How to Plan for the Unexpected: What to Do in the Event of An Emergency

As I drifted in and out of sleep, a sharp pain in my side reminded me that something in my body wasn’t right. It was the day after Christmas, and everything ached. My brain was foggy about what had happened—but then it started coming back to me. Emergency surgery. The words “You almost died.” 

It was a lot to take in, and my mind had trouble wrapping itself around what had happened. As I lay in the stiff hospital bed watching the snow fall outside my window, I was suddenly gripped with the terrifying realization that I needed to do payroll for the group practice I run. My mind swirled. I tried to find my phone so I could text my husband to bring my computer, but my phone wasn’t nearby. My body seared with pain as I tried to move. When the nurse came in to check my vitals and give me more pain medication, she told me not to worry. “You need to rest, honey. Somebody else can do that for you. You nearly died!” 

How to Create an Emergency Plan

But the thing was, no one else could do it for me. I had no contingency plan for something like this. I had no back up plan that spelled out who would do the things that only I knew how to do, and I knew that if it wasn’t done in the next few days, my staff wouldn’t get paid. 

As a seemingly healthy young clinician in my thirties, I had never thought that I needed to plan for what would happen if I was incapacitated and couldn’t do my job. This experience taught me that we all need to plan for the unexpected—for our staff and for our clients. In this field, we often talk about the importance of self-care. Having a plan for when you can’t do it all is one of the most important ways you can care for your future self. 

For those of us who are not planners, this can feel daunting—but it doesn’t have to be! The key is to start small. Here’s a brief outline of items that can help your practice be more sustainable, successful, and secure all the time, but especially if you have an unexpected emergency. 

1. Start with a list
Start with making a list of all the things you do to run your practice on a daily, weekly, and monthly basis. List the things that only you can do, the things that others can do, and the things that others already do. Write up your process for each of the tasks. Go back to your grammar school days and ask yourself: what, when, where, how, and why? 

What is the task at hand? Describe it in your document, including any considerations that may help someone else do it if they can’t reach you to ask questions. 

When do you do this task? Weekly? Monthly? Yearly? Can the task wait, or does it have to happen on that schedule?

Where do you do it, and where are the items you need to complete it? List them as specifically as you can. 

How do you do this task? Describe in your document the steps you take to complete it. These steps should be very simple and easy to read, so think about the language you use here. 

Why do you do it, vs. having someone else do it? Can this task be done by someone else? If not, who can you trust to do it in an emergency and how will they know when they need to do it?

Making this list in a methodical way will ensure you don’t leave anything out, and will also let you know if there are any gaps in your practice that need to be filled even if it’s not an emergency. And once you have the when, what, where, how, and why documented, you can easily direct someone to that document if you need emergency coverage. 

2. Create a locked document
As private practice owners, we know the ins and outs of our businesses—but we may not have those ins and outs documented where others can access them. To address this, create a simple spreadsheet or document that has the accounts you use, the passwords to access them, and key people and processes for the things that keep your practice running. This should include a section that details what days, weeks, or months the items need to be completed by. 

Some important categories to have in this document are payroll (Who does payroll? Who has access and who can be trusted with the financial documents of your practice?) and bill pay (Who pays the bills, on what dates, and out of what accounts?). It’s also important to note insurance or payor contracts, if you accept insurance in your practice. Who is the point of contact on the contract? How are invoices sent and received? This document should be straightforward and easy to read, so it can be easily used by someone who needs to view and use the information inside quickly. 

It’s important to note that all the information you include in this locked document is useless unless you have a dedicated person who can access it. Due to the sensitive nature of the information in this document, it’s essential that it’s password protected and not accessible to anyone and everyone.

Here’s an example. I have a designated person who knows the password to my locked document, which lives on a shared drive. In the event of an emergency, my office coordinator knows to call that designated person and request the password to the document. This system double-protects the information in this document, as it’s not available to my office coordinator all the time. At the same time, the person who holds the password doesn’t have access to where the file is stored, so they also can’t see my information. 

3. Make a plan for client communication
If you have sessions scheduled during your emergency, someone will need to contact your clients to let them know. If you’re in a solo practice, think about if you have a trusted colleague that you could ask to do this for you? A professional will is a good way to document this person while also making sure they have the appropriate clinical and contact information to make those calls for you. If you’re in a group practice, you can give another clinician or your administrative assistant a script that they can use to communicate with clients in emergency situations. 

Other Things to Consider

The three steps listed above are the first steps to creating a plan for unexpected emergencies, and all of them are fairly quick to implement. If you set aside an afternoon for each of those tasks, you’ll have a solid foundation for what would happen to your practice if you had an emergency. That said, there are a few other things to consider to make sure you’ve covered all your bases. 

For instance, if you do have known health issues, then what kind of insurance you have is an important consideration. These questions are deeply personal, so you’ll have to consider your situation and decide yourself. To start, you can think about if key person insurance is the right choice for your practice.

Whether you run a group or solo practice, most organizations have a key person without whom the organization couldn’t run as usual. As you’re creating your emergency plan, you need some kind of contingency planning document that includes all the processes and procedures that need to be followed—or put in place—in case that key person isn’t able to lead. This document details how the organization can continue without that person, and what steps need to be taken so that transition can occur. 

The process of making lists, contingency plans, and putting information together for other people is often a good time to ask yourself if there are tasks that can be assigned to others now—not just during emergencies. Are there any items on your list that could be permanently delegated to others now, so that in an emergency not everything falls on someone who maybe has never actually done those tasks before? This kind of audit is a good thing to do on a regular basis anyway, and may free up more of your time in the present so you can do more of the things you love. 

Emergency events are often incredibly stressful, but they don’t have to have an impact on your practice too. I was grappling with the emotional and physical aftermath of nearly dying, while simultaneously trying to figure out how to keep my practice afloat from a hospital room. Don’t end up in a position like I did. Don’t do payroll while on pain medication after emergency life saving surgery. You’ll likely end up doing it wrong—take it from someone who did! If all you start with is making a list or creating your locked document, start somewhere. Your future self will thank you.