Dr. Khawar Siddique: California 2nd elective surgery shutdown 'only a matter of time'

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Khawar Siddique, MD, a neurosurgeon with DOCS Spine + Orthopedics in Los Angeles, outlines how his practice has dealt with the economic challenges caused by the COVID-19 pandemic and predicts a second elective surgery shutdown to hit the state soon.

Question: How has your practice navigated the economic challenges brought by the COVID-19 pandemic?

Dr. Khawar Siddique: When California shut down in March, everything came to a pause, including our ability to bill and collect payments for services that were rendered prior to the pandemic. The billers and payers were at home, as they should've been, but now we're dealing with a backlog of processing for the physicians. DOCS Spine + Orthopedics is fortunate to be considered an essential business, so we will remain open and available, although at a more limited capacity, throughout the year, regardless of a future shutdown. 

Q: What percentage of patient volume is your practice currently operating at? What was your strategy for ramping up?

KS: During the height of the shutdown, we were operating with about 20 percent of our staff. The DOCS Spine + Orthopedics team was only seeing urgent patient cases in-person. After the 'Safer at Home' order was lifted, the majority of the team returned to the office with strict safety guidelines. We installed glass barriers at our check-in desks, and screen every patient upon entry to the building and parking garage. Masks are required in all of our facilities. 

Our practice does not treat COVID patients, so when it came to fully reopening, we used social media to communicate our safety protocols, and continued to tell our existing and prospective patients that the risk of complication of a medical injury is higher than the risk of complication from contracting COVID. For example, some patients that had broken bones were too scared to leave their house — the consequences of staying home without treatment are far worse than if the patient had come into our facility with proper personal protective equipment. 

Q: Is a second elective surgery shutdown likely in California? How would that affect your practice?

KS: It seems a second shutdown is only a matter of time. Even though we're an essential business, many procedures end up being deferred until the government gives us approval. Elective surgeries are the lifeline for any surgical practice. Not just from a payment perspective, but from a momentum standpoint. We gain momentum by word-of-mouth and when we're shut down, in any capacity, that organic word-of-mouth-marketing decreases significantly. It's almost like starting a new practice each time we re-open. 

Q: Is your practice considering any strategies, such as partnering with larger groups, for added protection from future similar events? 

KS: No — this is a unique answer to our practice. We already created an independence from major hospitals in that we perform all of our acute surgeries in our own hospital. 

My practice sees a silver lining in two ways:

1. Patients don't need to be nervous to come into our facilities because we employ every possible safety protocol and we do not treat anyone with COVID. 

2. Large hospitals can allocate their staff and PPE resources to treating COVID patients. We 'lighten their load' in a way. 

We are continuing to perfect our telemedicine process, which has become an essential part of our practice, and also asking our patients to follow us on Instagram for up-to-the-minute updates.

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