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AMA Recommends Better Security & Disaster Planning (By Julie A. Jacob, AMNews staff. Oct. 22/29, 2001. Julie is a staff writer covering managed care issues.) If you woke up one morning and discovered that your office had been damaged or destroyed, would you know what to do to get your practice quickly back up and running? While the Sept. 11 attacks brought disaster planning to the forefront, calamity from natural disasters has always been a possibility. If a disaster did destroy your office, as a physician and small business owner, you would need to figure out a way to contact your employees, arrange for alternate care options for your patients and make sure that your practice's medical records and financial data were safe. About 25% of small businesses that shut down due to a disaster never reopen, said Diana McClure, consultant with the Tampa, Fla.-based Institute of Business and Home Safety, a nonprofit insurance industry initiative. Nonetheless, few small businesses have developed plans to deal with disasters that disrupt or shut down their business, said Patricia Thorp, president of Thorp & Co., a public relations firm in Coral Gables, Fla., that specializes in crisis management. "It's odd how many employers don't even have the most basic things like having the phone numbers of their employees [outside the office]," said Thorp. It's also important to keep copies of medical records, financial information and other important records stored at a location away from the office, said McClure. Doing so can mean the difference between getting your practice up and running quickly and having to spend weeks reconstructing records and data. When the corporate headquarters of Empire Blue Cross Blue Shield was destroyed in the World Trade Center attack, for instance, the company was able to resume business right away because Empire's claims processing and member information were stored at another location. A Little Planning Goes A Long Way H. Hugh Vincent, MD, an anesthesiologist in Mill City, Calif., said that, according to his informal survey of colleagues, few physicians he knows have plans in place for dealing with a practice disruption caused by a disaster. None of the physicians he queried had copies of medical records or financial date stored in a location other than their office. Only a few said they had thought about how they would contact their patients and staff in the event of an emergency. Some doctors, however, have thought about what they would do if a disaster affected their practice. For example, Eric Tabas, MD, an ob-gyn in San Francisco, said the 1989 San Francisco earthquake motivated him to do some basic planning. If another disaster struck, Dr. Tabas said he would close his office, contact his employees to tell them to stay home, put a message on his voice mail informing patients that the office was closed and then go to a hospital to help care for injured people. Planning for a disaster doesn't need to take a lot of time and effort, said McClure. What disaster planning boils down to, is answering the question: "How can I integrate any sort of business interruption into the way I do business?" It's easier to come up with a disaster-preparedness plan when it's framed in general terms like that, she said because it's impossible to think of every possible situation that could shut down your business. In some cases, your practice may even be disrupted by something that happens miles away. For example, flooding that shuts down roads leading to your office could make it impossible for your staff and patients to get to your office, even if your office isn't flooded. A disaster affecting your medical supply or prescription drug vendors could also disrupt your practice. McClure recommended that physicians consider the following questions when developing a disaster-response plan: What sort of disasters or hazards could shut down my practice? How long can my practice be shut down without completely depleting the practice's financial reserves? How would I contact my employees and patients? How would I contact them if the phone lines were down? Is there an alternate site where I could temporarily run my practice? What are the most vital practice functions that must be attended to? What supplies and prescription drugs do I absolutely need? What vital records and data should I keep copies of off-site? What disasters does my business insurance cover? Do I need business interruption insurance? Another reason why it's important for doctors to develop a plan is that a physician's staff will look to him or her for leadership during the crisis, said Thorp. "As the leader of the office, the physician needs to show a great deal of sensitivity as to how his or her people are cared for." Even if your employees aren't directly affected, they will still be anxious and worried about the safety and welfare of their family and friends. Making plans isn't complicated. It just takes a little bit of time and thought. "A lot of the planning and paperwork is just sound business practice. It's just running a smart business and being organized," said McClure.