Prepare Your Practice for a Disaster

November 12, 2012 in Managing Your Practice

prepare your therapy practice for a natural disaster

The horrible storm that recently struck the east coast is a powerful reminder that we need to be prepared for emergencies in our practices. Not paranoid mind you, but prepared. Prepared in the event that mother nature delivers somthing that makes it difficult, or even impossible to open our doors to patients.

I have lived this scenario firsthand. Several years back, a major ice storm struck the region in which our practice is located. The storm hit and hit hard– no one in our practice was able to see their patients for over a week as our city struggled through the effects of the storm. Power was out in most of our region, and telephone and cell phone service was virtually nonexistent. Fallen trees crushed houses and cars and shattered the electrical grid completely.

For the first few days after the storm, the downed trees and live electrical wires made many roads all but impassible. Gas stations were unable to pump gas because they had no power, food spoiled in grocery stores that didn’t have back-up generators, and pipes burst in unheated buildings as we all did our best to stay warm in our dark homes. Many people relocated to emergency shelters for warmth and food. In terms of Maslow’s Hierarchy, we quickly worked our way down to the bottom of the pyramid.

Our therapists knew their patients were probably very distressed by the storm but had no way to reach them. Our therapists were also under a great deal of physical and mental stress themselves, but couldn’t even reach one another for support.

It was not the sort of thing we had ever thought to talk about in peer consultations or administrative meetings before. What do you do when your entire city is turned upside down? What do you do when you can’t physically reach your office, can’t communicate with patients or staff? What do you do when your practice grinds to a halt because of a natural disaster?

We were very fortunate compared to those on the east coast. The clean-up effort was swift and power was restored to most of the region within a week or two. While we suffered some financial losses and property damage because of the storm, we weathered it very well thanks to good fortune and a solid practice management structure. We were able to go back to practicing in our own office building after some minor repairs, and our patients quickly returned, albeit a bit shell-shocked from what they had experienced.

Here are some thoughts about disaster preparation, based on that experience:

Although you are in a helping profession, know that you’ll have to address some of your own needs in the short-term in order to be most helpful to your patients and others in the long-term

  • As the flight attendant says, “Put the mask over your face first then assist those around you…” In the chaos and confusion of the moment, you may be surprised at how focused you’ll become on basic necessities like food, water and shelter.
  • Once you’ve been able to address your basic needs, you’ll have a much clearer head and the energy to help you focus on reestablishing communication with patients and getting your practice up and running again.
  • Cut yourself some slack. Recognize that you are running a marathon rather than a sprint and in order to serve the community best, you must preserve yourself to successfully carry out your mission.
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    Have key phone and account numbers handy
    Be sure to keep important phone numbers handy (stored in your smartphone, wallet, or other easily accessible place) in the event you need to contact key personnel or suppliers and are unable to access this information from your office.

  • Staff cell phone and home phone mumbers
  • Insurance company phone number and policy numbers
  • Landlord phone number
  • Bank and credit card account numbers and phone numbers
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    Plan ahead for recovery of your important records

  • We have all been through HIPAA training stressing the requirements for a backup of our data and having a solid disaster recovery plan. HAVE A BACKUP FOR YOUR DATA. HAVE A PLAN FOR DISASTER RECOVERY. It’s easy to get lazy on this, but, when things start falling apart you can see why having a plan and having backup are really good ideas.
  • I would also add that it is important to plan ahead for how you will recover your financial and other important records as well.
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    Have a financial disaster plan in place

  • Most business insurance plans do not provide coverage for lost revenue. If you are unable to see patients, most insurers will expect that you can simply reschedule your appointments and see your patients at a later time. Do you have a sufficient financial cushion built up to absorb the loss of a few days (or even weeks) without seeing patients if your practice is shut down by a natural disaster?
  • If your patients are slow to return to therapy as they rebuild their lives after a calamity, can your practice take the hit?
  • Do you have a sufficient financial cushion to pay for needed repairs, replacement equipment and furnishings to get back up and running, or for a relocation while you wait for insurance reimbursement?
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    Make sure your property insurance is sufficient

  • Have your insurance agent review your policy with you so that you have a solid understanding of what is and isn’t covered in the event of a natural or man-made disaster. Are you covered in the event of a flood or do you need special flood insurance? What about earthquakes?
  • Is the current dollar amount of your coverage sufficient? It’s a good idea to review your policy on a regular basis as your property value changes and as you acquire new equipment and furnishings.
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    Build strong relationships with other local clinicians

  • If you are struck by a disaster and are unable to reopen your practice, you should be familiar with therapists in the area to whom you could refer your patients. Being able to “match” patients with providers who are well suited to your patients’ needs can greatly ease the transition for those patients who have already experienced a traumatic event and will now have to experience the loss of their therapist.
  • A therapist who has an established relationship with you may also be willing to open their doors to you under reasonable terms in the event you need temporary office space while you get back on your feet.
  • Experiencing a natural or man-made disaster is not only traumatic for patients but for mental health professionals as well. Peer support can be invaluable and should be accessed as quickly as possible after the event. Reach out for the help you need and extend help to others.
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    Keep your practice nimble

  • Having off-site backup for your computer systems and patient records that can be restored at a new location can get you up and running again quickly. Familiarizing yourself with how to restore from a backup and making sure key staff members also have training in restoring key systems should be part of your disaster planning and training.
  • Make sure your website can be easily updated by you or your staff (not just your web designer or some other third party). Having this kind of access can allow you to quickly get the word out to patients and the community that your office has reopened or that you have relocated.
  • If you have administrative staff, make sure they are cross-trained so that if not all of your team is able to immediately return to work, you won’t lose the ability to perform key functions.
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    Hope for the best but plan for the worst

  • We may not like to think about it, but we have a responsibility to our patients and those we love to make plans for our practices in the event that we become incapacitated or die while still actively seeing patients or while still in possession of patient records.
  • If you have a family to support, you may want to consider investigating disability insurance to help replace your income should you become unable to work (not just in the event of a disaster, but in general).
  • Life insurance may be another product to consider if you have loved ones who count on your income as one of their primary means of support. (And please note: I am NOT in the insurance business!!)
  • Have you ever thought about exactly what would happen to your practice and your patient records if you died unexpectedly? Establishing a professional will can formally outline the details of the dissolution of your practice so that if something unexpected happens to you, your practice can be closed and your patients and patient records can be taken care of in a confidential and professional manner. Just like a will for your personal estate, this can be an invaluable guide for those responsible for handling your professional estate.
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    Disasters like the one my practice experienced as well as the recent hurricane that struck the east coast are unusual events. However, it is responsible practice management to be prepared for the unforeseen, and it can help to bring you peace of mind to know that you are ready in the event that a natural disaster strikes.


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