American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Economic Survival Strategies in the COVID World

The American College of Surgeons (ACS) has been closely monitoring both the development of the federal response to the COVID-19 epidemic and how the programs and regulations coming out of Washington, DC, are being utilized by surgeons. In addition to the federal response, there are a number of tips and strategies that the ACS Practice Protection Committee has developed to assist Fellows maintain financial viability. The Practice Protection Committee has released its work in this area in the form of a resource document entitled Economic Survival Strategies in the COVID World.

The Practice Protection Committee would emphasize the following key points found in the document:

  • Because numerous tax provisions are available to assist in freeing capital, Fellows are encouraged to make an appointment with your tax professional and or financial advisor and seek their advice.
  • Consider speaking to your medical liability insurance provider and ask about reducing and/or deferring payment of premium for a negotiated period of time based on reduced surgical activity during the period of declared emergency within your state. The ACS has prepared a resource document for the many major malpractice carriers and the accommodations they have made during the pandemic. Review the committee's malpractice resources.
  • If funds have been received from the Medicare Advance Payment Program or Small Business Administration loans (Paycheck Protection Program [PPP] or Economic Injury Disaster Loans [EIDL]) treat those funds as general receipts and carefully document where they are expended.
  • For those applying for a loan through the PPP, engagement of your tax professional has been found to be extremely helpful. The application is complex, and true benefit is obtained by seeking professional assistance.
  • For those who receive a loan through the PPP, keeping accurate records on expenses that can be counted toward the loan forgiveness provisions is imperative. Those expenses include payroll, mortgage interest, rent and utilities. Up to the full loan amount may be forgiven if the proceeds are used to keep staff on payroll and proper documentation is maintained.
  • To preserve your personal assets and retirement savings, avoid loans that use those as collateral.
  • Reassess your personal budget via the Excel spreadsheet exercise in the Economic Survival Strategies in the COVID World document and make appropriate adjustments.
  • Develop a cash account and work toward accruing a three-month personal expense cushion.
  • Do not miss your life insurance or disability insurance premium payments.
  • Look for payment deferral and leniency possibilities—rent, mortgage, student loan repayment, malpractice premiums, other loans, etc.
  • Keep track of work RVUs in the ramp-up period, even if you are not on a production model. You may be in a position later to negotiate recovery of some of your lost revenue, but only if you know that you have produced above the baseline.

Additional Resources

Economic Survival Strategies in the COVID World Webinar

ACS Employed Surgeon handbook

ACS Private Practice Surgeon handbook