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Working from home: Is it possible for physician practices?


How can medical care provided by a physician's practice, which often requires face-to-face interactions, work remotely?


As the coronavirus (COVID-19) spreads around the world, employers such as Amazon, JP Morgan Chase, and even small businesses are ordering employees to work from home in an effort to keep operating and keep people safe.

While physician offices will likely need to remain open to help treat people as the virus continues to spread, this pandemic also represents an opportunity to test flexible work options. For instance, many administrative tasks, such as appointment scheduling, bookkeeping and insurance filing, can be successfully handled remotely-but until now, doctors’ offices have had little incentive to give remote work a try.

“There’s been an organic creeping toward flexibility in the workplace, but there hasn’t been motivation for organizations to do the work to really make it happen on a large scale,” says Cali Yost, workplace strategist and CEO of Flex+Strategy Group in Madison, N.J. As the coronavirus outbreak continues, it has become increasingly important to keep staff safe while continuing operations. It’s an ideal “opportunity to experiment with new ways of working that can be a necessity now, but could possibly get you organized for future success beyond this moment,” Yost says.

For instance, Lugo Surgical Group in The Woodlands, Texas, has been operating almost completely remotely for about two years. Clinic owner Rafael A. Lugo, M.D., and other clinicians see patients in person one and a half days each week. If a patient has an emergency, Lugo meets the patient at the ER. All other work is conducted remotely, including scheduling, billing and follow-up.  

Incorporating remote work

Lugo believes that the ease of practicing medicine remotely depends on the type of medicine in question. “As a surgeon, I do not have to see a patient frequently and the most important visit is the first to discuss the procedure and do an exam,” he says. “Post operatively, as long as everything is going well, we pretty much do a social visit that is included in the global fee. So [when you don’t work remotely,] you have an office open and spending money for something for which you do not necessarily get reimbursed.”

Physicians practicing in other specialties may need to be available for office visits on a more regular basis, although for some, telemedicine is replacing some in-person appointment. But even if the doctor and nurse see patients in the office, most other staff can telecommute from home. For example, most electronic health records software offer virtual options such as the ability to accept payments remotely, Lugo says.

Most remote work policies are not “all or nothing,” Yost says. Instead, the policies that work best allow for a remote work hybrid, which involves some tasks happening in person while others are conducted off-site. “Think about which parts of your business could be done more flexibly and which parts need to be done in person,” she says. “Then you can create a hybrid model that works for you.”

That may mean allowing some employees to work remotely while rotating in-office assignments, or it could mean using a shared office space so you can see patients on certain days and work from home on other days.

Before sending employees to work from home, it’s crucial to provide an appropriate, secure technology setup. Any employee who has access to patient files should access the internet through a virtual private network (VPN). Always require passwords for staffers to log into meetings or access documents, and use multi-factor authentication when possible. Practice leaders can facilitate remote team meetings with tools like Zoom and Workday, and communicate regularly with their teams with cloud-based messaging software such as Slack.

Remote work: A long-term solution?

Taking advantage of this current opportunity to try new ways of working can pay off in the future. Not only will you be prepared for the next crisis, but you’ll also cut costs on office space, gain access to a larger workforce interested in flexible work, and provide even better care for patients.

For Lugo, working remotely allows his practice to decrease overhead costs, no longer paying for an office to be open every day and 24-hour electricity costs. “Doctors are not making more money and we are not getting paid more by insurers,” he says. “In fact, we get paid less and it does not keep up with inflation. In the meantime, the cost of practice goes up. We have to find ways to decrease the overhead, and with the broad use of EHR and everything cloud-based, you can have a virtual office anywhere.”

Flexible work options also make it easier to attract and keep good employees: For instance, 96 percent of white-collar workers say they need workplace flexibility but only 47 percent have it, according to the Harvard Business Review. And studies show that most employees are more productive when they work remotely than in the office, according to Forbes.

“Employees seem to be willing to do more when they are remote instead of sitting in an office eight hours a day,” Lugo says. For example, because his nurse works remotely and gets to be home with a new baby several days a week, she is willing to take calls after hours and act as an answering service, which has further decreased costs.

For patients, a virtual office can fit into their current expectations of having services available when and where they need it. For instance, consumers who can order anything online to be delivered promptly at their front doors no longer want to drive across town or further, look for parking, and manage the hassles of elevators, parking stubs, and waiting rooms.

“People will demand more and more to have everything conveniently closer,” Lugo says. “If you are a specialist, for example, you need to see patients from all areas in town and people hate to be driving. Rather than having costly multiple offices and signing many long-term leases, we’ll see more short-term leases or subleases to see patients that need to be seen physically. That way, you can have multiple offices and different days at a fraction of the cost of one long-term lease. All you need is the computers and a nurse that travels with you. The rest of the operation can be done remotely.”

Moving to a similar model has saved Lugo thousands of dollars and headaches every month, he says. “It is a more efficient way to use your time, and you only pay for what you use, not for empty space and unused time,” he adds.

Having the ability to work flexibly allows physicians to adjust to patient needs and expectations, as well as achieve a better work-life balance. “Mentally, it gives you a freedom that makes you feel more positive and frees you to do other things to improve your visibility and presence in the community,” Lugo says.

Taking steps now to accommodate remote work can keep staffers safe and help slow the spread of COVID-19. But physicians may find that the ability to work more flexibly offers benefits worth maintaining even after the current crisis has subsided.

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