COVID-19 has created a lasting and profound impact on the aesthetic industry as a whole. Since being declared a global pandemic on March 11, 2020, the nation and the world have been in total lockdown. All industries have been affected, with widespread layoffs and state mandated business closures. These closures and the resulting quarantine has had an effect on all aspects of our organizations. It has affected our employees; not only has it threatened their livelihoods, it has changed the way we work together. It has changed the way we communicate with patients and provide care. It has placed burdens on supply lines for much-needed resources. It has impacted the fundamental pillars of our industry.
A new reality
While we may not see the full effects just yet, COVID-19 has established a new “normal”. It will take some adjustment, but using the lessons we have learned during these times, we can and will move forward.
For most, one of the major challenges presented by COVID-19 was protection of your most valuable asset – your team. Even prior to the mandated shutdowns, practices began taking physically protective measures, such as increasing the frequency of sanitizing the office or spreading out patient appointments.
These social distancing efforts have already had a lasting impact on how practices function. There is an expectation that many of these procedures will carry on well past the threat of COVID-19. In addition to providing patients with peace of mind, practices have embraced being held to a higher standard.
Practice owners have also been forced to navigate complex human resources issues. In addition to their responsibilities to the practice, physicians have a responsibility to the members of their team. Unfortunately, due to the economic conditions, many practice owners have had to make the difficult decision to let staff members go or even close entirely.
“It has added a lot to my plate. In addition to being a doctor and a business owner, now I’m a home school teacher, personal chef, receptionist, nurse and even psychologist. It is really tough,” said board certified plastic surgeon Kimberly Carpin, MD, who in addition to running her plastic surgery practice, also owns Acqua Medspa in Webster, Texas.
The COVID-19 pandemic served as a reality check for a lot of businesses by exposing how truly unprepared they were. It emphasized the importance of having strong plans and procedures in place. Practices that kept proper employee files and records were easily able to obtain government aid and take care of their team. More importantly, it has put them in a much better position to recall staff and rebound once this is over.
For many practices, especially surgical practices, the decision to close came down to a lack of personal protective equipment (PPE). Gloves and masks are precious resources and are extremely limited in number. With the burden placed on existing supplies, many are left without the necessary items to perform even the most basic services.
Then there are the practices that are generously donating their existing supplies to those fighting on the front line. In addition to PPE, many surgical clinics have been donating their ventilator units to hospitals. This lack of vital resources has placed a standstill on all elective treatments. Until the country is able to scale up production of these items, it may delay the industry’s recovery.
Using this time wisely
Practices that have remained open have largely abandoned elective treatments and instead focused on patients that truly require immediate care.
Dermatologists, plastic surgeons and even certain medical spas (where state law allows), have shifted their focus in response to community needs. Aesthetic services have taken a back seat to other medical procedures. Moreover, many practices that are staying open are not doing it to generate revenue. They see providing these services as fulfilling their commitment to patient care, often via telemedicine. By taking on many of these cases, practitioners are freeing up time and resources for urgent care facilities and emergency rooms.
After addressing their immediate financial concerns, and for those without the ability to treat patients, many facilities were left wondering what to do in the downtime. Some practices took the lull as an opportunity to work on things within their business that haven’t or don’t normally receive the proper attention.
“We didn’t want to sit around and just wait for everything to end. We are taking this time to be productive; we are working on a lot of processes we haven’t been able to focus on when we have patients in the office,” said Jean Casello, MD, medical director of RenovoMD in Northborough, Mass. “We are cleaning up and improving a lot of key areas in our business now, which is going to be incredibly helpful moving forward.”
As busy practices, it is no surprise that attention is divided and certain processes and protocols did not get the proper care and attention. Without the “distraction” of patients in the office, practice owners are tightening up their organizations and building a stronger foundation for the future.
Open lines of communication
While social distancing efforts are the norm during the COVID-19 outbreak, many practices have largely turned to virtual methods of communication with their patients. Efforts have been made to keep patients informed about what a practice has done during the outbreak and the steps they have taken to protect patients from infection. And, while many patients can’t leave their homes, practices have had no shortage of phone calls and requests. Since businesses have been required to close, there has been an increase in two-way communication between the office and patients.
For many practices, including RenovoMD, the message has been more about reassurance. Constant and open communication during the outbreak has set many offices up for success once they are allowed to return.
“We really just let them know that we are here for them, that we’re still around. Our focus has been on keeping people engaged and with all the positive feedback we received, the results are very encouraging,” said Dr. Casello.
As the closures persist, more and more doctors are relying on telemedicine in order to see their patients. Skype, Zoom, GoToMeeting and more have been incredibly effective tools for many physicians.
“Teleconferencing has been great,” said Dr. Carpin, when discussing the difference in remote consults with a video component versus phone calls. “It is a really interesting psychological change we are seeing in our patients. They are happier; they are smiling. You can tell that they are instantly more comfortable when they can see you. I feel that, in a lot of ways, they open up more on the video chat compared to a face to face interaction”.
RenovoMD shared similar feelings about video consultations.
Thus, in a way, the COVID-19 epdemic was a catalyst to show practice owners what is possible in the realm of telemedicine.
“We really understand what we can accomplish with technology,” Dr. Casello shared. “We are realizing how much time we can save while maintaining a stronger relationship with our patients.”
While it started off as a temporary solution, practices now see the value in this new technology. “When we started RenovoMD 13 years ago, virtual consults were not even a thought. It is crazy to see how much things have changed since then.”
Dr. Carpin has noticed the change as well. “My patients love that they can get in touch with me so easily,” she said. “It is a level of access people aren’t really accustomed to and it really reinforces that we are here for them.”
Consultations were not the only important function that transitioned to virtual. With brick and mortar locations shuttered, patients have been forced to get their favorite skincare products through other means. In response to the outbreak, many practices have enhanced their online retail operations. Dr. Casello’s practice followed suit.
“It is a very interesting insight on how people view skincare as an essential part of their daily routines,” she expressed. “With the increase in online sales, we now know a good portion of our clients really consider their skincare essential, I even had a few patients remark how they can live without toilet paper, but they wouldn’t last a day without their moisturizer.”
Online shopping has been a savior for many small businesses around the country. COVID-19 has reinforced the importance of having an online store and this is expected to be a necessary feature of practices moving forward.
A return to normal
While many practices have developed ways to cope with the new way of doing business, there is still a concern as to when businesses will be able to bring their patients back to the office. Many practices have adopted a “wait and see” policy when it comes to booking appointments. With calendars all but wiped out for the past two months, practices are moving appointments back past the tentative reopening dates outlined by state governments.
With full schedules on the horizon, many practices are optimistic about the future. However as non-essential businesses, they are severely limited by government protocols. Within the community, there is still a great deal of uncertainty.
Dr. Casello echoed this sentiment. “We have moved back every appointment that we can,” she said. “However, scheduling has been more difficult because we don’t have any hard answers on when we can reopen.”
The uncertainty is a huge struggle for everyone, and with timelines changing almost daily, it is important that plans to reopen remain adaptable.
Texas had been one of the first to draft tentative plans for reopening businesses within the state, yet there has still been a great deal of hesitation and question marks. With PPE resources dangerously low, there is still a concern as to what is deemed essential.
According to Dr. Carpin, “There is a disconnect between the state and the medical board. There is a great deal of uncertainty as to what procedures we can perform, so a lot of physicians will not return to work in fear of legal repercussions down the road.”
In addition, Texas’s proposed plan also includes measures that prevent facilities from ordering even basic PPE like gloves and masks.
“So even though they are saying we technically can reopen, it is not realistic,” Dr. Carpin pointed out. “We have no way of getting what we need.” The virus and legislation are in a never-ending game of catch up. Once the government and society as a whole can get ahead of the issue, things will start to improve.
COVID-19 is hardly the first crisis the medical aesthetic industry has had to overcome. It is not even the first pandemic we have endured – both SARS and H1N1 negatively effected the industry – but with COVID-19, we experienced a trial by fire.
Our industry is so susceptible to economic factors that any effect on personal finance will influence the market. Case in point, the 2008 recession. With the crash of the housing market, and the resulting financial catastrophe, patients did not have the discretionary income to spend on elective treatments. However, despite these hurdles, the industry has managed to persevere, and many times come out stronger on the other side.
About the authors
Mara Shorr, BS, CAC
Ms. Shorr serves as a partner and the vice president of marketing and business development for Shorr Solutions, assisting medical practices with the operational, financial and administrative health of their business. She is a Certified Aesthetic Consultant (CAC) and program advisor, utilizing knowledge and experience to help clients achieve their potential. A national speaker and writer, she can be contacted at [email protected].
Jay A. Shorr BA, MBM-C, CAC
Mr. Shorr is the founder and managing partner of Shorr Solutions. He is also a professional motivational speaker, an advisor to the CAC program and a certified medical business manager from Florida Atlantic University. He can be reached at [email protected].
Robert C. Deters BS, CAC
Mr. Deters is the business development manager at Shorr Solutions. Having previously worked as an administrator at a large family practice outside of Boston, Mass., he has first-hand experience on running a busy physician-owned medical spa. This unique perspective makes him an invaluable asset to all of Shorr Solutions' clients.