Preparing Your Medical Practice for a Disaster

Daniel Padavona/123RF.com

The year 2017 is remembered in infamy for its disasters: hurricanes, wildfires, blizzards, floods, heat waves, tornados, mudslides, mass shootings, school violence, terrorism, and more. What are the roles of physicians and their practices in disasters? What are their obligations? If a natural or man-made disaster shut down your office and wiped out your office records, would you know how to piece your practice back together and quickly start seeing patients again?

The events of September 11 had previously been unthinkable, but for many organizations they were a wake-up call, demonstrating the necessity of planning for unexpected disasters. Many businesses in lower Manhattan that had back-up operations, such as Empire Blue Cross and Blue Shield, were operational within a short time after the terrorist attacks. Many small operations, including medical practices that lacked contingency plans, sustained financial blows from which they could not recover. Experts estimate that at least one of four firms that experience major setbacks is unable to recover.

If you've never planned for disasters, you would probably be at a loss over how to proceed when a disaster occurs. With the tragic events of last year still fresh in memory, this is a good opportunity to evaluate your current plan to keep your medical practice functioning, or to develop a plan if you have not done so already. A plan for responding to a disaster is a foundational element of a medical practice. It is a blueprint for recovery. A comprehensive plan should be documented, frequently reviewed, and practiced. Practice is essential for identifying gaps in the plan, and to develop speed in readiness.

Both the development of a plan and its execution can be team-building experiences – brainstorming, collecting and compiling information, and practicing. A brainstorming team should have at least one person from every department within the practice. Each employee will have valuable insight about their roles in a disaster plan and how to recover quickly after a disaster. Review with each department the critical steps contained in the plan; then have all members sign a document indicating they understand how the plan will be implemented in the event of an emergency. Designate a trusted individual to implement the recovery plan if you are unavailable. Review the plan periodically and make updates when needed.

As you develop your plan, keep in mind what could be missing from your day-to-day operations in the event of a disaster. Assume that you will experience either temporary or permanent loss of access to:

• Patient charts and other key information
• Medical information, such as specialty journals and textbooks
• Support and clinical staff, such as nurses, administrative and billing personnel

An essential part of the plan is a method to store vital records (duplicate patient records, employee information, financial documents) safely and securely away from your main office, so that this information can be quickly retrieved in an emergency. The Empire Blue Cross mainframe computer center was housed away from its World Trade Center headquarters. According to Deborah Bohren, vice-president of public affairs, there was no interruption in the insurer's ability to process claims and provide customer service. Experts recommend storage at least 50 miles away from your practice, even if most of your records are stored electronically. In your plan, include:

• Home phone numbers, e-mail addresses and cell phone numbers of all staff members. Periodically update this information, which should be stored off-site.
• Secure contact information for government and emergency agencies.
• A telephone message informing patients of who they should call for medical emergencies. Include additional contact information.
• Keep extra copies of all the forms you use in your practice.
• Secure copies of loan applications, grant proposals, real estate records, advertising contracts and other documents that are crucial for your business.

Sufficient insurance coverage is vital. As the statistics from businesses that fail to recover indicate, erring on the side of too much coverage is better than having too little. Calculate how much revenue you can afford to lose and cover the rest with insurance.

• Your insurance should cover catastrophic events. Coverage for war or terrorist acts may be costly. Basic insurance may not cover events like floods and other so-called "acts of nature.”
• Ensure that your insurance covers both your equity liens against your business and property damage. Insurance should cover the replacement value of your building, including reimbursement for potential building code upgrades.
• Consider business interruption coverage, which reimburses the revenue lost during the time your practice was unable to function. Read your policy carefully before assuming that coverage applies in all circumstances. Some plans do not cover power interruptions.
• Periodically review ways to exit your office. In a building with other businesses and practices, coordinate your emergency plan with your neighbors.