Managing Your Private Practice Through the Coronavirus Crisis

Managing Your Private Practice Through the Coronavirus Crisis
For an article with more recent information, please read: How Private Practice Psychologists Can Survive Whole Community Telehealth Bulk Billing.

With the coronavirus (COVID-19) being declared a pandemic since the 11th of March 2020, concerns and even panic around the virus are sweeping across the world.

In addition to the health consequences, the virus and the responses surrounding it are affecting small and big businesses all over the country and world, following recommendations of social distancing and self-isolation.

Whether your private practice is in the “danger zone” or not, there are some concerns regarding private practice owners and practitioners – and rightfully so.

This post is going to try and address some concerns and questions about managing a private practice business during the current coronavirus pandemic, and how you can prepare your practice to prioritise your own, your team’s and your client’s physical and mental health.

 

General Resources for Yourself and Your Clients

It is a good idea to keep yourself informed with the latest updates about COVID-19 and to help inform your clients, too. With so many official resources available, there is no need for you to rewrite anything in your own words.

Coronavirus Health Information Line
Call this line if you are seeking information on coronavirus. The line operates 24 hours a day, seven days a week: 1800 020 080

 

What to do with these resources

  • Inform your clients in person
  • Send the resources in an email newsletter
  • Print and display in your waiting area and consultation rooms

 

Mental Health Support for Clients

It is expected that the general public would experience heightened levels of anxiety and stress when the whole world seems to be in panic mode. During times of uncertainty, physical and mental health can take a toll.

Send out an email newsletter or other forms of communication to your clients and offer them additional resources for managing their stress levels. Share this guide from the APS or if you are a psychology practice, I recommend sharing some advice and tips in your own words.

 

Medicare Information for Clients

As clients are now able to claim coronavirus-related items (more about this below), it is a good idea to inform them about their options should they need to access these items.

General information about Medicare and coronavirus can be found on the Medicare website, including information about virtual check-ins and e-visits.

For more information about how they can access these items through your practice, send an email with step-by-step instructions and contact details for more support.

 

Should I ask clients to stop coming into the practice if they’re feeling unwell?

The short answer is yes. In fact, you may already have an Illness Policy in your practice which states that anyone (practitioner or client) with an illness should refrain from coming into the practice. If you already have this policy, review it carefully and update it if necessary. If you don’t already have an Illness Policy, this is a good time to develop one.

You can send out the updated Illness Policy via email to your clients. In addition, you can inform your reception team so that they can notify all incoming client enquiries and reach out to clients with already booked sessions.

If you’d prefer to quickly send something out without developing an Illness Policy, use the following script as a starting point.


“In response to the spread of the coronavirus, we have put in a number of measures to help protect ourselves and our clients from contracting the virus. We are frequently and carefully wiping down all surfaces with disinfectants, and taking extra care to sanitise all equipment. In addition, hand sanitisers are available in the practice for all clients, and all our practitioners are washing their hands between each session.

Our practice will stay open during this time for the foreseeable future in order to continue providing health services to all our clients. We do, however, ask that any client who feels unwell stay home. We would like to continue to be here for our clients and we can’t do that if we’re sick. With this said, if you’re feeling unwell and have an existing appointment with us, please notify us via phone or email as soon as possible.

If you are unwell and can’t attend your session, you may be able to access our services via telehealth. To see if you’re eligible for telehealth sessions, you can contact us via email or phone and we’ll be happy to assist you.

For more information about telehealth support and Medicare claiming, please visit our website or call us on ___.

For general information about the coronavirus and how you can protect yourself and prevent its spread, please find the following resources.”

 

What should I do if a client with an illness has come into the practice for their appointment?

While this is the last thing you want during this time, there may be some clients that are adamant about coming in even when they are coughing, sneezing and showing other symptoms of an illness.

Understandably, this could be a little awkward for any practitioner to handle on the spot. However, if you’re well prepared for situations like this, it can be managed with care and grace.

Try saying something like this:

“This is not the time for any of us to take health risks in any way. I care about you and your health, and I also care about my own and other client’s health. And if I’m unwell, I can’t continue to support you or my other clients. So, today’s session will need to be done over the phone or video call. If you came here in your car, you could continue this session in the car. If that’s not possible, we’ll need to reschedule.”

As you’re saying this, it may be easier if you remain standing and start directing the client towards the door.

 

Should I continue doing home visits?

If you are offering home visits as part of your private practice service, then you may need to temporarily withdraw the service and offer alternative services and resources instead.

This is to protect yourself and your clients from contracting any virus, and as people who require home visits are generally the elderly or otherwise unwell, they may need extra care and protection.

If possible, call your home visit clients and find an alternative solution such as telehealth or if necessary, refer them to a practice that is set up for conducting home visits under these circumstances.

 

Should I offer telehealth options? If so, how can I go about it?

A hundred times yes.

Telehealth is something I would recommend for most private practice businesses anyway as it allows better reach for you and better access to care for your clients. In addition, it allows a smoother business experience during stressful times like these and events like the recent bushfires.

If you already have telehealth systems set up at your practice, I recommend sending out communications to your clients to remind them that it’s there and how they can access it.

If you don’t have telehealth set up, now is a good time to do so.

As telehealth options are likely to stay as a part of your private practice in the future, it is important to approach it strategically instead of from a place of panic.

 

Telehealth Platforms

Providing allied health services via telehealth is not as complicated as it might seem. You can deliver video sessions via video conferencing platforms such as Zoom or FaceTime. You could also look into using software built specifically for telehealth such as Coviu.

 

Encourage your clients to use telehealth

At times like these, it may not be enough to just inform clients about the telehealth options. It may be a good preventative measure to actively encourage your current clients to access their sessions via telehealth platforms for the time being, if applicable.

Of course, this is a decision you’ll need to make depending on the structure of your practice and other practical considerations.

 

Collect client responses and objections

Some clients will be open to the idea of telehealth and some won’t. This is expected and it’s likely that there are some concerns about the (in)effectiveness of telehealth compared to face-to-face sessions.

While you can handle such objections with reason and evidence, not everyone will opt in for telehealth. However, it may be a good opportunity to collect important data to gain more useful information for the future.

Ask and write down the reasons why some of your clients are unwilling to access your services via telehealth. This data may be useful for you in the future when properly setting up or improving the telehealth part of your practice.

 

The New 13 March 2020 MBS Items

On the 13th of March 2020, an update to the MBS items became available in response to the COVID-19 pandemic. This is to provide bulk-billed video-conference and telephone consultation services to certain vulnerable people who meet at least one of the following criteria:

  • the person has been diagnosed with COVID-19 virus but is not a patient of a hospital; or
  • the person has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee (AHPPC); or
  • the person is considered more susceptible to the COVID-19 virus being a person who is:
    • (i) at least 70 years old; or
    • (ii) at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
    • (iii) is pregnant; or
    • (iv) is a parent of a child under 12 months; or
    • (v) is already under treatment for chronic health conditions or is immune compromised; or(d) the person meets the current national triage protocol criteria for suspected COVID-19 infection.

 

Do I need to bulk bill everyone?

The new MBS items mentioned above are bulk-billed for patients and clients that meet the criteria. This means that you don’t need to bulk-bill everyone that you see during this time or via telehealth.

Remember, while there are new measures to help protect the vulnerable population, the majority of our population isn’t going to be needing or accessing such measures. This likely means the majority of your clients will access services under the usual item numbers or they may be able to access telehealth items based on eligibility.

UPDATED 30 March 2020: As per the most recent MBS updates for psychologists in Australia, any MHCP appointment delivered by telehealth must be bulk billed.

 

How should I deal with cancellations?

In an ideal world, all of your clients will attend their session or take up the telehealth option rather than reschedule or cancel. But in this imperfect world, that’s probably not going to be the case.

It’s important not to panic and consider putting in preventative measures as well as strategies to deal with current or expected high cancellation rates.

 

Tap into your waiting list

If there is generally a waitlist at your practice, you may be able to reach out to the clients in cases of high dropout rates. Off the bat, offer them telehealth options and inform them about how they can access all services available to them.

 

Business as usual – just carefully

It’s important to remain calm and also help your team and clients remain calm. Instead of phrasing your communications from the point of view of responding to a global pandemic, approach it as a way of going about business as usual, just a little more carefully.

Your services and support are still there and your clients can still access them. All that’s different is that you’re providing your clients with different and safer ways to access the services.

 

Focus on minimising disruptions to the treatment or session plan

As you would for general cancellations and reschedules in your practice, inform your clients about the importance of staying on track of their session plan.

 

Help, my practice is going to take a hit from this!

If you experience a high rate of cancellations and no-shows over the next few weeks, it’s going to be a difficult time for your practice – financially and mentally.

It can also weigh on you as the owner, as you may be faced with the reality that your contractors can barely make ends meet due to decreased client volume.

In order to minimise negative impact on your business and your team, try the following approaches:

1. Manage reschedules, cancellations and no-shows by implementing strategies as shown above. Ask your team to stay on top of their client appointments diligently.

2. Reach out to your landlord (if applicable) and negotiate if possible. They’re only human and may be sympathetic to your situation. Ask if they could reduce your rent for the next few months. You won’t know until you ask!

3. Reach out to your past and current clients individually for a brief check-in via phone. Help them consider telehealth options and develop a session plan for the upcoming weeks. It’s important to provide more support during times like this, not less.

4. Invest your time (and if possible, money) into marketing your telehealth services. AdWords is a good starting point.

5. Update your website to include information about telehealth options and how you are supporting your clients during this time. You could include some health tips to prevent coronavirus as well as steps you’re taking in your practice to ensure a hygienic environment.

6. Update your referrers and the local community about telehealth options. Reach out to the GPs and notify them about telehealth and how they can inform their patients.

7. Reach out to EAP companies and offer to provide telehealth support. If necessary (in the cases where telehealth wasn’t included in the original contract), try to renegotiate the terms for telehealth sessions.

 

What else can I be doing?

Having implemented all above strategies, you may still find yourself with an almost empty diary in the near future. First, just remember that this is only temporary. It may be really touch and go for a lot of you (as we all know that private practice owners in Australia aren’t exactly sitting on a lot of saved money…), but just remind yourself that you only need to survive this temporary season. Then, sooner or later, things will be back to normal!

Now, what else could you be doing? There are a number of things you can do that could decrease the stress put on your practice during this time or benefit your practice in the future.

1. Move your appointments into a smaller window. If your appointment volume drops and there are large gaps in between your appointments, cluster them into one morning/afternoon or day. This way, you can have longer stretches of non-booked time that you can use to work on other things.

2. Follow up on things you’ve been putting off because of time constraints or just because you were too tired to get to them. These tasks can include cleaning up your invoices, consolidating your finances and chasing up old debtors.

3. Plan for the future based on your learnings. Most private practice owners don’t have a concrete business plan that allows for reserves in cases of emergency (or happy occasions like a holiday). Perhaps not right this minute, but when this is all over, you may need to review your current business plan and develop one that prepares you for situations like this.

4. Do things that are important but may not immediately translate to revenue. These things include writing blogs, improving your website, SEO management and scheduling social media posts in advance. While they may not return results right away, these are time-consuming things that you would often put aside when your diary is full.

 

I hope this post has been helpful to you. I’ll keep coming back to update this as more information and resources become available.

The current situation (or in fact, this whole year so far) is not ideal for any of us. But I’m reminded of my favourite saying: “If you can’t avoid it, enjoy it.” Now, we can’t exactly enjoy the current circumstances, but we can accept the fact that we can’t really change or avoid them. What we can do is manage the situation as best as we can and hope that we come out of it stronger and more prepared for the future.

If you have any further questions about managing your private practice during the coronavirus pandemic or would like to share your own advice, share them in the comments below!

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