The Outpatient Visit Volume Rebound Begins ... Will it be Enough to Save Small Private Practices?

Posted by Dike Drummond MD

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.

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Tags: covid19, 2020 pandemic, private practice, healthcare economy

RESILIENCE Won't Save you now - you need a New You for the New Normal on the far side of this COVID19 Pandemic

Posted by Dike Drummond MD

I have talked to hundreds of physicians in the last six weeks and two things are consistent.

1) Everyone knows the Old Normal is gone. There is no going back.

Once we get through the infectious disease crisis, round two of COVID-19 is the economic impact on your organization. Can you be certain at all what your practice will look like this time next year?

2) AND YET ... Most doctors don't want the Old Normal back again in the first place. 

No one is longing for a return of the good old days of EMR overwhelm, the fee-for-service hamster wheel, Pajama Time documentation at home and burnout rates of 50% and more. Who wants that back again? Isn't there a better way?

Isn't there a way to practice your craft as a helper, healer, caregiver and Lightworker without so much waste and brain damage??

The answer is YES - we know it to be true. And yet, the New Normal is completely unclear at this time. There is a chasm to cross.

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Tags: physician coaching, physician coach, physician resilience, covid19, coronavirus, 2020 pandemic

When "The Patient Comes First" Can Get You Killed - Rehearse Your Boundaries for this COVID19 Pandemic

Posted by Dike Drummond MD

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.

So for instance,

  • as a health care worker
  • if you see somebody down
  • who's not breathing and they don't have a heartbeat
  • you're gonna probably jump on them and resuscitate them.
  • It is a reflex action
  • We don’t even think about it under normal circumstances.

These are not normal circumstances. Stop for just a second.

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Tags: covid19, coronovirus pandemic, thought experiment, the patient comes first

Show Your Patients Your Face Despite Full PPE - Two Cool Methods

Posted by Dike Drummond MD

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?

Here are two things:

  • The PPE Project
  • The Selfie Mask Generator

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Tags: covid19, ppe, pandemic physician stress

Lightworker Forum Resources Page

Posted by Dike Drummond MD

Lightworker Forum Resources Page - Crowd-sourced from our Weekend Lightworker Forum Mastermind Calls 

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Tags: lightworker forum

The 13 Impact Layers of the COVID-19 Pandemic

Posted by Dike Drummond MD

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!

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Tags: dike drummond md, Physician burnout, physician burnout videos, covid19, pandemic survival guide, Pandemic impact

Preventing Physician Suicide - it is time to Step Up

Posted by Dike Drummond MD

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.

==========

We know three things for sure:

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Tags: physician suicide, prevent physician suicide, reach out to a colleague

COVID-19 Pandemic Thought Experiment - When to re-institute Social Distancing??

Posted by Dike Drummond MD

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.

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Tags: Physician burnout, covid19, social distancing, healthcare

Massive Losses in US Healthcare Industry Due To Fee For Service Payment Systems

Posted by Dike Drummond MD

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 Old Normal is clearly gone, toast, history and kaput.
  • The New Normal is well off into the future and only after Darwin has done his nasty thing on the US healthcare industry.
  • Are fee-for-service and for profit motivations actually on the way out?

Key Resource: Pandemic Survival Guide for Physicians
ONLINE VIDEO TRAINING PROGRAM
5 Lessons to Navigate the Crisis with Confidence

How did it all come to this?

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Tags: covid19, Healthcare industry, capitation, Fee for service, Healthcare Financial Losses

The Pandemic Survival Guide for Physicians - Online Video Training

Posted by Dike Drummond MD

Pandemic Survival Guide for Physicians – Online Training Program. Five Proven Tools to Navigate the COVID-19 Crisis with Confidence.

TheHappyMD.com is pleased to announce the release of the Pandemic Survival Guide for Physicians.

This online video training program, specifically for doctors, teaches the skills to navigate the multiple layers of the COVID-19 crisis to a safe landing in the new normal, however long that might take.

The training is open for individual enrollment and volume admission packages are available for medical associations, societies and physician employers.

Pandemic Survival Guide for Physicians
Online Video Training Program
Learn More and Get Started Now

This is clearly one of those moments we will all look back on and say, "Remember 2020, when everything changed?" Physicians are no exception.

The healthcare industry has been split in two by the pandemic - half in a life and death battle with the virus, the other half throttled back or furloughed, with red ink, pay cuts and layoffs everywhere. The old normal is gone and chaos rules: the hospitals, the economy, the small businesses on Main Street, social distancing. Nightly death tallies and political mudslinging only add to the suffering.

Doctors are at unique risk. They learn to put the patients first and lack basic self-care skills - especially at times of crisis. Navigating this dark passage will depend on learning new tools to find and hold their center, their health, their focus and happiness even when the way forward is not clear.

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Tags: dike drummond md, coronovirus pandemic, pandemic survival guide


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