#8 , #19 , #23b: Of course clinicians want the full pay that’s guaranteed to them by contract (don’t we all!). And yes, you should sit down and have a chat with your clinicians.
First of all, study the contract you have with your providers and be sure it says what you think it says.
It appears that you have multiple choices:
- Make no change. You’d have to get a loan to finance the delta between practice revenue and provider salary. Alternatively: the provider sees 1/3 of their usual patients but, by contract, collects their full salary until a) you can let them go for no cause or b) your practice goes bankrupt, at which point the provider can take up their salary with the court. Providers who “just don’t want to change anything” need to look at the mid- and long-term picture.
- Cut their salary, with a cut in productivity expectation. The provider who used to work M-F 8-5 now works three days a week at 60% former salary for the next 3 months, at which point you will mutually reassess the picture. If you want to pay a flat salary, put it prospectively in writing as an agreement. If you don’t, and her salary goes up and down, e.g. “pay more if you work more, pay less if you work less” - you’ve just disqualified her from being an exempt employee. This is my preferred option for clinicians who are good at being clinicians but don’t have other flexible or versatile skill sets. If your employee gets cut to part time work but still wants full time employment, they may also qualify for partial unemployment.
- Keep their salary the same, but increase or change their productivity expectation. If you have guaranteed a particular salary, but not maximum hours of work, this is fairly straightforward. How do you increase someone’s productivity during a slowdown? Move them to the front lines. (We make it hard for our patients to connect with us, putting phone trees and nurse message-takers between us and them.) For example, the clinician starts answering the phone and triaging calls herself; the clinician takes back night “mommy calls” from the nurse service and turns them into evening telemed visits. This requires a dynamic, can-do sort of clinician who likes a challenge.
Alternatively, you can give them other projects that require a clinician’s knowledgebase to complete.
- Clean up your EMR; learn those shortcuts and make those templates you’ve been putting off.
- Clean up your patient records. Update those laggard problem lists and social histories.
- Learn something new; have them complete online suboxone training.
- Put them in charge of your patient communications during the crisis. Rewrite all the patient articles on your website.