Physicians Need to Plan for Disasters Assuming They Will Happen

Murphy�s law proclaims that �If anything can go wrong, it will.� That�s not necessarily a pessimistic attitude; more likely it�s realistic, especially when it comes to disaster planning and preparation.

Murphy’s law proclaims that “If anything can go wrong, it will.” That’s not necessarily a pessimistic attitude; more likely it’s realistic, especially when it comes to disaster planning and preparation.

“You can never be too prepared,” says Neil Notaroberto, MD, who runs a three-office ophthalmology practice in New Orleans. His robust disaster plan helped him successfully weather Hurricane Katrina. “No matter what contingency plans you have, believe me, life can throw you a curve that you never saw coming.”

Planning ahead

In 2004, Notaroberto determined that his practice, EyeCare 20/20, needed a new practice management system, and he made the switch from an in-house network to an Internet-based solution. The initial benefits, he says, were obvious. “Instead of having a separate server for each office with separate software licenses, I had one software solution that was off-site. Instead of having my own computers and worrying about breakdowns, hard drive failure, electrical and software issues, I let somebody else handle that.”

And he’s glad he did. In August 2005, Hurricane Katrina tore through southern Louisiana and ravaged New Orleans. Somehow, Notaroberto’s offices escaped with no structural damage. “I was very fortunate; the big man must be looking out for me,” recalls Notaroberto. More importantly, however, the doctor and his staff were able to re-open the offices less than 3 weeks later and began seeing patients immediately thanks to his Internet-based practice management solution. “My electronic medical records, practice management software, accounting software, billing and accounts receivable—everything was done in that manner. It allowed me to recover much faster.”

As the only ophthalmologist open for business in the entire New Orleans metropolitan area, Notaroberto quickly took on new patients. He experienced an increase in patient load of more than 50%, and he has retained those new patients to this day. “I was available and able to offer quality care,” the doctor says. “People tend to not want to change if things are going well. So, after several months, when things got back to normal for the other [ophthalmology] practices, I was able to retain those patients.”

Katrina lessons learned

Christopher O’Connor was the vice president of clinical services for Ochsner Clinic in New Orleans when the city was clobbered by Hurricane Katrina. Now, as the president and CEO of Caritas St. Elizabeth’s Medical Center in Boston, O’Connor has brought his lessons learned in disaster preparation with him and instituted Incident System Command training at the hospital. The system, which is widely used by firefighters and emergency medical teams, is a disaster response structure intended to guide staff through specific emergency procedures to ensure they can effectively perform their jobs during a disaster.

“[The system] sets up a natural chain, because in [an emergency situation], there is no way any senior executive can manage every single item of need,” says O’Connor. “The Instant Command System empowers everybody, and sets up parameters for people to be successful. I think it’s an imperative system that we need to do more discussion around, because you don’t need it until you need it.”

O’Connor also says that communication, both internally and externally, is critical both in disaster preparation mode and once a response to an emergency has begun. “Communication was critical to make sure that our staff knew that they were safe—that they were our primary concern,” recalls O’Connor. “And that we would do everything and anything to make sure they and their patients were safe throughout the response to Katrina.”

Pandemic flu

Emergencies don’t always come in the form of response to a fire, earthquake, or flood. Matt Conlon, vice president, market development for Cantel Medical, a supplier of medical devices, has been working with the National Safety Council, Centers for Disease Control, and other authorities to help prepare for disasters such as pandemic flu. The goal is to help hospitals, clinics, and businesses formulate emergency preparedness plans against potential pandemic infections.

“An overarching statistic [in the event of pandemic flu] is an estimated overall reduction of 6 percent in gross domestic product in the U.S., which is a loss of about $690 billion,” says Conlon. “Statistics also show that there will be an increased demand for healthcare services by as much as 15 percent. The healthcare system will be overwhelmed.”

Conlon is working with the National Safety Council to roll out a series of 25 seminars on emergency preparedness, the first of which was recently held in Nebraska. He says the best place for hospitals and physician practices to begin emergency preparedness is by looking within and assessing their organization’s ability to respond to a disaster. “Paint a realistic picture of how you want to be set, and plan for that scenario,” says Conlon. “You have to look at [disaster preparation] as a ‘when’ and not an ‘if.’”

Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at edwardr@frontiernet.net.