Vetting Surgery Jobs In The Era of Pandemics. The Business of Medicine for Residents, Fellows and Nurse Practitioners.

In an earlier blog I looked at the changes in the delivery of surgery at hospitals and how this should be researched as part of vetting any potential job opportunity.  From what virologists have been saying, these questions may be more important than ever.
We all know about the incredible disruption the COVID virus has caused to almost every aspect of healthcare, and how the pandemic has remodeled the delivery of healthcare through, among other things, the rapid development of telehealth.  All of my primary care clients are fully engaged in the latter, and it’s showing up with others, including physical medicine and even oncology. 
For many months in the Spring and Summer of 2020 the busines of surgery and the delivery of surgical care came to a crashing halt as hospitals dealt with the onslaught of virus patients.  Hospital margins dried up as their primary source of revenue—elective surgery—stopped.  The impact of this is well documented, as are the myriad ways hospitals are (still) dealing with the emergency.
Just how this was handled is of great importance, especially if you are looking to build a surgical practice at a hospital.  Getting block time should no longer be your primary concern. 
In your job interviews you need to research not only how your prospective hospital handled the crisis, but how they will deal with the next pandemic and what impact that will have on those hospital operations that will affect your new practice.  How is the hospital going to continue scheduling electives?  If hospital revenues are impacted—will surgery related jobs be in jeopardy?  Is the anesthesia relationship stable?  What about other departments like radiology and pathology?  How has the hospital planned to continue and possibly expand the segregation of virus patients? What about the status of the ICU?   
In short, what has hospital leadership done to minimize the impact of another virus on electives, which almost all virologists predict will be part of our future?  In the history of COVID we witnessed the severe problems that arose without the necessary leadership (of the Federal government), and how the abandonment of issues related to preparedness (again by the Federal government) crippled the response.  Is hospital leadership as ready as they can be?  You should explore these questions with the head of surgery and hospital executives you meet as part of the interview process. 
All issues critical to the success of your practice.  But don’t stop there.  How has your prospective employer addressed all of this and what is the plan?  It has to go beyond just cutting everyone’s salary.  What has the practice leadership done to prepare?  Are they looking at alternatives, like investing in an ASC, or finding ways to move practice surgeries to surgery centers not at capacity? Are they truly committed to telehealth and tracking its efficacy?  What about other revenue lines, like remote patient monitoring?  
You want to find an employer that exhibits leadership in these areas;  it’s as important as vetting the issues outlines in www.FirstMEDPractice.com.  The employment decision is much too important to leave any stone unturned.
–Tom Ellis III