Lessons Learned From a Year We Want to Forget

There’s no doubt that 2020 and the COVID-19 pandemic has been a test of fortitude for every private practice, regardless of your discipline or location. It was disruptive, disorienting, frustrating, and heartbreaking. 

The pandemic shook the entire healthcare industry, which introduced and exacerbated challenges that will affect business now and beyond. Practitioners have come a long way in adapting to this pandemic and we’re still feeling its repercussions. Our industry has a lot to be proud of. 

The Importance of Community in an Isolated World

Many practitioners were acknowledged as essential workers, which is something we already knew. Practitioners working in acute care settings were—and continue to be—on the front lines helping patients survive COVID. 

Those working in home care, rehab settings, and private practice are helping post-COVID patients overcome residual symptoms and long-term musculoskeletal, respiratory, psychosocial, and cognitive issues—all in addition to the work we do in a normal year. Now more than ever, we know that therapists help patients in ways no other medical provider does. We see what others don’t. We tell our patients “why.” We see solutions—not problems.

Our community also found a way to feel solidarity with each other, even as we were isolated. We realized that we don’t need to be in the same place to support, network, and learn from each other. We became tougher, more nimble. 

Overcoming Financial Challenges

Although the pandemic exposed weaknesses and vulnerabilities of many private practices, business owners were resilient in creating new revenue streams, pivoting to telehealth, and elevating their own financial literacy

Practices are streamlining to lower operating expenses as many still see a 30-40% decrease in gross revenue. There are therapists who lost their full-time jobs as the census of facilities plummeted, and became what I call “forced” or “accidental” entrepreneurs. If that happened to you, don’t worry. History is on your side. General Motors, Burger King, CNN, Uber, and AirBnB were all founded during economic downturns.

No one is going back to “business as usual.” Attitudinal and regulatory barriers that came down during COVID are leaving long-lasting effects as the industry moves forward in how we deliver care to the patients we treat. These are just some of the most striking trends we saw COVID reveal that will have a long-term impact on the field. 

But here are some of the biggest lessons I, and I believe a lot of us, have learned or relearned this past year.

1. Therapists need the ability to practice across jurisdictional and state line boundaries with minimal barriers.
Compact agreements among states allow eligible, licensed therapists to practice in a member state—other than the state they live in—without going through the licensure process in that member state. This concept is more relevant than ever. 

As of now, physical therapists can take advantage of this in 20 states, with eight more pending. Speech-language pathologists can take advantage of compact agreements in six states, with 14 pending. Occupational therapy has entered into exploration of compact agreements, another exciting development for that field. 

2. We need to rethink family planning, and how and where we care for our growing population of seniors.
In the short term, more people over the age of 65 will remain in the family home, as families realized the detrimental impact of quarantine isolation and the vulnerability many elderly people experience in nursing homes and assisted-living facilities. This shift will provide many opportunities for practitioners who offer services related to aging in place and home modifications. It’ll also challenge those who work in facilities to develop new and better senior care models. 

3. We need to reduce—or completely eliminate—barriers to telehealth.
This includes both attitudinal barriers and regulatory ones. We’re already seeing the temporary relaxation of rules that took place in the spring become permanent. Telehealth has offered unprecedented access to care for clients across the country, and a low-cost, mass-scaling opportunity for many private practices. Virtual care is now becoming a permanent treatment approach, an additional revenue stream, and a means to increase capacity to treat clients beyond the confines of a brick-and-mortar practice. 

What’s Next?

If you didn’t have a good experience incorporating telehealth into your practice at the beginning of the pandemic, don’t give up. Especially if you were in panic mode—which we all were. Take the time now to explore it again in a more methodical way. Figure out what the best fit for your practice will be going forward into this year and beyond. 

For instance, you can explore a hybrid model that lets you do in-person sessions two days a week and remote sessions the other days. If you decide to return completely to the office, you can keep telehealth as an ongoing option to decrease your cancellations for things like inclement weather or transportations issues. You can also use it on an “as needed” basis to evaluate specific situations or environments in your clients’ homes, or as a scheduled follow-up visit post discharge from the hospital. 

Telehealth is Here to Stay

The pandemic has shown us that while most private practice will always be “hands-on,” technology needs to be fully embraced to enable us to offer hands off services. Many practitioners once felt that technology would replace us, but now we’re starting to view it as a valuable, complementary tool. 

Technology is simply a service extender. It helps us position ourselves as experts in how healthcare interacts with the environment, and lets us stay truly connected with our clients. We need to continue to innovate service provision by incorporating more healthcare technology into our practices. The question is no longer “Is there an app for that?” Now the real question is, “How are you using it?” 

The year 2020, though a year haunted by so much loss, also helped us discover who we really are and what we value. People everywhere had to determine what we missed and what we can do without. As the vaccine gets rolled out throughout the country, there’s every reason to think that 2021 can be both a transitional and transformational year for all of us. Sometime in 2021, life may start to look a lot more normal, but it will not be the same. Let’s make the best possible use of that change. 

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