The economic impact of COVID-19 is unfathomable. No one, not even the greatest economic minds can agree on what will happen going forwards from a macro-economic perspective.
However, in this article I want to be more industry focused and look at the specific reasons why there is hope if you run a healthcare practice. Then I’ll review the financial measures that you should take to maximise your personal and business cashflow so that you survive the next few weeks/months. I’ll conclude by looking at the specific actions that I believe you should take in the next 3-6 months to bump-start your practice and start generating income again.
The economy is global and circular. With an economic shock as large as COVID-19 everyone will be affected. But, some individuals and businesses will be impacted less than others. Below I’ve listed a few reasons why I think you should be more hopeful than many entrepreneurs if you run a healthcare practice:
- for many patients the services that you provide are necessary, as opposed to discretionary. Discretionary costs like eating out or a Netflix subscription can be cut back in times of hardship. Necessary ones like treatment for a debilitating physical or mental condition generally aren’t
- it’s an unfortunate fact but longer wait times for Allied Health Professionals (AHP’s) in the NHS mean many patients have no realistic option but to go private
- many patients who might have historically waited for outpatient treatment may feel disinclined to attend outpatient clinics in short/medium term. Either because they don’t want to further burden the NHS or because they are fearful of contracting COVID-19
- there is no doubt that money will be tight for many post COVID-19. But, it’s worthwhile bearing in mind that the proportion of the population that pay for private treatment is relatively small and fluid so there is always likely to be a segment able to pay
- based on economists most dire estimates of unemployment (say, 20%) infers that 80% of the working population will remain in employment (either directly or via furlough). During lockdown these individuals have had their spending significantly curtailed. When restrictions are eased they are likely to seek treatment for the conditions that have remained untreated since lockdown began.
- many small to medium sized healthcare practices are not weighed down by debt or encumbered by external shareholders. In most cases, it’s a single owner and small team, rent and a relatively small amount of capital expenditure. Aside from the short-term personal financial pain, which I’m not under-estimating, many practices will not have accumulated the financial baggage (unsold stock, higher raw material prices, excessive debt) that many will have during lockdown.
- without a vaccine in the short/medium term (i.e. in 2020), it’s likely that lockdown will be eased in phases and that restrictions will be lifted on different businesses at different times. The government has stated on a number of occasions that lockdown may itself be causing physical and mental suffering and that this should be factored into its plans when considering when and how to lift restrictions. There are already signs of this happening in other European countries where restrictions on Hairdressers, Physiotherapists and other healthcare professionals have been partially lifted.
If I’ve convinced you that there is cause to be hopeful, these are the financial actions that you should take (or not take) to help you survive the next few weeks/months:
- If you’re eligible for small business rate relief apply to your Council/Local Authority for the Small Business Grant (£10k). The process seems to differ between councils with some requiring you to fill out a form whereas others contact you if you’re eligible. Either way, I wouldn’t wait. Go onto your Council’s website, find the Business Support – COVID-19 section and get the ball rolling. If you have to complete a form here’s a video showing the form for my local Council (Cheshire West) just so you know what to expect -> https://www.loom.com/share/d470227a52f241149fb7a6c05f5174ac
- Determine which staff members are going to be furloughed and provide confirmation to them in writing. Sample letter here. Timescale: Immediate
- Create a 180-day contingency budget based on the furloughing that you have implemented and the grants that you have or will receive. Get the budgeting template here. Timescale: ASAP
- Defer any VAT payments that may be due between now and June.
Timescale: As and when due
- Don’t make any self-assessment payments in July. These have been deferred until January 2021. Timescale: January 2021
- If you’re self-employed this article hopefully makes it a little easier to assess your eligibility for the Self-employment Income Support Scheme (SEISS) ->Summary of the Self-employment Income Support Scheme (SEISS)
Timescale: You will be contacted in June 2020
- If you have a mortgage contact your mortgage provider to request a 3 month payment holiday. Timescale: ASAP
- If you’re renting contact your landlord and discuss deferral of your rent. The government confirmed on the 19th March that landlords will not be able to start proceedings to evict tenants for at least a 3 month period.
- Keep any eye on the HMRC website for details of the portal where you will submit information about your furloughed employees. I will also track this and let you know as soon as I see anything.
Timescale: Likely End of April 2020
- If your business premises are rented contact your landlord and discuss deferral of your rent. Following the Chancellor’s announcement on 23rd March, no business will be forced out of their premises if they miss a payment in the next 3 months. Timescale: ASAP
- If appropriate, apply for the Coronavirus Business Interruption Loan Service (up to £5m loan with no interest for first 6 months). You can find a list of CBILS approved lenders here. Timescale: ASAP
With your finances stabilised its time to start taking some positive action. Every business is different but with no imminent possibility of face to face consultations, the only viable opportunities to generate short-term income are video and tele consultations.
I know many of you are adapting your businesses with amazing results but for those who might be struggling to get to grips with video consultation here are four things to consider:
Does your speciality lend itself to video consultation?
Some obviously don’t but many surprisingly do, particularly when there is no other option. Over the past few weeks a whole host of physios, speech therapists, podiatrists, psychotherapists and many more have been in touch to let me know how they’re switching to video and/or tele consultations.
Here’s just one example from Dianne Ashcroft at Lane Ends Podiatry. She’s put this informative and entertaining video together to explain to her clients how video consultation is going to work despite not being able to get hands-on.🦶
Are you able to offer video consultations?
Zoom, Skype and FaceTime all provide potential platforms for video consultations but none of them offer the kind of protection, control and audibility that clinicians might need.
Be sure to check with your practice management system provider to see if they offer (or are planning to offer) video consultation capabilities in the next few weeks/months or as long as you believe lockdown is likely to last.
Here at WriteUpp, we’ve released a fully embedded video consultation platform within WriteUpp that you can use to schedule and conduct video consultations directly with your patients. Here’s a quick summary of its capabilities
- Book sessions directly from the diary
- No need to exchange Skype/Zoom details
- Designed specifically for clinicians
- No data shared with third-parties
- Clients can pre-pay & book online 24/7
Are you set up for video consultations?
As a remote business we’ve been using video chats for 7+ years and we’ve learnt what works well and what doesn’t. Over the coming weeks we’ll be sharing some practical tips on how to ensure that your video consultations are effective and professional.
Can you generate enough income from video consultations for it to be viable?
A number of the practitioners that I’ve spoken to (virtually!) over the past few weeks have made the switch to video consultations but are only getting a handful of enquiries.
Please don’t let this dampen your enthusiasm for video consultations.
Try instead to put yourself in the position of the person (in lockdown) requiring your services and consider how they would find you or get in touch. Most likely it would be online so here are few simple tips to help you get started:
- Make sure your website makes it VERY clear that you offer video consultations
- Make sure that your online presence in search (Google, Bing etc) makes it clear that you offer video consultations, by this I mean the snippet that appears in the search results when you search for your practice. Here’s our snippet:
- Consider running some localised pay-per-click ads that explicitly make reference to the fact that you offer video consultations and where possible link them to a page on your website that describes how your video consultations work both from a practical and therapeutic perspective.
- If you don’t have any online presence you need one quick. Get something knocked up on Wix or one of the many website builders out there. Nothing fancy just a few key pages that explain the treatments you offer, some evidence of credibility and an easy way for them to take action (call, email or preferably book). If you want to know more about building a simple site that will generate income for you check out my article “How do I build a conversion-focused website?”
To build upon these tips we’ve asked our friends at UpRaw Media in Amsterdam to help us on this. They’re one of Europe’s top PPC (pay-per-click) agencies and have tons of experience at generating demand online. We’re going to work with them to pull together in a more detailed article on this specific subject over the coming weeks.
I don’t have a crystal ball and as I write this, we have no idea how long this will last and for that reason alone I personally believe you need to have a positive plan.
If your assumption back in February was that Coronavirus wouldn’t impact us, you were wrong. If, when lockdown began, you believed that it would be done and dusted in 3 weeks you were probably being naively optimistic.
Here we are 4 weeks in, the government has deployed most of its financial firepower (grants, loans, funding etc) and there is no perceivable end in sight. Normality is not returning any time soon and in my opinion if you accept this reality head on you stand a much better chance of getting through this.
As a healthcare professional there are reasons to be hopeful. If your finances are under control (as much as they can be) and you have time to consider how you can repurpose your skills to generate an online income you will survive this. You may be battered and bruised but you’ll make it through.
Good luck and thanks for reading!