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This article appears in the June 2021 issue of the

PE GI Journal

June 24, 2021

The four pillars of recovery from the 2021 pandemic.

When the COVID-19 pandemic hit, many healthcare practices ground to a halt. Fears about the virus and shifting markets stifled patient and procedure volume, suppressed revenue, and brought workers to the brink of exhaustion. Patient volumes in physician practices dipped as much as 30% to 75% by April 2020. Many patients put off screening tests, such as screening colonoscopy, which are often the bread and butter of endoscopy units. In fact, nearly 200,000 people had missed their colonoscopies by October of last year.

Mass vaccinations are providing a glimmer of hope that 2021 will be closer to normal. However, after nearly a year of fumbling in the darkness, tribulations, and turmoil, it may be difficult for some practitioners to remember what “normal” looked like, much less navigate back to it. It can also be tough to imagine surviving a second pandemic, if a similar situation should arise in the future.
Practices can take four steps to recover from lackluster patient volume and lost revenues associated with COVID-19. Integrating these four strategies into the organization’s overall structure can help a practice maintain operations in the event of another pandemic.

1. Human resources

People are the backbone of any successful business, of course, but especially in GI practices. Gastroenterology is a complex specialty that requires advanced training and expertise in GI best practices. Recruiting and maintaining an exceptional team is difficult in any year, much less during a pandemic.
Like other healthcare workers, GI professionals experienced COVID-19 fatigue, brought about by long work hours, added shifts, lack of sleep, short staffing, and dealing with the ever-changing guidelines for personal protective equipment (PPE) and COVID-19 testing—all while risking infection to provide care to patients in their hour of need. Stress and fatigue increases the risk for injury, infections, illnesses, and mental health disorders.
Recovery begins and ends with human resources. The first step is to recognize the staggering amount of stress, fatigue, and misery the pandemic inflicted on healthcare workers. The next step is to create a care plan to help your staff navigate the choppy waters back to normalcy. Consider educating staff on self-care strategies and ways to improve sleep quality, for example, or providing healthy food and drinks in the break room. Establish a Fatigue Risk Management Plan, and use tools like the Epworth Sleepiness Scale to help workers quickly rate their fatigue.
Create a culture of safety, one in which management and team members feel comfortable talking about their fatigue, challenges, and struggles during recovery. Build a system in which workers can report their own fatigue or signs of fatigue in their co-workers without fear of punishment; use language that stresses team camaraderie.
Develop a safety-centric work schedule that features shifts shorter than 12 hours, allows at least 11 hours between shifts, and shorter shifts for those monotonous or physically- and mentally-demanding tasks. Offer short breaks every two hours and longer breaks for meals, or even naps, as necessary.

2. Finances

The pandemic caused financial chaos in nearly every industry, including healthcare. Economic slowdowns across the various sectors disrupted cash flow throughout the entire supply chain, the effects of which are palpable today.
Experts stressed the importance of cash reserves throughout the pandemic, suggesting that those with unstable cash flows and low cash reserves would be particularly vulnerable during the thick of the outbreak. Practices that managed to keep their coffers somewhat full will also stand a better chance at bouncing back during the recovery phase. Cash reserves can fund human resource considerations, PPE, and socially distant workspaces, for example.
Maintaining a cash reserve can also help practices prepare for the inevitable increase of patient volumes by subsidizing equipment upgrades to attract new patients and supporting a larger staff to care for all those new patients. Increasing patient volumes increases revenue, of course, but only for those practices that are ready to handle the influx—patients will likely favor practices with short wait times for appointments and those that provide the services patients are interested in receiving.
Practices that know their way around government funding have the upper hand. The newly approved COVID-19 stimulus bill earmarks $3 billion in additional grants to reimburse hospital and healthcare providers for healthcare-related expenses or lost revenue resulting directly from the pandemic, for example. The NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funds digestive diseases centers and research through Center Core Grants (P30). Other universities and organizations offer grants, such as the American College of Gastroenterology’s (ACG) research awards, to keep research moving forward.
The pandemic pressed the pause button on GI training as well, which could affect staffing during the recovery phase. Some organizations provide funding to keep the pipeline of new GI doctors flowing into rebounding practices. For example, ACG’s North American International GI Training Grant provides partial financial support to U.S. and Canadian GI fellows in training or GI doctors who have recently completed their training.

3. Safety and compliance

COVID-19 protocols, guidance and recommendations are here to stay for the near future, and compliance may require significant changes in GI practices. At the very least, the pandemic introduced pre-procedure COVID-19 testing to routine protocols, which takes extra time and labor to perform and manage. The highly infectious nature of coronavirus has also added a new layer of PPE and rearranged the endoscopy suite to accommodate social distancing.
To make compliance with the constantly evolving mandates and guidelines easier, GI practices can sign up for communication updates from their state associations and departments of health. Check updates frequently, and plan to implement changes quickly.

4. Marketing

Marketing will pump new life into patient volume and practice revenues. In a post-pandemic world, patients will look for practices that are safe, staffed well, and ready to go with comfortable surroundings and state-of-the-art equipment. Now more than ever, patients have learned to be good consumers and educated participants in their own healthcare; many use the internet to research conditions and select doctors.
As the pandemic wanes, practices that lean into the digital world and put a stress on patient outreach initiatives will have a better shot at increasing patient volumes after one of the toughest years on record. GI practices can offer virtual appointments, for example, or publish online seminars for colon health. In addition to increasing patient engagement, outreach programs can present practices as safe and reliable during the waning days of the pandemic.
By resting their practices on these four pillars, gastroenterology clinics can be fully operational and functioning at the “new normal” by this time next year. Renovating the foundation of a GI practice can also help it survive the next catastrophe.