Lessons for Medical Practices From Hurricane Milton

I was impressed with Gov. Ron DeSantis’s (R.-Fla.) preparations before Hurricane Milton came ashore in Florida last Wednesday night. DeSantis took steps to prepare for Hurricane Milton, including:

• Declaring a state of emergency and activating the state’s Emergency Operations Center.
• Deploying over 5,000 National Guard members from Florida and other states.
• Securing approval for a major disaster declaration from the Federal Emergency Management Agency (FEMA).
• Deploying over 50,000 utility workers to help restore power after the storm.
• Staging gasoline tankers to replenish supplies to allow people to fill their tanks before evacuating.
• Mobilizing law enforcement resources, including highway patrol officers, to maintain law and order and prevent looting.
• Setting up staging areas, like the Tropicana Field parking lot, to accommodate hundreds of power company trucks. Additionally, the state planned mass evacuations and quick debris pickup after the storm passed into the ocean.

More broadly, there was coordination of local, state, and federal agencies, and President Biden promised assistance. Gov. DeSantis and the state of Florida took the threat of Hurricane Milton very seriously. They made significant efforts to prepare for and respond to the storm.

There are occasions when a crisis occurs in our practices — whether external like a storm or internal like a technology failure — that can make patient care difficult or impossible. Therefore, whenever we can, we must prepare before a hurricane or other natural disaster hits our community.

For example, suppose there is a power outage and wifi connectivity is lost. In that case, using our computers and electronic medical records is impossible. Practices that prepare for this know that they can temporarily convert to paper records until power is restored. The practice should have backup generators or battery-powered equipment to ensure critical medical equipment and systems can continue functioning. Practices also should stock surge protectors to protect the computers, and all data should be regularly backed up to the cloud to protect against patient data loss.

It is not uncommon for a patient to experience a cardiac arrest or another life-threatening medical emergency while in the office. In times of crisis, transport to a large health facility may not be possible. The staff must receive training in basic life support and have access to appropriate equipment, such as automated external defibrillators (AEDs). Oxygen cylinders and an emergency drug kit — including epinephrine, nitroglycerin, albuterol, and an EpiPen — must be checked regularly to ensure everything is up to date.

Staff should be trained in fire safety and evacuation procedures, and the practice should have fire extinguishers and smoke detectors in place. The practice should have a plan for evacuating patients and staff and communicating with them during and after the emergency. In addition, practices should have security protocols to protect staff and patients from violence or other security threats.

Check with your insurance agent to confirm you have business interruption insurance. Business interruption insurance, also known as business income insurance, is insurance coverage that helps medical practices protect against financial losses resulting from temporary closures or interruptions in operations. This type of insurance can cover various scenarios, such as natural disasters, property damage, or other events — including fire — that prevent the practice from operating normally.

Business interruption insurance and other coverage helps to replace lost income and cover ongoing expenses during the period of interruption. Reviewing your insurance policies to ensure adequate coverage for potential business interruptions is important, because these events can significantly impact the practice’s financial stability and ability to provide care. An example from my practice: after Hurricane Katrina in August 2005, my medical office lost power for 2 months. I had medications that required refrigeration that were not removed in time and could not be used. This was an expensive loss that the pharmaceutical industry did not replace and was not covered by my insurance. I put in place a plan to remove all medications, including samples, if another prolonged power outage occurs.

Finally, practices must have a cyber-hygiene protocol, since healthcare practices are attractive targets for cybercrime.

Bottom line: Preparing for emergencies ahead of time can help ensure the safety of patients and staff and minimize disruptions to patient care. Just like the governor of Florida, who was well prepared for Milton, medical practices must prepare for emergencies ahead of time.

As they say in Cajun Country, “You have to put your ducks in a row.” Governor DeSantis had his ducks in a row in preparation for Hurricane Milton. How about the ducks in your practice?

Neil Baum, MD, is a urologist in New Orleans, the corporate medical officer of Vanguard Communications, adjunct professor of the Tulane University School of Medicine in New Orleans, and the author of The Complete Guide to a Successful Medical Practice.

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