Same here with private Peds practice and inpatient call.

Our clinic is sloooow. Happens normally during the summer but june/July and not from mid March. Call will help but inpatient pay sucks. Inpatient usually makes 5% of my annual total... this year is gonna be a hard one.

Our clinic works in preventative medicine. Executive physicals and the like. Pt. totals are definitely decreasing, especially since quite a few are out of state. Pretty worried going forward.

CapCityAg89 said:

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Bars and restaurants forced into failure as well. I get it. It might be bad. But there is a real risk people will be destroyed by this.

I'd think there needs to be a hiatus on mortgages, rents,, utilities until this is over I just have no idea how that would be implemented.

Such a cluster.

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Yep - bad indeed.

I've thought about what you mentioned re: mortgages and the like, but I'm sure that would have a devastating impact on those holding the notes as well (and their employees).

I have no idea how to solve any of this - just acknowledging it is really bad.

There are many businesses being directly impacted. For example, friend of mine has a dog kennel. He is empty and everyone is canceling reservations in the coming months because they are canceling their trips. He has debt service to pay and depends on the income. He will be closed in a month if there is no government assistance or relief program.

Chetos said:

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CapCityAg89 said:

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Bars and restaurants forced into failure as well. I get it. It might be bad. But there is a real risk people will be destroyed by this.

I'd think there needs to be a hiatus on mortgages, rents,, utilities until this is over I just have no idea how that would be implemented.

Such a cluster.

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It doesn't work that way. I have a client threatening to take a haitus on a half million dollar invoice. There's always someone on the other end of that bill that's gets hurt. And don't count on Uncle Sam to bail you out anytime soon. The only way out of this is to get the government out of the way and let everyone get back to work.

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It's why I said I have no idea how to make it work but we already have businesses closed. Throw those folks on the street and you've made a bad situation worse. The problem is a cash flow problem - the stream of cash through the economy is restricted. I have a job and work from home already but there are billions of dollars in different industries that are just sitting in pockets.

Assuming we can't go to work or the health system crashes, somebody is going to have to address it somehow. And I do look to Uncle Sam to lead that charge. Protection is one of the core fundamentals of government.

The patients who come and see me are by and large dependent on their injections to maintain their eyesight so I haven't had many cancellations. At the margin the less acute outpatient visits have dropped off somewhat. The longer this goes on I expect I'll feel it as well. Even worse is the majority of my practice falls into the at risk age groups which is of greater concern.

State and local governments have a huge roll to play. Saying, for example, "our sheriffs are not going to come out and remove your evicted ass out of your apartment" buys time. Or, your judges can halt eviction hearings. Or foreclosure proceedings. These measures at least keep people in homes for the time being.

During that interim, folks at every level of government have to be talking and they have to be discussing how it all fits together.

(And local officials cannot be stubborn. If you think this is an overreaction, that fight has been lost. The reaction is happening. And wrong forum, I know.)

Marcus Aurelius said:

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There is a dental thread re this but I felt it deserves its own. I am a pulm/CC doc. I pay the bills with my outpt revenue stream. The hospital E and M helps but doesn't compare. I am private practice 100% production.

COVID-19 has / is wiping out my outpt clinic. Well visit cancellations and social distancing policies applied which are understandable. I am on the front line. I saw 8 potential COVID-19 patients today in the hospital awaiting results. The increased hospital revenue will not make up the difference.

I am looking at financial disaster due to this.

Curious as to other docs thoughts/experiences on this forum.

I pray govt will have some relief / assistance.

We can't force those on front line into failure.

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We're going to have to save a lot of businesses from this. Its almost like we are hitting a 2 month long pause button on society so there will have to be allowances made. This needs to be treated like a war time response.

I hope we all come together to help people like you in a time of need to way you're helping patients in a time of need.

If this gets as bad as people are predicting, I think we will need to restructure our medical facilities almost like how we retrofitted factories back in WWII. Small clinics can be repurposed to work as fever clinics, minor covid cases, or focus on non-covid cases. Then the ERs can focus on the worst cases. Unfortunately, that will probably mean you don't get to pick your doctor for a while. Hopefully, it doesn't get to that point. Hopefully in two weeks, we find this is overblown...

I am sick over this, as a small business owner. But what can we expect the govt to do??

Gyms, doctors, restaurants, dog kennels, coffee shops, mortgage lenders, banks....everyone is affected. Everyone. It's the entire economy. Our govt doesn't have the money to bail out the entire country. And they can't be expected to pick winners and losers..

This is really scary.

It's really a problem without a solution at this Point.

If the government forces shut downs, then maybe the government forces leniency or other measures. The taxpayers obviously can't bail everyone out, but those disproportionately and directly impacted by government mandates should be at the top of the list. You interfere in the market, then you should bear the cost of that interference (in theory).

Hell, there are changes that need to be made to bankruptcy laws right now in anticipation of this for many small businesses. But our "leaders" are not strategic thinkers in that vein.

As for those of you that own small businesses, you need to reach out to your creditors ASAP to have these discussions. Have hard numbers and an alternate proposal ready when you reach out. Many of them will likely work with you on timelines and payment schedules. Their BATNA is not getting any money at all if you go under. You DO have leverage.

UHC is gonna seem like a great deal for Independent docs when this is over. At least, that's what they'll tell you.

I feel for you. What's going to also be rough is the billing and reimbursements. I can foresee all the "non-essentials" at Medicare , Humana, and BCBS etc not being at work.

It's going to be a rough spring and summer.

True.

I am doing most everything I can to avoid it.

Hang in there Ag

I was kinda joking about a tax free year on the other thread, but maybe some serious tax breaks might help some people out of this financial crisis.

I am an ob/gyn and my wife is a plastic surgeon/breast surgeon. We will have work but the elective stuff and routine offive visits will be wiped out. Been a tough year financially already. Will be rocky for a while!!!!

Marcus Aurelius said:

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Man. I get it . But I am exposing myself and potentially my family to the virus daily.

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If it's that serious, close up for a couple of weeks. Take care of yourself and your family. Use your rainy-day savings or your emergency fund to get you through 2-3 weeks. Try to help your employees as much as you can and tell them they'll still have their jobs when things blow over.

Like others have said, almost every business in the country is going to be affected by this in some way. But if we all just walk around with blinders on, we risk it getting out of control, and then it won't matter who's president or whose business has failed. Some things are bigger than "I" and "mine". This is one of them.

Please do not take this in a condescending tone, it's pure ignorance on my side. What are the chances that you can change your game up for a little while, become a testing center to keep the lights on? What else can you do with the tools available to you?

when y'all compare notes at the end of the day you get the whole picture huh?

NM sorry.

It's very difficult to try to thread the needle between exposing yourself and your staff to a potentially life-threatening illness and ignoring patients who still need to be seen. Coronavirus isn't the only malady out there right now. I am a solo practicing ENT, although I am integrated (Stark compliant) with 19 others. I do not share revenue with the others. If I don't see patients, my bills continue ($45K per month), but I have no income. I am keeping my doors open for now, but asking patients with non-emergent conditions to reschedule if they can, and obviously I am referring patients with fever, shortness of breath, and cough to stay home or go to the ER depending on their level of symptoms.

All elective surgeries for the next few weeks have been canceled by the hospitals and ASCs where I work. Most patients canceled their visits today. Tomorrow's schedule is full of holes.
Further complicating all of this is that I have one employee, who has always been a germaphobe, questioning why we are remaining open at all. Revenue this month will definitely be down, and if I get sick and have to stop seeing patients for two weeks, I will definitely have to reach into my pocket and cover my expenses without any income. I am fully expecting no take-home pay for this month, at least. As others have said, many people are in the same boat. Some professions are MUCH worse off than we are. After speaking with my manager, I sent all of my employees the following message tonight:

"Just a quick shout out. I cannot predict the future, and everything is changing very rapidly right now. I just want everyone to understand that if they feel unsafe it is OK and you do not have to be here. Let (manager) know. As one of our infamous patients recently said, "This ain't no slavery times!" Also, I know that we are all at different stages of our lives. Even if I get sick and can't work for a period of time, nobody needs to be concerned about missing hours and having smaller paychecks. I've asked that everyone who wishes should schedule a private conversation with (manager) about any concerns they might have. Nobody needs to get sick or get poor from this situation. I/we have a duty to patients, but we can't provide for them unless we also take care of ourselves."

Just after having sent this out did I hear from the manager of another group of 9 physicians (in our big group) who told me they are furloughing staff this week until volume picks up. That REALLY upset me. BTW, my staff, including the germaphobe, all expressed appreciation for the message. I hope nobody has to close down an office, but I certainly expect a month or two of very little income, if any at all.

Marcus Aurelius said:

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Man. I get it . But I am exposing myself and potentially my family to the virus daily.

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If you are under 50 years of age your morbidly rate is equal to the annual flu.

The good news is once this is over, people will still need dental and medical care and you should be pretty darn busy. Recovery might be financially difficult but will likely happen. This is why it's so important that even people with high incomes be disciplined and save money. Too many folks making 6 figures still living paycheck to paycheck (not saying this is the case with ya'll, just a general observation).

I'm really concerned about folks in the service industry who don't have a lot of financial leeway and don't have much money saved in the bank. Hourly employees are ****ed right now.