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“I have often depended on the kindness of strangers.” Thus, wrote Tennessee Williams in his famous Streetcar Named Desire. We, too, looked to the kindness of strangers in the early days of the pandemic, particularly for personal protection equipment. It was an all-in, humanitarian effort to keep our colleagues and patients safe. Because there were more stringent demands for the wearing of PPE for longer durations, and for more frequent changing of PPE than in our halcyon pre-pandemic days, the need to quickly source PPE for immediate use was paramount.  

I wrote in a previous column of the need for keeping a 30-day inventory of PPE. I want to reiterate that, but also stress that depending on strangers to step in and restock PPE inventory as the pandemic continues, is a foolish and fraught strategy. Poor planning on your part does not constitute a crisis on my part. A colleague shared this adage with me years ago, and it’s a perfect fit for this situation. If you need more stable channels for reliable PPE supplies, look to your physician organization for referrals, talk to your existing office and cleaning suppliers or consider joining an association that offers PPE resources as a member benefit. I did that recently when I joined the Small Business Administration of Michigan (SBAM) on the key value proposition that they would guarantee me access to PPE. Delegate the responsibility to your office manager or a key clinical member of your team – but don’t abdicate the responsibility. Demand accountability and a timeline so as not to be caught off guard by excuse-based explanations of why the PPE cupboard is bare. The PPE discussion does not live in a vacuum, though; it’s part of the broader need to have a well devised business strategy and crisis planning. If that’s not at the top of your list, put it there. Now.

I also want to give a shout out to my healthcare colleague Marianne Udow-Phillips, who was part of a Michigan Medicine team that sent out a survey in May regarding trustworthy sources of information on COVID-19. Udow-Phillips noted in a local business publication that 80% of respondents trusted their healthcare provider to share correct information. Yet she acknowledged that providers weren’t necessarily reaching out to their patients to communicate information. What an excellent opportunity to remind physicians that your patients respect you and want to hear from you – even when they don’t have an appointment! Patients want to be engaged with their physician’s office – their medical home. What better way to reinforce your patient-centeredness than to reach out specifically on health and safety matters related to the pandemic? 

Now, onto one of my well-known concerns about the erosion of primary care from well financed (and soon, potentially publicly traded) companies like Oak Street Health and Village MD, who siphon off Medicare patients from the private practice community. As great as the impact of the pandemic has been on the healthcare profession, behind the scenes positioning for aggressive moves into the primary care market have not ceased. Quietly and not-so-quietly, big players continue to enter the scene or solidify their plans to do so. Make no mistake, they can change the nature of your practice within a few years.

What should a primary care physician do today to ensure continuity of his/her practice? 1) Join a physicians’ organization. There are nearly 40 in the mitten. These robust organizations can guide you through the initial phases of practice transformation. 2) Commit to being an active change agent, not only supporting but engaging in practice transformation activities that focus on creating and maintaining the patient-centered medical home model of care. If you are not familiar with the model, ask a colleague in primary care, or get on the BCBSM Value Partnership website.  3) Perform your own practice assessment.  How many patients are attributed to your practice?  Review the gender, age, diagnoses and payer mix of your practice population. 4) If the age of your patient population hovers around 65, you’d be wise to start a marketing campaign to not only recruit new patients, but to offer new services to your older population. 

Now is the time to learn more about your practice.  Don’t sit on the fence – jump off and get engaged. Your future depends on it.