Financial Impacts of COVID-19 on Practices: Q&A with Norman Gaylis, MD

Dr. Gaylis and staff in his practice in Aventura, Fla.

Q: How has this shifting situation affected you and your staff?
It’s extremely stressful. It was very emotional and difficult to talk to staff about potentially having to take less salary or lose their jobs. So there was this insecurity, the stress of what could happen financially. Then there was the stress of potentially becoming exposed to COVID by being at work. I was extremely transparent with my staff about the business, and to this very moment everybody has really stayed positive and worked together as a team. I’m very proud of them. The continued stress and insecurity are taking their toll on the well-being of all of us working in the office.

Q: What pandemic-related factors are contributing to ongoing financial stress for community physicians?
When we opened back up after the two-week shutdown, the practice didn’t bounce back by any means. We’re seeing fewer patients, probably about 60–70% of our normal patient flow, and our costs have gone up between coronavirus antibody testing and increased use of personal protective equipment.

Q: What do you see for the future?
As we look forward, if this pandemic continues, we will have to look at our business model and how we might do things differently. We are not going to be able to continue to sustain the practice the way it is at the moment. Community practices are really threatened and may have to shut down without financial resources. This is going to be a catalyst to reduce community health care dramatically, which is a tremendous loss for many reasons. Obviously, we fill a tremendous need for the community.

Q: What solutions, if any, do you see for helping rheumatology practices return to normal?
Number one, we’ve got to get past this pandemic. Until then, we are going to have a tremendous problem with our current business model. Unless we get help and unless we reduce overhead, we may not be able to stay viable.

Beginning July 1, our stimulus money was gone. Since then, we’ve asked each staff person to take one personal day off each week for three months. That alone will save 20% on payroll. Maybe there will be more virtual medicine practice, so you can reduce some of your space needs by doing home visits, telemedicine and so on.

We need to harness all of our resources to get through this. We recognize that this isn’t going to be the best year of our lives, but if we can hold on, maybe we’ll be in decent shape when this thing turns around.