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Curbside Consult with Dr. Jayne 8/10/20

August 10, 2020 Dr. Jayne 1 Comment

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I thought I had previously registered for ONC’s tech forum this week, but when I noticed I didn’t have any meeting information, I figured I should double check. Turns out I didn’t register.

I would have definitely remembered, because I thought their registration form was a little problematic. First, one of the required fields for registering is a Twitter handle. Of course, one could just put junk in that field, but I found it odd that it was the first field required past name and email address. Another required field was “Affiliation” without any indication of what they were looking for. Did they mean employer?

I’m becoming quite the connoisseur of virtual conferences and have enjoyed doing a few more of them than I might otherwise have done had travel been required. For those of us who foot the bill for our own conferences and education rather than charging it back to an employer, it’s all about making the most of your time and your travel resources.

Speaking of, I cancelled my hotel for HIMSS21 “spring edition” today and worked on making my reservation for HIMSS21 “roasting hot desert summer edition.” Unfortunately, my hotel of choice isn’t taking reservations just yet, but I was able to book a backup for reasonably cheap. Like Mr. H, I’m a little uncertain on exactly where the conference will take place since the official notice includes Caesars Forum and Wynn as venues as well as the expected Venetian-Sands Expo Center. I loved my stay at The Venetian a couple of years ago, but it’s not in my current budget. My new hotel is fully refundable, as was the previous one (and the credit was already showing up in my online account before I had booked the next reservation).

The flight is in my budget, however, as I’m sitting on several thousand dollars of unused plane tickets that were supposed to take me to all kinds of interesting places this year. Now the challenge will be to use them before they expire. Some airlines have been more generous than others in pushing their expiration dates well into 2022, but I anticipate more than one will just become a loss. I’ve found charities that you can donate miles to, but haven’t figured out a way to donate tickets since they’re supposed to be nontransferable. If anyone has ideas, let me know. I doubt I’ll be rescheduling my trip to the Vancouver area anytime soon, given the current status of coronavirus transmission in the US.

Once I finished moving my hotel reservation, I was in an administrative mood, so I spent some time trying to do forecasting for what I’ll be doing the rest of the year. It’s a difficult time to be an independent consultant. Earlier in the year, I watched six months’ of bookings evaporate in a single afternoon, and it hasn’t been easy replacing that business. Many of my ongoing clients are mid-sized organizations that are in dire financial straits as they wrestle with continued shortages of personal protective equipment and struggle to try to figure out how to kickstart their revenue streams during failed economic re-openings across the US. My larger clients are experiencing across-the-board project freezes after furloughing internal staff. They’re more likely to reactivate those staffers than to use an external consultant, which is understandable.

For those clients who are continuing to have me work, I’ve seen some fairly extreme layoffs and restructuring, with one client literally moving the work of two departed project managers onto the one remaining one. The remaining project manager is struggling under the workload, but is afraid to complain because he fears he might be next. As you can imagine, the project management that’s occurring is fragmented, behind schedule, and generally ineffective, because you simply cannot just pile work on people and expect them to work magic. I’ve had a couple of conversations with the director of the program management office about it, but she just throws her hands up because she doesn’t have the authority to challenge decision-makers who still want all the projects running.

It feels like everything we’ve learned about happy staff being productive staff has been thrown out the door in the last few months, and people are operating from a position of desperation. This is only being magnified as various parts of the country head back to school and working parents are trying to figure out how they’re going to juggle childcare with assisting children who are expected to learn at home. I have a lot of friends who are able to work their IT jobs from home and have been successful during the pandemic, but all bets are off when they’re expected to support their elementary aged students in virtual learning plans that have varying degrees of planning and forethought.

Despite industry players like Epic pushing to have workers return in person in the name of “culture,” it feels like most of the health system folks I speak with are happy to let people work at home as long as possible while making plans to jettison the soon-to-be-unused office space and its associated costs.

Two more of my physician friends made plans to close their offices this week. One was already struggling with health issues when the pandemic hit, and the stress has definitely worsened her condition. Another is retiring early to move in with her physician daughter to help with her grandchildren. Both of these physicians thought they had much more time in their careers. Their patients will certainly miss them.

The local health systems have all stopped acquiring practices and one has laid off dozens of physicians, so there wasn’t an option to sell the practices. Since they each carry several thousand patients on their panels, I’m not sure where all those patients are going to receive specialty care, and they only have the state-mandated 30-day notice period to figure it out.

We’re certainly living in strange times. Although my practice hasn’t had to lay anyone off, they’ve made it clear that physicians aren’t getting any extra money regardless of our insane patient volumes and that we should be happy we are employed and working a normal number of shifts each month. They did give generous bonuses to the staff, which we appreciate, but you would think physicians seeing an extra 20-30 patients a day might be worth a little financial boost. I suspect that more than one of us is planning to depart after the end of the year because you can only work at this pace for so long before you start to crack.

In the mean time, it’s all about keeping your chin up, your mask on, and putting one foot in front of the other. We’re all looking forward to the time when this pandemic is under control . We are crossing our fingers that it’s not going to be confounded by a hellacious flu season once we ease into winter. Normally we start our flu vaccination campaigns in September and October, so only time will tell on this one.

Are you preparing to cope with children learning at home? Have any good strategies to share with the rest of us? Leave a comment or email me.

Email Dr. Jayne.



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