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    Christian Green
    Christian Green, MA

    The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders: “Has your practice been affected by a natural disaster this year?” The majority (82%) answered “no,” while 18% responded “yes.” Responses included:

    • “Every hurricane that has hit Louisiana has shut us down for at least a day or two.”
    • “Northern California fires caused lots of staff to be evacuated and couldn't come to work. Also heavy smoke limited our outdoor COVID testing sites.”
    • “Our main office was hit by a tornado in April. We had to relocate to a new location while repairs are being made.”
    • “Major shipping delays in flu vaccine. Had to cancel flu clinics. Hundreds of patients got their flu vaccine at pharmacies significantly impacting our income.”

    The poll was conducted Nov. 10, 2020, with 976 applicable responses.

    According to Scientific American, there have been 16 natural disasters in the United States in 2020, which includes drought, hurricanes, tornadoes and wildfires. These disasters have already been responsible for more than $1 billion in damage.1

    During a natural disaster or other crisis, it’s imperative to have sound leadership to establish the right tone and provide guidance for your organization and your team. In trying times, leaders should focus on keeping team morale high, ensuring the financial viability of each department and being flexible amid an ever-changing environment.  

    In their recent session at the 2020 Medical Practice Excellence Conference, Aimee Greeter, MPH, FACHE, senior vice president, Coker Group, Charlotte, N.C., and Alan Vierling, DNP, MSN, RN, NEA, BC, FABC, president and chief nursing officer, Sparrow Hospital, Lansing, Mich., described several essential traits leaders should exhibit during a crisis to help champion a culture of psychological safety and engagement.

    An important aspect of setting the tone during crisis is taking the pulse of your organization. In other words, “Do you want to be a thermometer that takes the temperature of the organization, or do you want to be the thermostat that sets the temperature?,” asked Greeter. This can be accomplished by frequently getting face time with your staff.

    Two important traits that can help leaders set the tone — while also promoting trust, mutual respect and inclusion — are:

    1. Deciding once, acting once
    2. Providing daily communication to your team.  

    Decide once, act once

    Decisiveness is paramount during times of crisis, yet leaders may not always have all the information they need, Vierling emphasized. “You are making some judgments based on your past experience, based on what limited data you have,” he said. “What you don't want to do in crisis is waver and you don't want to waffle.”

    Vierling pointed to his time with Harris Health System's Lyndon B. Johnson Hospital in Houston during Hurricane Harvey, when the administration acted decisively to bring in providers and staff 12 hours before other area hospitals. This enabled them to get ahead of the storm and the wave of storm-related medical needs.

    “For a full day it seemed like we were there too early, and other hospitals had delayed because the weather had slowed down and not moved in,” Vierling said. When flooding was worse than expected, the hospital had two full shifts of staff to run 12-hour shifts for six days, all while other hospitals lacked staff and supplies.

    Leaders also should compartmentalize decision-making, depending on time frame. “What are we going to do in the next two weeks to get through this? What are we going to do in the next three months? How are we going to manage this over the next year?” Vierling said of looking through different lenses to prioritize issues and needs. Although that’s not always easy, if you assign responsibility to different stakeholders, you’ll get an array of opinions that can help you make the right decision, he added.   

    Provide daily communication

    An integral part of promoting psychological safety in an organization is continuous communication between leaders and team members.

    In times of crisis, daily communication is even more important, because, as Vierling detailed, team members need to know that they are making a difference. “You have to be transparent,” Vierling stressed. “We start every conversation here with the ‘why.’ We're always honest — if things look bad, we're going to tell you it looks bad. If the financial situation is tough, we're going to tell you the financial is tough.”

    During Hurricane Harvey it was a priority for Vierling’s leadership team to update hospital workers frequently and through different channels regarding the storm’s impact. “We put out communication for Hurricane Harvey 20 hours a day,” Vierling said of the urgency. “We put it out roughly at least once every hour to an hour and a half. Sometimes it would come in 15-minute bursts depending on what the notion was — rumor control, rising floodwaters, need to move cars, we're about to land a helicopter and we don't have a helicopter pad.”


    1. Thompson A. “A Running List of Record-Breaking Natural Disasters in 2020.” Scientific American. Oct. 9, 2020. Available from:

    Additional resources 


    Would you like to join our polling panel to voice your opinion on important practice management topics? MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at:

    Christian Green

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