This independent orthopedic practice retained all its employees through COVID-19 — here's how

As an independent orthopedic surgical practice with a more than 40-year history in Illinois, Elgin-based Midwest Bone & Joint Institute weathered the COVID-19 pandemic without having to lay off or furlough a single staff member.

The practice was subject to Illinois' restrictions on elective surgeries but made a series of proactive moves to weather the virus-related shutdowns and remain whole. Here, orthopedic surgeon Joshua Alpert, MD, and CEO David D'Silva explain how the practice was able to do it:

Note: Responses were edited for style and content.

Question: How did your practice manage to retain all its employees?

Dr. Joshua Alpert: Back in March, our leadership sat down as a team and put a plan in place to get ahead of COVID-19 as best we could. While we could not predict everything to come, the commitments we made early on set a foundation for the months ahead.

First, we decided that any financial losses sustained by the practice would not affect our employees. Unless it became critical to do so, we did not want to lay off any employees, cut pay and/or benefits or cut hours.

Midwest Bone & Joint Institute has been in the community for close to four decades. Many of our staff have been with us for a long time. We wanted to repay that loyalty by doing what we could to make sure our team did not have to worry about job security or their paycheck during an uncertain time.

We also worked hard at making certain that not only our current patients, but our community at large knew that we were open for both in-office and telemedicine visits. Patients who were uncomfortable coming in for an office visit were offered a telemedicine appointment. We were also able to get patients in critical need seen immediately in our offices, bypassing the local emergency rooms and urgent care facilities. By pivoting quickly to telehealth and staying in close contact with our patients via email and text, we were able to lessen the impact that canceled elective surgeries and appointments had on our office. Patients still needed care during the pandemic, and being able to provide it in a way that met the patient where they were helped us keep busy and minimize losses from surgery cancellations.

Q: What COVID-19 practices will you continue to use going forward?

JA: In keeping with CDC recommendations, we implemented the use of mask/facial coverings for our staff and patients. We believe it provides an important level of protection and reduces the risk of transmission. Until the CDC offers guidance that masks are no longer recommended, we will continue requiring them in our offices. We plan to continue offering telemedicine appointments, as many patients were incredibly pleased with how easy and convenient they proved to be. We also changed some of our waiting room policies and procedures. When patient volume becomes such that social distancing is difficult, we request that patients stay in their vehicles until we call them and let them know we have an exam room ready. We have gotten great feedback on this option as well and plan to continue it. As a clinician's office, we have always made certain our offices were cleaned and sterilized to the highest standard. COVID-19 did not necessarily change our cleaning policies, but they certainly drove home how vital they are in protecting both our patients and our team.

Q: What does the new normal look like for your practice?

David D'Silva: The new normal involves our practice continuing to adapt to the ever-changing world we now live in. Although we hope to return to the "old way," we are realistic that facial coverings and social distancing are not going away anytime soon. Telehealth will certainly become part of a new normal. We will continue to ensure that patients feel safe and secure in coming in for care. There is no doubt that things have changed, and they will continue to do so. The best we can do as a practice is to continue holding high standards for ourselves and taking thoughtful care of the people who entrust us with their health and safety.

Q: What's a lesson other practice administrators can use to replicate your success?

DD: What has allowed MBJI to be successful during the pandemic was built on strategies that were implemented both before and leading up to this unfortunate situation. We kept our overhead low and outsourced activities that did not make sense to keep within a practice. Areas such as marketing, legal, accounting and billing have been outsourced for years. That resulted in our ability to easily pivot during the pandemic and simply reduce the activity for those functions through our outsourcing partners, [instead of] having to concern ourselves with furloughs or layoffs.

More articles on ASCs:
The 'new normal' for ASCs: 16 admins on how the pandemic will change the field forever
Dr. Thomas Vikoren: Same-day TJR 'made all the more important' by COVID-19
Indiana orthopedic practice with surgery center to open

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