Practice Management During the COVID-19 Pandemic

Abstract

On March 14, 2020, the Surgeon General of the United States urged a widespread cessation of all elective surgery across the country. The suddenness of this mandate and the concomitant spread of the COVID-19 virus left many hospital systems, orthopaedic practices, and patients with notable anxiety and confusion as to the near, intermediate, and long-term future of our healthcare system. As with most businesses in the United States during this time, many orthopaedic practices have been emotionally and fiscally devastated because of this crisis. Furthermore, this pandemic is occurring at a time where small and midsized orthopaedic groups are already struggling to cover practice overhead and to maintain autonomy from larger health systems. It is anticipated that many groups will experience financial demise, leading to substantial global consolidation. Because the authors represent some of the larger musculoskeletal multispecialty groups in the country, we are uniquely positioned to provide a framework with recommendations to best weather the ensuing months. We think these recommendations will allow providers and their staff to return to an infrastructure that can adjust immediately to the pent-up healthcare demand that may occur after the COVID-19 pandemic. In this editorial, we address practice finances, staffing, telehealth, operational plans after the crisis, and ethical considerations.

The impact of COVID-19 on allied health professions

“…Barnett, Mehrotra, and Landon [ 6 ] reported that due to COVID-19, hospitals have laid off employees and reduced salaries, ambulatory practices have considered closing down, and there is a possibility of more closures and bankruptcies. Similarly, orthopedic practices have been forced to limit staff hours, close offices, and reduce salaries during the COVID-19 pandemic greatly affecting allied health professionals within these practices [ 7 ].…”

Orthopaedic surgeons’ perceptions on COVID-19 related changes in practice: an international survey

“…The emergence of such a crisis provides a timely opportunity for us to re ect and evaluate the use of novel technologies in the workplace. This includes the adoption of telemedicine and telerehabilitation initiatives, allowing patients to be consulted and followed-up in the comfort of their own homes [4,5,[8][9][10].…”

Cardiopulmonary exercise testing in the COVID-19 endemic phase

“…Use of CPET in the COVID-19 endemic phase should be a priority, but must be undertaken safely and only when necessary. Indeed clinical resources will remain directed towards tackling the pandemic, 12 and shortages of personal protective equipment demand the correct use and deployment of any investigation (Fig 1).…”