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Layoffs - FQHC and others

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bebbercorn has 10 years experience and specializes in Family practice, emergency.

11,882 Profile Views; 455 Posts

Hello, all. My small FQHC just started layoffs and hour reductions. Most providers were not impacted, but we lost psych, and there were a couple of providers that had modest reductions. However, we lost a lot of staff that do a lot of the paperwork, outreach, our social workers hours got cut... some of our other programs for marginalized populations were also cut or on an indefinite hold... apparently this has been needed for a while but I'm curious about other clinics and how you all are handling reduction in visits. We went to telehealth really rapidly and that's going well, but still can't fill all of the slots. We were told no more layoffs for at least another week. I'm a little concerned about how to handle loan repayment through HRSA, but they seem willing to work with me. This is a partial vent post and partial request to hear how you all are getting through.

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Mr.Sta has 6 years experience as a BSN, MSN, NP.

6 Posts; 141 Profile Views

My clinic has switched all the providers to one week on and one week off. This has been for the Month of April. We have not gotten rid of any staff at this point but I am unsure how long this week on/week off will last. With HRSA they said you can put a pause on your time and just repay it at the end, at least that's what we were told. I will miss 10 days the Month of April, so if I go over before my anniversary days they will just tack those 10 days on the back half. We have also started to do some Telehealth but has not replaced the numbers fully, not sure how long this will all last or what May will bring. I have reached out to the locums companies I have worked with before and have that in place if needed. Great game of hurry up and wait.

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djmatte has 7 years experience as a ADN, MSN, RN, NP.

2 Followers; 920 Posts; 8,315 Profile Views

10 hours ago, Mr.Sta said:

My clinic has switched all the providers to one week on and one week off. This has been for the Month of April. We have not gotten rid of any staff at this point but I am unsure how long this week on/week off will last. With HRSA they said you can put a pause on your time and just repay it at the end, at least that's what we were told. I will miss 10 days the Month of April, so if I go over before my anniversary days they will just tack those 10 days on the back half. We have also started to do some Telehealth but has not replaced the numbers fully, not sure how long this will all last or what May will bring. I have reached out to the locums companies I have worked with before and have that in place if needed. Great game of hurry up and wait.

If you’re incorporating telehealth, I would get on the horn with as many patients you previously saw who are in for regular chronic conditions at the intervals they would normally come into the clinic and get them on the schedule. Have someone go back 3 to 6 months and start calling anyone who hasn’t been seen that probably should be. Any refill requests are put on the schedule. Any patient advice that requires any form of medical thought is put on the schedule. Our scheduler’s have done this and where before patients had to initiate this contact, our group is under the impression the clinic is allowed to get that ball rolling through this. lately some of my days have been pushing 24ppd. Granted some are still slow but getting better. We’ve incorporated a range of options including Doxy.me and now Doximity App has video capability. I’m suspecting this whole thing will be pushing clinics and clinicians to do things they never had to do before.

Edited by djmatte

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bebbercorn has 10 years experience and specializes in Family practice, emergency.

455 Posts; 11,882 Profile Views

Djmatte, are you having anyone do any blood draws for any reason? My numbers have been picking up and we had some staffing decreases but I see no reason why our MA's can't help out here- their workload is down a lot because with telehealth they aren't "rooming." If I have someone in clinic and can justify I blood draw, I get it done, but we've been asked to avoid getting VS even on patients in clinic, so I'm not sure we can even bill appropriately for that visit - although I'm not sure it matters in our patient population... thanks for the advice. The good news is I've been asking for telehealth for years and now here it is, and I am a fan!

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djmatte has 7 years experience as a ADN, MSN, RN, NP.

2 Followers; 920 Posts; 8,315 Profile Views

9 hours ago, bebbercorn said:

Djmatte, are you having anyone do any blood draws for any reason? My numbers have been picking up and we had some staffing decreases but I see no reason why our MA's can't help out here- their workload is down a lot because with telehealth they aren't "rooming." If I have someone in clinic and can justify I blood draw, I get it done, but we've been asked to avoid getting VS even on patients in clinic, so I'm not sure we can even bill appropriately for that visit - although I'm not sure it matters in our patient population... thanks for the advice. The good news is I've been asking for telehealth for years and now here it is, and I am a fan!

We have a quest lab on site at most of our clinics. So don't technically do our own draws. What I push my MA to do is pick up the slack on what scheduling should be doing as it is only run by two schedulers who aren't really good at what they do. One method I recommend on the telehealth side is to get a system where the MA calls the patient and gets them the access to whatever system you are using. They can also validate insurance and if you are collecting a copay, they can do it over the phone. Doxy.me is my preference as it is free (or you can pay 30 bucks a month on it). But epic also has some video functionality. But it's slow and obnoxious.

Edited by djmatte

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bebbercorn has 10 years experience and specializes in Family practice, emergency.

455 Posts; 11,882 Profile Views

4 minutes ago, djmatte said:

We have a quest lab on site at most of our clinics. So don't technically do our own draws. What I push my MA to do is pick up the slack on what scheduling should be doing as it is only run by two schedulers who aren't really good at what they do. One method I recommend on the telehealth side is to get a system where the MA calls the patient and gets them the access to whatever system you are using. They can also validate insurance and if you are collecting a copay, they can do it over the phone. Doxy.me is my preference as it is free (or you can pay 30 bucks a month on it). But epic also has some video functionality. But it's slow and obnoxious.

That's frustrating about the schedulers- I've been having a hard time with them deciding what should or should not be seen in person - but trying to be patient and scrub as soon as I get an appointment booked. The way you're using youre MA's is close to how I'm trying to use it - letting the MA set up the interpreter, or calling before for a zoom visit. For now, we are using the medical version of zoom but I hear we're going to EPIC. I don't mind zoom but the recent bad press for the free version makes our medical directors nervous. I heard that on doxy.me that you can use video chat as long as your patient has a smart phone, so I'm interested in trying that.

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djmatte has 7 years experience as a ADN, MSN, RN, NP.

2 Followers; 920 Posts; 8,315 Profile Views

2 hours ago, bebbercorn said:

That's frustrating about the schedulers- I've been having a hard time with them deciding what should or should not be seen in person - but trying to be patient and scrub as soon as I get an appointment booked. The way you're using youre MA's is close to how I'm trying to use it - letting the MA set up the interpreter, or calling before for a zoom visit. For now, we are using the medical version of zoom but I hear we're going to EPIC. I don't mind zoom but the recent bad press for the free version makes our medical directors nervous. I heard that on doxy.me that you can use video chat as long as your patient has a smart phone, so I'm interested in trying that.

Anything with a browser. You can send a link to their text or email.

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