Allegro Pediatrics—Brett Vandenberg, CMPE Chief Executive Officer
OF ALL THE SURPRISES THAT CAME ALONG WITH COVID-19, WAS THERE ANYTHING THAT STOOD OUT?
It was surprising that a health crisis became a business crisis for us, too. COVID-19 has had a huge impact on us from a business perspective. We ended up laying off 30% of our staff at the end of March, but have gradually brought back many. People in my personal life assumed, “You guys must be swamped,” not realizing that—in the early days, because Washington responded quickly—we were not able to be open to see patients. Remote learning also had a huge impact on our business—and in pediatrics, it was a double hit. We suddenly had employees with childcare concerns, because their kids weren’t in school. Plus, we had far fewer visits from sick patients. I’ve joked, “What do you know—social distancing really works!”
IS THERE ANYTHING THAT HAS BEEN ESPECIALLY CHALLENGING?
I think the biggest challenge for us has been trying to create a level of certainty for future scheduling. When COVID-19 hit and we were shut down, we had to reschedule more than a thousand appointments almost overnight. We like to book as far out as we can, but it’s hard to do when we’re not certain if a visit will need to be virtual or in person, or which office it’ll be in.
WHAT ARE YOU MOST PROUD OF, REGARDING YOUR CLINIC’S RESPONSE TO COVID-19?
I’m most proud that we maintained the ability to put our patients first. Rather than distracting us, COVID gave us renewed intensity in making patients our priority. Also, within a two-week period and using internal resources, we trained every single physician in our practice on providing telehealth services. In April, we had 3,300 virtual appointments. That’s trailing off now to about 2,000 a month.
WHAT WORKED WELL DURING COVID-19 THAT YOU’LL MAINTAIN AFTER IT SUBSIDES?
Telehealth was a big one. It has allowed a layer of flexibility that’s provided a way for us to be more available to patients.Always refining our services, we’re now working to balance the appropriateness of telehealth with the best practices in clinical care—in a time when providers aren’t able to put hands on patients for an exam, we’re focusing on some visit types that work well with telehealth. We also increased our use of technology to support pre-visit processes around paperwork and pre-screening. Patient acceptance of these online processes has increased.
We have renewed appreciation for the value of communicating with patients. This means connecting with them to prompt a wellness appointment or promoting our latest service, as well as in a general sense to keep them informed with what’s happening in the community regarding healthcare. We’re also offering drive-though flu vaccinations this fall, which is good preparation for when a COVID vaccine becomes available for national rollout.
HOW IS PROVIDER WELLNESS CHANGING DURING THE PANDEMIC?
We’re very much concerned about provider wellness. When possible, we create flexibility to support wellness or seek solutions. What we’re trying to solve for now is that, with our separation of clinics—some are devoted to wellness appointments, and some are devoted to sick patients—providers have a lack of variety in their day and the kind of patients they see, which impacts their job satisfaction.
WHAT WAS THE MOST IMPORTANT THING THAT YOU OR YOUR CLINIC LEARNED IN ADAPTING TO THE CIRCUMSTANCES CREATED BY COVID-19?
Communication and flexibility are, far and away, the things we have to maintain post-pandemic. They’re what has allowed us to be resilient to the pressure and make quick decisions to move forward faster, on anything. For instance, when COVID-19 first appeared, we were planning around how to ramp up for it quickly. Then the next week, it was the opposite—we were shut down! We learned we had to be good at communicating and confident in our decisions, but also willing to change. The pace has now slowed, but COVID is still evolving, so we’ll need to continue being flexible.
Family Care Network—Rodney Anderson, MD, President and CEO
WHAT WAS THE MOST IMPORTANT THING THAT YOU OR YOUR CLINIC LEARNED IN ADAPTING TO THE CIRCUMSTANCES CREATED BY COVID-19?
During the early stages of the pandemic, when the situation was fluid and rapidly changing, we learned the importance of frequent, effective communication throughout the organization. It was not enough to simply create a new strategic approach; we had to immediately implement it and get that information to all our providers, employees, and often our patients in real time. Our team did an excellent job at this.
After the first few months, we learned the importance of pacing ourselves for the marathon that this pandemic has become. We’ve put a lot of energy and thought into how we can support our physicians, APPs, and employees to ensure they feel appreciated and are taking care of themselves through these challenging times.
WHAT ARE YOU MOST PROUD OF, REGARDING YOUR CLINIC’S RESPONSE TO COVID-19?
I’m extremely proud of how rapidly Family Care Network adapted to keep our patients and employees safe while still providing outstanding care. It is hard to describe how immense the changes were initially, on almost a daily basis, in literally every aspect of delivering care—telemedicine, car visits, changes in our waiting rooms, billing and EMR changes, staff working from home…the list goes on. I watched an amazing group of people draw on everything they had in order to ensure our patients could turn to us throughout the crisis. This was, and is, driven by a deep sense of obligation to our patients, our communities, and each other. As challenging as COVID-19 has been, it has been equally inspiring to see our group rally in response.
OF ALL THE SURPRISES THAT CAME ALONG WITH COVID-19, WAS THERE ANYTHING THAT STOOD OUT?
What stands out to me is how exhausting the pandemic is! COVID-19 impacts nearly every aspect of our professional and personal lives. That means we have massive professional change and uncertainty, paired with massive personal change and uncertainty. The result is that employees, including our physicians, are dealing with COVID-19 all day, every day. This constant presence can affect our patience, creativity, and professionalism. Figuring out new and effective ways to combat “COVID fatigue” will be a major ongoing challenge for us, for as long as this pandemic lasts.
WHAT WORKED WELL DURING COVID-19 THAT YOU’LL MAINTAIN AFTER IT SUBSIDES?
I expect the move toward telemedicine and the adoption of other technology to support care will persist even after COVID-19. In many ways, these new technologies have allowed patients to take a more proactive approach in how, when, and where they access care, which has been a positive change overall.
IS THERE ANYTHING YOU’D DO DIFFERENTLY, OR ANY LESSONS LEARNED?
In hindsight, it would have been helpful to think about this pandemic as a marathon right from day one. We went into full sprint mode at the beginning, and that initial pace was not sustainable. While FCN has done a decent job transitioning from sprint to marathon mode, it would have been helpful to start thinking about that in the very early stages.
IS THERE ANYTHING YOU HOPE THE MEDICAL COMMUNITY HAS GAINED, LEARNED, OR BENEFITED FROM, REGARDING THE CHALLENGE OF COVID-19?
I hope we’ve learned to be more nimble and adaptable in meeting patient needs—from what a typical office visit looks like to how care is funded. I hope we are more willing to adopt technology to improve access and reduce costs without sacrificing quality. I also hope different healthcare entities are willing to collaborate more closely to meet the needs of the communities we jointly serve.