Behind the Mask

Financial uncertainty. Another pandemic stressor for doctors

Staying open in a closed economy.

For a US-based Neurologist, the COVID-19 pandemic forced him into into a whole new type of battle, and one he wasn’t prepared for. Because while businesses were shutting down, and everyone was staying inside, he found himself doing everything he could to keep his practice up and running.

“I recall learning the word “Pandemic” in 5th grade but not until about 3 months ago have I truly experienced this word firsthand come alive. Practicing for the past 3 months have been very challenging to say the least.” 

Like other medical practices during the initial months of the pandemic, our neurologist saw patients cancel their appointments out of fear of contracting the virus, and to not put their loved ones at risk. This dramatically impacted revenue and threatened the livelihood of both him and his employees. 

“During the March thru May, our volume was down by about 55%. All the employees including our physicians were very concerned about the possibility of being laid off.” 

He was able to maintain some patient volume by quickly integrating Telehealth into his daily practice as so many physicians have, however this amount of income still wasn’t enough to support his finances. Finally, he turned to the support being offered by the US government. 

“Our practice had avoided to lay off any individual in no small part due to the first round of the HHS Stimulus package… Although this did not cover our losses, it definitely was a lifeline to keep us afloat during these trying times” 

But getting assistance from the government wasn’t always so simple. Many businesses were fighting for the same small pot of funds, and the window to apply was usually short due to the overwhelming number of applications. 

“My practice had also applied for the Pay Check Protection Program. My business manager had logged online and submitted our application 15 min after the initial opening date. The website closed sometime in the afternoon the same day.”  

What’s more, application wasn’t a guarantee of approval. As had been criticized in the media throughout 2020, the businesses receiving financial aid from the government were sometimes larger, and drew questions from the public. 

“We were not able to acquire any funding during the first round of the stimulus package. Much to our surprise, organizations such as Ruth Chris and the Lakers secured funds. I was not bitter but just had to chuckle.”  

Despite this, the aid he was able to receive throughout the year was crucial in allowing his practice to stay open and fully staffed.  

“Unless there is a second wave of lockdowns, my practice should be in good shape to sustain moving forward thanks in no small part from the various governmental external support that we had received.” 

However, he saw other practices were not so lucky, and a concerning trend started to materialize. Small and mid-size practices were harder-hit financially than larger practices, which led to a lot of them closing temporarily, if not permanently. 

“Many private practice solo practitioners have closed down their shops. The younger physicians have joined larger organizations while the older physicians have retired earlier than expected. Group practices with 3-4+ physicians have held steady… As a general observation, the larger groups have been able to keep their doors open. Strength in numbers. More and more physicians in our area have opted to give up their autonomy and be employed physicians. There is less autonomy but they get a steady paycheck week in and week out.” 

While this neurologist believes he’ll be able to maintain his practice thanks to the support he’s received from the community and the government, this brings to light a larger scale impact the pandemic will have on the American healthcare system. With smaller practices shutting down, the dynamic of how and where patients will be able to access healthcare, and the level of competition in the marketplace among the smaller number of providers, will change. More bureaucracy could negatively impact overall levels of care, with longer wait times and less personal relationships between patients and providers. 

“Despite these changing times, I don’t foresee selling my practice any time in the near future. I treasure the autonomy and not having a boss to dictate my style of practice. This is what I enjoy most in the private practice setting.”