the release. "To stay competitive, medical practice leaders must stay on the pulse of macroeconomic forces and invest in strategies that create rewarding and fulfilling workplaces. This latest data provides invaluable compensation benchmarks for job titles throughout a medical group practice — from the C-suite to the front desk — to help healthcare practices overcome retention and recruitment challenges."

Compensation is rising, as staffing shortages persist.

Report: Health care facility management, nurse compensation rising

Editor's note: Our partners at Medical Economics are hosting a free Summer Bootcamp: Beyond the Classroom Business Training for Physicians, June 30, from 3-7 p.m. as part of their series of informational webinars for physicians and practice managers. You can sign up for the upcoming bootcamp

. The story below is the information shared in a session at a bootcamp earlier this year.

To see the entire video presentation, go 

For primary care practices, earning enough revenue to meet overhead expenses and provide quality care has always been a challenge. But practices often make the challenge even greater through sloppy coding and billing, leading to delayed or incorrect reimbursements from payers. The Centers for Medicare & Medicaid Services estimates that in fiscal year 2021, Medicare made $6.25 billion in fee-for-service payments that were improper under its coverage, coding and billing rules.

Fortunately, there are steps doctors and practice administrators can take to ensure they receive all they are owed in a timely fashion. But it requires forethought, training, and commitment from everyone in the practice.

Identify the most common reasons for denials and how to handle them differently to improve practice revenue.

Audit your practice’s coding program and identify areas for improvement.

Learn coding best practices and what changes may be in store.


Independent Consultant
MGMA Health Care Consulting Group

“I didn’t go to medical school to become a medical coder or biller” is a common refrain among doctors unhappy with the time and resources those tasks require. Nevertheless, coding and billing are inescapable parts of practicing medicine, and doing them poorly can have severe financial consequences, either from frequent claims denials or overbillings that the practice must then repay.

Longtime coding consultant Nancy Enos, FACMPE, CPC, CPMA, says claims denials often are the result of errors in billing. Consequently, reducing denials requires identifying the source of the mistakes and providing feedback to staff on how to avoid them. “Without that feedback loop there’s no education and no stemming the tide,” she says.

Enos advises practices to focus on three areas for reducing billing errors and claims denials: front office, clinical staff and back office. Common front office-related reasons for denials include the following:

Lack of coordination of patient benefits.

Expenses not covered by a patient’s insurance.

Expenses incurred prior to the patient’s coverage date.

Lack of required precertification/authorization for an expense.

“The front office is where the revenue cycle begins,” Enos says. That means staff members need to verify eligibility up front so patients know their financial responsibilities and agree to meet them.

Clinicians can minimize claims denials by making sure their notes are concise, detailed and specific, Enos says. “’Diagnosis lacking specificity is one of the biggest reasons for denials. Putting in the clinical details such as the problem’s severity and whether it’s chronic or acute will get you to the most specific diagnosis code and get your claim paid faster,” she explains.

Other problems she frequently sees in clinical notes include:

The date of service doesn’t meet frequency limits.

Time spent with the patient for time-based services is not documented.

The billing provider’s and service provider’s names don’t match.

The note doesn’t support the CPT codes reported for it.

In some ways, back office staff face the biggest challenges in the effort to reduce claims denials because many of the issues they deal with are ambiguous, Enos says. She cites the example of erroneous unbundling. “It’s difficult to completely prevent it because you don’t always know which payers will pay for lesser procedures at the same time as more comprehensive ones,” she says.

Other issues back offices frequently deal with include the following:

CPT codes are inconsistent with the place of service.

The patient has reached the benefit maximum for the time period.

Procedure/modification combinations are incompatible.

When such mistakes occur, “it’s the back office’s responsibility to rectify them as quickly as possible, then share the feedback with the source of the errors,” Enos says.

The possibility of having to repay thousands of dollars following a payer audit is another reason for closely monitoring billing and coding procedures, Enos notes.

“Plan to be audited at some point, and don’t assume everything’s OK as long as you’re getting paid,” she advises. The best way for practices to prepare, especially individual and small group ones, is to follow the compliance program developed by the U.S. Department of Health and Human Service’s Office of Inspector General. Its recommendations include the following:

Conduct internal monitoring and periodic audits.

Implement compliance and practice standards by developing written standards and procedures.

Designate a compliance officer or contact(s) to monitor compliance efforts and enforce practice standards.

Conduct training and education on the standards and procedures.

Investigate violations or allegations of violations and disclose any incidents to the appropriate government entity.

Develop open lines of communication such as staff meetings on how to avoid erroneous or fraudulent conduct.

Enos recommends doing “benchmark” audits of five to 10 records per provider, followed by a minimum sample of 10 to 20 of the provider’s claims submissions, either retrospective or prospective. Departments or individuals of particular concern should undergo focused audits using at least 50 charts.

“Don’t look at auditing and monitoring as a form of punitive obligation, but as a way to ensure that you’re billing and coding properly,” Enos says. She says internal monitoring has the additional benefit of identifying and correcting undercoding, a problem common to most of the practices she works with.

After completing an audit, it’s critical to share the results throughout the practice. “It makes sense for a patient to see their doctor after getting an MRI, so why wouldn’t you want to provide feedback after an audit?” she says. Then she urges using the results to develop further training and education.

“Use that audit feedback to learn, to protect your practice and make sure that you’re optimizing your reimbursement and reducing your risk,” Enos says.

Front office staff can help minimize claims denials by verifying patient insurance coverage and eligibility before the appointment.

Clinician notes should be as detailed and specific as possible in order to obtain the correct billing code(s).

Billing and coding errors should be corrected immediately and feedback provided to the source of the error.

Practices should conduct periodic internal audits of their billing and coding and share the results with clinicians and staff members.

Don’t treat internal audits as an onerous task but rather as a method of self-protection and a tool to prevent undercoding.

For primary care practices, earning enough revenue to meet overhead expenses and provide quality care has always been a challenge. But practices often make the challenge even greater through sloppy coding and billing, leading to delayed or incorrect reimbursements from payers.

Bootcamp 2022: The foundations of a great tax plan

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, 

Marketing Your Medical Practice-Ethically, Effectively, and Economically,

 which has sold over 225,000 copies and has been translated into Spanish. He contributes a weekly video for 

 on practical ideas to enhance productivity and efficiency in medical practices.  His 5–7-minute videos and short articles provide practical ideas that can be easily implemented and incorporated into any medical practice. Dr. Baum can be reached at 

One day after school, a young girl noticed that her mom was cutting off the ends of a pot roast before putting it in the oven to cook for dinner. She had seen her mom do this many times before but had never asked her why. She asked, and her mom said, "I don't know why I cut the ends off, but it's what my mom always did. Why don't you ask your Grandma?"

So, the young girl asked her grandmother, and Grandma said, "I don't know. That's just the way my mom always cooked it. Why don't you ask her? The young girl called her great grandmother, who was living in a nursing home and asked her the same question, and she replied, "I cut off the ends of the pot roast because that's what my mother did." And she did not say it because it makes the meat juicier. She said, "When I was first married, we had a tiny oven, and the pot roast didn't fit in the oven unless I cut the ends off." Or, in other words, she said that's how we do it here, which was passed down for nearly three generations.

What are examples of using too small a pan for your roast in your practice?

Having been in practice for more than 40 years, I have witnessed several areas where we tend to behave and perform actions and behavior on our patients just like they've been done before.

Example 1. Treatment of uncomplicated UTI (no fever, chills, or flank pain) with a 7–10 day course of antibiotics. Studies have clearly shown that a short course of antibiotic therapy, i.e., 1-3 days, is just as effective in eradicating symptoms with fewer side effects than the longer course of treatment.

Example 2. Symptomatic treatment of URI without antibiotics. Since 1946 when Dr. Benjamin Spock wrote his book on childcare, 

, hundreds of thousands of pediatric patients have received antibiotics for a viral infection. It wasn't until the 1990s that it was appropriate to counsel parents that most URIs are viral infections and self-limiting and require only symptomatic treatment and not antibiotics.

Example 3. For several decades most physicians allocated 15-minutes for each patient. This was the standard operating procedure for most offices. Now it is more efficient to identify the reason the patient is coming to the office and schedule a time that is most appropriate for that visit. For example, if a patient is coming to check their blood pressure and blood cholesterol level, that visit is approximately 5-minutes. However, if a patient is coming for a new visit to discuss the result of a biopsy that revealed cancer, then 30 minutes might be more appropriate.

Here's my question or request for the readers of this blog: do we need to swab the antecubital space with alcohol before phlebotomy? I advocate that unless a patient is immune-compromised or using chronic steroid medication, wiping the skin with alcohol, which burns and increases the pain associated with phlebotomy, then alcohol is not a requirement. I was interested in performing a study with patients receiving an alcohol swab before phlebotomy vs. a saline\sterile water swab and comparing the pain and erythema or any other adverse events when only saline or water cleansed the skin before phlebotomy. I know this is a minor issue, but it serves as an example of using old-fashioned methods or a too-small pan for the roast placed in the oven. It would be nice for multiple practices to look at this antiquated tradition and demonstrate that this is an example of a roast too big for the proverbial pan used for centuries. Anyone interested in pursuing this study, please let me hear from you.

Bottom Line: Every practice has archaic methods and procedures being performed or conducted in our practices and on our patients that need to be modified or even removed. We don't have to look very far to identify those roasts that don't fit the roast pan. I agree that sometimes they are small changes, but more significant improvements will soon follow when you start with minor changes. I am eager to hear from your opinions or comments. (doctorwhiz@gmail.com)

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish. He contributes a weekly video for Medical Economics on practical ideas to enhance productivity and efficiency in medical practices.  His 5–7-minute videos and short articles provide practical ideas that can be easily implemented and incorporated into any medical practice. Dr. Baum can be reached at 

Just because it's always been done a certain way, doesn't mean it needs to be.

The roast and the pan: Implications for healthcare

With all the useful information available on Physicians Practice, it is easy to become overwhelmed.

With this in mind, the tip of the week is a chance to reflect on some of the wisdom found all across the site.

Set very clear rules on just how many calls or letters you will send.

It works much better to ask if the patient would prefer to pay with a check or credit card.

Make sure that the person you choose has excellent phone etiquette, but also has tenacity to not take “no” for an answer.

 of to get the full scoop and be sure to come back next week for another 

Your weekly dose of wisdom from the Physicians Practice experts.

Practice tip of the week: Collecting past-due patient balances

Richard Payerchin is associate editor of Medical Economics.

 has overturned the landmark Roe v. Wade case that legalized abortion in 1973.

The ruling means states will govern abortion rules, which could lead to abortion being outlawed in half the country, according to one organization that advocates for reproductive rights.

On June 24, the Supreme Court issued 213 pages with its ruling and opinions in the case known as Dobbs v. Jackson Women’s Health Organization, which the court heard on Dec. 1, 2021. The Supreme Court considered the state of Mississippi’s appeal of a lower court ruling that struck down as unconstitutional the state’s law banning abortion after 15 weeks of pregnancy, according to the 

A summary in the ruling syllabus stated: “The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives.”

The ruling also referred to the 1992 case Planned Parenthood of Southeastern Pa. v. Casey, another landmark case in U.S. abortion law.

“We hold that Roe and Casey must be overruled,” the ruling said. “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision, including the one on which the defenders of Roe and Casey now chiefly rely—the Due Process Clause of the Fourteenth Amendment.”

Citing case law, the draft ruling said the Due Process Clause “has been held to guarantee some rights that are not mentioned in the Constitution, but any such right must be ‘deeply rooted in this Nation’s history and tradition’ and ‘implicit in the concept of ordered liberty.’

“The right to abortion does not fall within this category,” the draft ruling said.

A 98-page draft by Justice Samuel Alito circulated to fellow justices on Feb. 10. That document was leaked to the news site Politico, which published the ruling on May 2, sparking a firestorm of reaction and demonstrations from abortion supporters and opponents.

Based on the ruling, at least half the 50 states are poised to ban abortion, according to CRR.

That organization called Dobbs v. Jackson Women’s Health “the most consequential abortion rights case in generations” and analyzed the various state laws that regulate abortion in the study, 

CRR categorized the states, the District of Columbia and the five most populous U.S. territories in four ways, based on analysis of current laws in a post-Roe legal environment:

Nine states are considered in the “expanded access” category, with abortion protected by state laws or constitutions, with other laws and policies for additional access to abortion care: California, Connecticut, Hawaii, Illinois, New Jersey, New York, Oregon, Vermont, and Washington

12 states and Washington, D.C., were considered “protected,” with abortion protected by state law, with limits on access to care: Alaska, Colorado, Delaware, the District of Columbia, Florida, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nevada, and Rhode Island

Three states and two territories are “not protected,” meaning abortion may continue to be accessible but would not be protected by state and district law: New Hampshire, New Mexico, Puerto Rico, U.S. Virgin Islands, and Virginia

26 states and three territories are “hostile,” meaning they could immediately ban abortion: Alabama, American Samoa, Arizona, Arkansas, Georgia, Guam, Idaho, Indiana, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, the Northern Mariana Islands, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming

In 2020, there were 930,160 abortions in the United States, an 8% increase from 862,320 abortions in 2017, according to The Guttmacher Institute, which conducts three-year surveys of abortion providers.

That group said the figures showed a reversal of a long-term decline in U.S. abortions that began about 1990, but noted trends varied across states from 2017 to 2020 with “no clear patterns to explain why some had increases or decreases.”

The Guttmacher Institute map of states that will or are likely to ban abortion generally matched that of the Center for Reproductive Rights.

Since the May 2 publication of the draft ruling, physicians groups have lined up in support of abortion rights, publishing statements and member advisories.

In its annual meeting June 10-15, before the Supreme Court ruling, the American Medical Association AMA members adopted a 

 “recognizing that it is a violation of human rights when government intrudes into medicine and impedes access to safe, evidence-based reproductive health services, including abortion and contraception.”

“A growing number of current and pending laws insert government into the patient-physician relationship by dictating limits or bans on reproductive health services and while also aiming to criminally punish patients for their health decisions,” AMA President 

, said in a published statement. “The new policy also calls for AMA to seek legal protections for patients who cross state lines to receive reproductive health services, as well as legal protections for physicians and others who support or provide reproductive health services or referrals to patients who cross state lines.”

This month, outgoing AMA President Gerald E. Harmon did not mention the Supreme Court, but noted “increased government interference in the patient-physician relationship and the practice of medicine,” in his address to AMA’s annual meeting.

“Whether the issue is women’s reproductive health, care for transgender persons, or appropriate treatments for COVID … the AMA demands that politicians get out of the exam room,” Harmon said in his speech.

Abortion bans are expected to take effect in more than half of states.

Breaking: Supreme Court overturns Roe v Wade abortion ruling

Editor's note: Our partners at Medical Economics are hosting a free Summer Bootcamp: Beyond the Classroom Business Training for Physicians, June 30, from 3-7 p.m. as part of their series of informational webinars for physicians and practice managers. You can sign up for the upcoming bootcamp 

The note doesn’t support the CPT codes reported for it.


Bootcamp 2022: Preventing coding and billing errors can reduce claims denials

Keith Algozzine is co-founder and CEO of 

. A board-certified Physician Assistant, he was formerly the Chief PA of Emergency Medicine for St. Mary’s Hospital in Troy, NY, where he witnessed firsthand the challenges of the modern healthcare system. Keith was also part of the national ER startup management team for Pegasus Emergency Medicine. He represents UCM Digital Health on the American Telemedicine Association Accreditation Advisory Board and serves as an advisor to the Clinical Practice Guidelines Committees dealing with telemedicine considerations for urgent and emergency care.

As COVID-19 descended upon unsuspecting communities, businesses, schools, all non-essential services closed down and sought sanctuary. Most surgeries, medical procedures, and appointments were halted and indefinitely delayed or even closed. Options became extremely limited—at times nonexistent—and many were left with no recourse on where to find answers to health concerns.

Once the quarantine cover was lifted, life began its slow crawl to the slightest sense of normalcy. An unexpected consequence was the cumbersome and lengthy wait times felt in clinics and doctor’s offices. Not only were patients faced with the threat of a global pandemic, but they also had to deal with the fact that the protracted time needed to schedule and secure medical care was an added obstacle. To add, the health care worker shortage continued, overworked staff and stretched-thin resources carried on past the pandemic and burdened physicians and all related medical staff.

Regardless of whether a patient's needs are considered essential or non-essential, access to health information—timely and accurate—is something everyone seeking medical care should have access to.