Dealing with the Absence of a Physician in Private Practice

April 30, 2012

The absence of a vital employee can have a huge impact on any business, but in medicine, there is not only the drop in practice income, there is the health and safety of patients at stake.

In a prior post, I wrote a little about disability insurance. It was from the perspective of the person who would be disabled, i.e. the importance of having money to pay the bills while one is unable to work.

But what happens to a small private practice, or any practice for that matter, when a physician is out? It’s hard enough when a non-clinical person is out; patients are still seen, it just gets a little hectic. When a doctor with a full schedule is out, that just blows things up. If he is to be out for a day or two, it’s OK. It’s inconvenient, but OK. His patients just need to be rescheduled and it may mean a few days of seeing extra patients and catching up on phone calls.

But what if a doctor has to be out for weeks? How about months? What happens to his patients? If there are several partners to pitch in, his patients can be distributed among them temporarily, but what if there’s only one other doctor in the practice? And what do people in solo practice do? Imagine if each physician in a two-doctor practice sees 20 patients a day and both schedules are full, and the wait for a new appointment is two months. If Doctor A is out, Doctor B can’t possibly see 40 patients a day, nor can he ask patients to wait two months to four months to be seen. Some may have to be advised to go elsewhere for their own sake, to avoid delay in their care.

The absence of a vital employee can have a huge impact on any business, but in medicine, there is not only the drop in practice income, there is the health and safety of patients at stake. Do you look for someone who does locum tenens to fill in the gap? Do you get a mid-level provider for that role? And then what do you do when Doctor A comes back?

Then, of course, there is the matter of paying Doctor A. If Doctor A isn’t seeing patients, Doctor A isn’t bringing in revenue, and in a two-physician practice that’s a 50 percent drop. There is the allocated personal time off, and in some practices sick time, but that’s limited. This is where disability insurance is so important.

I’d be glad to hear what other practices have done when in this situation. It is definitely a tough one - for the doctor who is sick, for the doctor left to work alone who is also a concerned friend and colleague, and for the patients and staff.

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