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Help! My Practice Is Drowning.

Be careful what you wish for. If you had asked many pediatric practices what is the one thing they wanted in April of 2020, they would have said “patient visits! We are dying without any patient visits!” And now, in many places across the country where kids are back to school (masked and unmasked—that’s a blog of it’s own and we will save for a different day) and Delta is surging, practices are drowning trying to meet the patient demand. 

What can a practice do to survive in this unprecedented time?

Forget About Business as Usual

First, forget about business as usual. We can’t scale our way out of high patient demand and a shrinking workforce. There are many practices who are handling a phone volume that is four times baseline. Add to that patients who have questions about quarantine, isolation, and testing. And pile on the demand for visits for testing, illness, well visits, and  vaccines (routine and flu and soon COVID for younger children). No wonder everyone wants to know who is going to throw them the life line. 

Push Key Information Out to All 

Once you have made peace with the fact that you can’t work enough extended hours or hire enough extra people (as hard as that is to grasp), the next thing you should do is to create a strategy to push key information to all your patients. That might limit their need to contact you personally. What are families calling about that you repeat over and over but shouldn’t have to? Create resources for your families about protocols for isolation, quarantine, community testing sites, when to reach out for an appointment, how to self-schedule an appointment – and then make sure the word gets out!

Thinking about how to serve all of your families, not just the ones that reach out, can be impactful through this crisis and beyond. If you create an ongoing relationship with families and build trust through repeated valuable interactions, you will start to create lasting bonds. Whether it’s Facebook Live, or short videos, or practice email updates, or text invites to go back to your website for updated content, you can reach far more people than one phone call and one office visit at a time.

Can’t find a nurse to hire? Hire a patient engagement/social media person to manage this. Feed them content and let them create the engagement vehicle. Ask them to gather a patient advisory group and ask how they would best like to receive content. Don’t assume, find out. 

Be Resilient 

It is crucial that you also cut yourself and your practice team some slack during a time of crisis. While you had a high performance sports car machine of a practice (or at least you were striving to), you need an all-terrain vehicle for this. It won’t go as fast or look as pretty, but it will be more resilient and get you through. Take a serious look at what is possible and start prioritizing. Don’t give up on those well visits. Those kids need you and you can’t get behind. You need to touch base with families, tell them you are in this together, build caring relationships and resilience. Tell them we are all struggling together and you are here for them. We need to keep vaccination rates up so we don’t have any unnecessary additional outbreaks. However, look at the screenings/surveys you do for all of those visits and decide if any of them are ok to defer. It’s a war zone. You can’t be perfect, and eventually this will pass. Ask a few screening questions during the visit and then insist on in-depth surveys if there is a need. Pare back those visits to the essential ingredients. 

Give Yourself Grace

Probably most importantly, give yourself grace. Partner with others and be honest with your families. Try a short video from one of your doctors explaining how everyone is under stress, including your team. Explain how you desperately want to give every patient what they want, but you have to make sure that all patients get what they need. Ask for patience, understanding and kindness and their help in being your ambassadors in the community. And invite them to join you in innovating to best serve the community.

Distribute the life jackets (there is enough for everyone). Then go build resilience for your practice team and your community together.

Sue Kressly
kiddrsue@gmail.com


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