No One Really Knows What is Going to Happen, And How to Move Forward From That

No one can predict the future, and as Thomas Hobbes once wrote, the best prophet is the best guesser. As is customary and normal in times of upheaval, therapists, like everyone else, have been seeking assurances  and some degree of “pandemic positivity”.  My perspective comes from many vantage points:

1)  My experience living through 9-11  and the  impact on the 14 practice downtown.  I got my start as a consultant the day after 9/11 when I realized I could make a difference helping to get the practices back on their feet.
2)  My belief  that therapists  are resilient –  problem solvers, adapters to situations and living with uncertainty while trying to prepare for the future.  How do we adapt to a situation while we are still going through it – how to accept the uncertainty of the situation. We are accustomed to working with our patients who come to us with this lens of uncertainty ( will I get better, will my child/family member get better??) but it is very uncomfortable for us to be in it. The post COVID future does not exist yet and will only exist after we have made it.

3)  We can use the information of  what a crisis reveals  and exposes and why a  SWOT analysis  –
strengths, weaknesses,  opportunities and threats is so pertinent to therapy practices

SWOT ANALYSIS – Catastrophic situations like COVID 19 this do expose vulnerabilities in any business and therapy practices are no different.  A SWOT analysis (SWOT -Strengths, Weaknesses, Opportunities, and Threats ) is a strategic planning tool and  can help to focus any practice owner so that you can make sure you both  protect your strengths and address your weaknesses.

Pandemic Positivity
Protecting Your Strengths – Most prominent strength – the intangible good will you have created over the years, the relationships you have built with patients, referral sources, the inherent quality of therapists to be problem solvers, and adapters; for many, your ability to fine tune your observational and communication skills especially during telehealth to maintain your relationships
Your communication skills – how well you are keeping in touch with patients and referral sources, how well you maintain the engagement is key to how well you will get through this

Those who are communicating how they will reopen – safety measures being introduced and followed – tell them in a write up, show them in a video – this instills confidence, and lessens anxiety.
communicating with referral sources – their successful re-opening is your successful re-opening?

Did COVID uncover opportunities you were able to capitalize on?? Are there temporary COVID driven changes in regulations /contracts that may become permanent and impact your practice permanently ?

There were many attitudinal and regulatory barriers to telehealth which held it back into the mainstream of practice in many cases and now this shift I think is here to stay as providers and patients realize the effectiveness. Ie – will telehealth continue to be allowed in EI, schools, etc for those children who were chronically under or un served???

Telehealth as a permanent secondary treatment approach  – an  additional revenue stream,  a means to increase your capacity to treat patients beyond the confirms of your brick and mortar, and a permanent way to increase capacity. You  have more flexibility; you will no longer be limited to the physical capacity within the real estate of your practice

HYBRID model – 2x weekly in office, 1x weekly telehealth

Regular in office sessions, telehealth as an ongoing option to decrease cancellation –  during inclement weather, scheduling conflicts, transportation issues etc

Telehealth only for regularly scheduled parent consultation.

Telehealth on an as needed basis to evaluate specific situations at home

Telehealth as a scheduled follow up visit post discharge

Telehealth for  multidisciplinary meetings

Patients who might normally go to a nursing home, or short term rehab facility may not-à  more people will be aging in place –
good opportunities for OTs PTs and SLPs – brick and mortar practices –
may want to add a home based component

Also – if some outpatient facilities are not reopening, or have staggered hours, this presents an opportunity for you as well.

Some practices will be hit harder than others.

If you were in a “ hot” zone, and your neck of the woods is still “closed”.

If existing patients who live in your area left the area, temporarily or permanently…

If  people are considering leaving the area permanently – ie families in NYC – may impact pediatric practices

If you were not able to pivot to telehealth for whatever reason – staff resistance, patient resistance, total lack of compatibility of your practice with telehealth

If your practice is based on people who work in your area and the businesses/offices/ etc are not open, and/or transitioning permanently to remote off site working

Practices who were not able to get consideration from landlords, were not able to get PPP etc etc. Practices who were not able to pivot to hybrid models of service – telehealth, at home services etc.

Are there potential  and possibly large competitors who may enter your  neck of the woods?

Are there market trends in your demographic that could become a threat? –ie –patients/ referral sources moving out of your neck of the woods??  Families who moved from urban to suburban, even out of state may have an “aha” moment, shift in priorities…

What will happen if more companies in your neck of the woods realize that 34% of their work force can work from home… will that change foot traffic in your neighborhood and thus your  practice for patients who normally come to see you before work, during lunch, after work…. ???

If schools in your neck of the woods do not reopen in this school year, how is that going to impact your peds practice – how many families are staying put, how many are leaving

If mom and pop stores do not reopen, how is that going to impact the ebb and flow of your neighborhood.

PANDEMIC POSITIVITY  – I never want to minimize the tragedy of this pandemic, and  the loss of life and loved ones. Yet I hope everyone will realize there is  hope for the future and for the ability for all practice owners to  become and stay  appropriately resourceful and flexible.