Dr. Laura Heisler is hoping that the new round of congressional funding for the Payroll Protection Program will provide a lifeline to keep her practice afloat.

The chiropractor has gone from seeing 15 patients a day to an occasional emergency case over the last month, since the coronavirus pandemic hit her community in New Rochelle, New York, and state officials asked all doctors offices to curtail nonemergency appointments.  

“I have a patient who emailed me yesterday and said, ‘I’m in acute pain, do you have any advice?’ I said yes come in and get treated, and she said, ‘I haven’t left my house for 44 days, I’m scared,'” Heisler said.

Stimulus checks

Heisler normally supplements her income by renting out space to another doctor, but he has stopped paying rent because his practice is shut down. While she received a stimulus check this month and a small advanced payment from Medicare, the money barely covered her personal health insurance premium.

We hear from practices in rural areas who say, ‘I can no longer afford to stay open’ or, ‘I don’t have any personal protection equipment and so I got sick and I had to close.’

Rebecca Etz

The Green Center co-director

It was blow when her bank, JPMorgan Chase, notified her that her application for an Small Business Administration loan had not been processed before the $350 billion first round of PPP funding ran out.

“I received an email saying, ‘we’re apologizing for not responding to you and your application,'” Heisler said. “Then I got another email a couple of days later that said … when the new funds are released, my application can go in immediately.”

Telemedicine

For primary-care doctors, telemedicine has provided a way to help maintain part of their practice. Still, nearly 90% of primary-care physicians say they’ve experienced significant losses in patient volumes, according to the most recent weekly Covid-19 impact survey from researchers at the Larry Green Center and the Primary Care Collaborative.

“We hear from practices in rural areas who say, ‘I can no longer afford to stay open’ or, ‘I don’t have any personal protection equipment and so I got sick and I had to close, and I don’t know what the people in our area are going to do'” said Rebecca Etz, Green Center co-director, who is an anthropology professor specializing in primary-care research at Virginia Commonwealth University.

Small practices are not the only ones feeling the financial strain. Larger practices have cut back on costs, with 42% of those surveyed reporting that they’ve laid off or furloughed staff. Nearly half of all primary-care practices say they are not sure they will have enough cash to survive, with 1 in 5 saying they’re worried that they may have to close within four weeks. Of practices that applied for SBA loan programs, many expressed frustration.  

CARES Act

“The loans that were set up and made available through the CARES Act don’t begin to touch the surface,” Etz said. “They also require a lot of paperwork in the application, and they aren’t as fast or as large as was initially stated, so the practices that are applying for them are still suffering.”

Some the nation’s large banks have faced criticism for processing millions in PPP loans for large businesses earlier this month, while a large percentage of their small business clients were shut out of the program.  

Heisler is hoping her lender, JPMorgan Chase, will approve her $10,000 SBA loan request this time. 

It makes me feel very unimportant in the world. I know I’m a sole practitioner, I have no employees at all, but … it would be nice if we were recognized as being as important as these huge companies.

Dr. Laura Heisler

chiropractor

JPMorgan revealed it had processed loans for 8,500 large businesses in its commercial and private banking division this month, compared with just 6% of the 300,000 small business client requests it received.

PPP funding

Filings from publicly traded health firms show many of them have secured multimillion dollar loans through JPMorgan.  Biotech firm Wave Life Sciences based in Singapore received $7.2 million in PPP funding, California biotech MannKind received $4.8 million, and The Joint Corp – an Arizona-based chiropractic chain — received $2.7 million. The three firms combined employ nearly 700 people.

A JPMorgan spokesperson defended the bank’s record, saying in statement: “We have secured more funding so far for small businesses than any other lender — helping ensure paychecks for more than 1.1 million hard working Americans.”

Heisler says the jobs of hard-working doctors in small practices are worth saving, too.  

“It makes me feel very unimportant in the world. I know I’m a sole practitioner, I have no employees at all, but I’ve been running a practice for almost 30 years successfully, and it would be nice if we were recognized as being as important as these huge companies,”  Heisler said.

For now, she’s drawing on her savings, but worries that this could be “the new normal” for a long while, and providers like her will face the same financial squeeze when coronavirus likely resurges next winter.  

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