A STORM WITHWIT H NO NNAMEAME A disaster without a label can still disrupt a thriving practice. BY BLAKE K. WILLIAMSON, MD, MPH, MS; AND A STORM WITHWIT H CHARLES H. WILLIAMSON JR, MBA, MHA A disaster without a label can still disrupt a thriving practice.

any disasters have names that help to lodge them in people’s memories. NO NNAMEAME devastated in 2005. Superstorm Sandy wreaked havoc on the East Coast in 2012. Hurricanes Harvey, Jose, and Maria laid waste to Houston, Florida, and Puerto Rico, respectively, this past year. But some events can be just as destructive to indi- viduals or whole communities while relatively escaping the consciousness of the wider public. Such was the Denham Springs, , of August 2016. In this suburb of Baton Rouge, according to local news coverage at the time, 90% of homes took on water dur- ing the flood, and the main highway through town was washed out by the floodwaters (Figure 1).1 can be deceptive. When we talk about a hurricane or tornado, there are no misperceptions about their destructive powers. Floods can be every bit as devastating, but when most people hear the word flood, they are probably thinking, “Worst case scenario, it could change my route to Starbucks that morning.” The word does not evoke the fear and respect that other words might. But now, given our experience, we know it certainly should.

“FOR THOSE SEEKING TO RECOVER FROM A COMPLETE DISASTER, WHETHER A TORNADO, HURRICANE, EARTHQUAKE, FLOOD, OR FIRE, THE RECOVERY PROCESS CAN BE LONG AND ARDUOUS. IT IS WORTH NOTING THAT RECOVERY FROM A NATURAL DISASTER, ONE THAT COMPLETELY WIPES OUT PART OR ALL OF A PRACTICE, MUST START BEFORE THE DISASTER.”

MARCH 2018 | CATARACT & REFRACTIVE SURGERY TODAY 77 s DEALING WITH DISASTERS “The damage from the flood of 2016 may have been more localized than the destruction caused by Hurricane Harvey...but it affected our local residents deeply.“ Figure 1. Arial shot of Denham Springs, Louisiana, and the surrounding area.

The damage from the flood of 2016 BEFORE THE DISASTER Springs location was taking on water and may have been more localized than the For those seeking to recover from a that our staff was not going to be able to destruction caused by Hurricane Harvey, complete disaster, whether a tornado, get to work, so we canceled clinic. across a wide swath of Southeast Texas hurricane, earthquake, flood, or fire, The Denham location was the one I and Southwest Louisiana, but it affected the recovery process can be long and was going to that day, and I knew clinic our local residents deeply. arduous. It is worth noting that recov- had been canceled because of the flood We know that because we are local ery from a natural disaster, one that waters, so I was taking it easy. Then I got residents. As a surgeon (Blake) and an completely wipes out part or all of a a screenshot of our reception area from administrator (Chuck) at Williamson practice, must start before the disaster. my father, Charles H. Williamson, MD Eye Center, with locations in Baton Having things in order before disaster (Figure 2). It looked like a fishbowl. The Rouge, Denham Springs, Zachary, strikes is critically important, especially water was almost up to the top of the and Gonzales, we felt firsthand the in relation to insurance. reception counter. It was a jaw-dropping effects of the Denham Springs flood How bad was this flood? In the town moment that I will never forget. of August 2016—a storm without a of Watson, Louisiana, a few miles north Chuck: I got the same picture. We name. In parts of this article, each of us of Denham Springs, it rained 31 inches had movement sensors on our security will speak in his own voice, but most in 48 hours. By comparison, Seattle gets cameras, and at 8 am the first signals of it is the two of us speaking together. about 34 inches of rain per year. The started going off. By 1 pm, water was This is the story of our practice and storm dumped three times the amount up to the counters. a storm with no name. of rain that our area experienced dur- ing Hurricane Katrina. Meteorologists EARLY RESPONSE have estimated that more than 7 trillion Blake: I have to say that my brother gallons of water fell in our region—that Chuck was instrumental in our is enough to fill , the response to the flood, and he quickly 40-mile-wide lake outside New Orleans, stepped into the role of leader, along four times over.2 with our nursing director Julie and sev- This was not just any flood. It was eral other staff members. a thousand-year storm, and we never They started calling staff members saw it coming. With a hurricane, there to find out where everybody was and is generally ample warning. In this case, whether they were safe. But it was Chuck we heard there was some rain in the who was running point on it all, mak- forecast. But, in our region, in the sum- ing an action plan as we were gathering mer months, it rains often, and so the information on our satellite offices. storm came silently. And then it wiped Chuck: The first thing we thought out everything. of, without question, was our staff. We made sure to contact every one of them Figure 2. The screenshot Charles H. Williamson, MD, A JAW-DROPPING MOMENT to see if they were OK. Our second sent to his sons, showing the damage at their Denham Blake: I’ll never forget the day of the task was to contact all of our patients Springs location. storm. We knew that our Denham scheduled for visits or surgeries in the

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got lucky with that particular circum- stance, but it still cost us well over a $500,000 to recover our losses, including equipment and renovations. Our insur- ance proceeds were about $370,000, so roughly $150,000 had to come out of our pockets. This does not include the loss of income we suffered as a result of our Denham Springs location being closed for 58 days.

HELPING THE STAFF In addition to the damage to our practice’s building, many of our staff members also experienced great losses, including 22 who experienced a total loss, meaning loss of house and vehicle. Figure 3. Interior shots (left, right) of the destruction at Williamson Eye’s Denham Springs location. To make sure that everyone had a next 3 or 4 weeks. We wanted to check For floods, insurance coverage can be roof over their heads, for those who on their status, especially those who had especially tricky. Events like tornadoes, didn’t have relatives they could stay medical issues that needed active man- fire, and hurricanes all have business with, we rented several extended-stay agement, and to let them know that we continuity riders that can be added to a apartments close to our main office. were there for them and were going to policy, meaning that if your business is That way, everybody could come continue to take care of them and try to destroyed and your practice generates, to work—these people needed the help them as best we could. say $100,000 a month in revenue, that paycheck now more than ever. At the Our next job was to try to physi- loss can be covered. But for flood, that same time, it was a delicate balance cally get to our practice locations to type of coverage is not widely available. because these people had just lost assess the damage. That was some- Many businesses in our area were dev- everything. thing we could not do for a period of astated by the flood, and I’m not sure That began our process of rebuild- days because, unlike hurricanes and how others made out with insurance ing the practice and coming together tornadoes that pass by, floodwaters coverage. We had two policies that we again as a team. Our main office in recede slowly. We could not access our relied upon for recovery of costs. We Baton Rouge became a makeshift Denham Springs location until 5 days lost almost all of our equipment, and staging area—a place for people to after the flood, and at that time the our flood policy covered the cost of bring donations. We have more than damage assessment was that it was reconstruction. 100 employees, and everybody who completely destroyed (Figure 3). Blake: We didn’t have flood insurance was not wiped out helped by bringing With that assessment in place, we on the building itself because we are at in clothes and other household needs. began contacting our insurance carriers or above sea level and outside of any We made sure there was always food, and scheduling assessments—that was flood zone. In fact, very few people in our and there was a daycare for a few days when I realized that our disaster recovery community had flood insurance because (Figure 4), as no daycare centers were plan should have started 10 days ago. If of this. Our insurance agent told us it open in the area due to the flood. you take away anything from our experi- wasn’t required given that we we were ence, let it be this: Every practice owner out of the flood zone. When your insur- s WATCH IT NOW should review his or her insurance plan ance agent basically tells you that insur- and make sure he or she knows exactly ance isn’t required, you tend not to buy. what is included in that coverage. Just Chuck: Luckily, the landlord for our look at everything you have, and then building had to get force-placed flood imagine it’s gone. Next, ask yourself, how insurance about a year before the flood. are you going to fund getting it all back? (Force-placed insurance, also known as That way, it is all sorted out before a collateral protection insurance, is an insur- disaster occurs. Often the coverage that ance policy placed by a lender or bank people think they have is not what they when a property owners’ insurance has actually have. lapsed or is deemed insufficient.) We HTTP://BIT.LY/WEFLOOD

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Figure 4. Employees brought in donations (left), and the practice ran a makeshift daycare so that employees could bring their children to the office and continue to work (right collage).

We kept our entire staff on payroll (Figure 5). We were there too (Figure 6), Chuck had: Rather than trying to line throughout the closure in Denham cutting out drywall, breaking down up local commercial contractors for Springs. A lot of other businesses in our damaged furniture and exam room the work, he called a large homebuilder area, including medical practices, did equipment, and staging it outside for friend of his who was pulling in skilled not do that. We thought it was impor- the insurance adjusters (Figure 7 and labor from New Orleans. Everyone else tant to keep paying our people. Our image on page 76). was calling the guy down the street, payoff, in a way, was that the experi- After getting the staff members’ help and the guy down the street was liter- ence brought the staff closer together. on some of the original demolition, we ally swamped himself. But just an hour Many of our employees—both those repaid the favor by helping them out away from us, there were plenty of from other sites who weren’t affected in their own homes, tearing out dam- people who could do the work. That by the storm and those who were— aged drywall and helping them try to decision was instrumental in getting us started volunteering to help with the resurrect their homes and recover their back on our feet in less than 2 months. contracting work. We had our techs belongings. Talk about a team-building Chuck: Obtaining immediate man- and nurses tearing down drywall and exercise; we were able to demonstrate power is the most important next step building things with hammer and nails. that this was not just about our office, it after damage assessment. You have to It was rewarding to see people who was also about them. have people on site immediately, start- didn’t necessarily know each other ing the triage process (Figure 8). Our beforehand working side by side. We A REAL GAME-CHANGER entire metropolitan area was effectively had opticians, technicians, and billing Blake: One thing that helped to get made unlivable overnight, without staff working shoulder-to-shoulder our reconstruction moving was an idea warning. Local contractors would not be available until they had looked at maybe 25 or 30 other clients. We decid- ed to basically contract the rebuilding effort by ourselves. Fortunately, over the years I have worked with a number of subcontractors I could immediately call upon to help in our rebuilding process.

KICKSTARTING It was heartwarming to see the outpouring of support from our col- leagues around the and from our partners on the industry side. Mark Boren of Bausch + Lomb and Figure 5. Staff working side-by-side to rebuild Williamson Eye. several other thoughtful people started

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Figure 6. Blake and his father walking through the Figure 8. The triage process at Williamson Eye’s Denham Springs location begins. practice during the rebuild. A CLEAN, BRIGHT SPACE it doesn’t cost too much to add a sup- On the bright side, we now have plement, you may want to add it on. a brand new shiny clinic. We tried No. 3: Preparing earlier is better. to use our tragedy as an opportu- Don’t wait to get that cell phone pic- nity to create the best satellite we ture of your flooded satellite; have a could, and we designed it from the disaster recovery plan in place. floor up. Where we had six refraction No. 4: When you reopen, be flexible. lanes before, we now have nine lanes Get patients back in the door and give and four workup pods—a total of them a sense of normality. You may 13 rooms to see patients in, increasing need to do things you don’t normally the efficiency of patient flow. do—see patients on the weekend, travel The design was industrial, with to different satellite locations—whatever exposed brick, and it is clean and it takes to get the patients back in. n modern-looking. With some new Figure 7. Damaged furniture and exam room equipment modern artwork by my aunt and 1. 90 percent of homes in Denham Springs flooded. WWL-TV website. August was staged outside for insurance adjusers. 18, 2016. http://www.wwltv.com/article/news/local/90-percent-of-homes- accomplished artist Betsy Williamson in-denham-springs-flooded/298547707. Accessed February 20, 2018. 2. 2016 Louisiana floods. Wikipedia. https://en.wikipedia.org/wiki/2016_Lou- Kickstarter-type donations pages for (www.betsywilliamsonart.com) isiana_floods. Accessed February 20, 2018. our 22 employees who experienced and local graffiti artist March Fresh total loss. These pages were able to raise (@marcfreshart), it transformed our about $10,000, which was incredible, practice into a bright space for our BLAKE K. WILLIAMSON, MD, and our father matched the contribu- teammates to walk back into when MPH, MS tions to bring the total to $20,000. we reopened our doors, 58 days after n Refractive and Anterior On the day we distributed the money, the flood. Segment Surgery, Williamson we invited everyone to the meeting Eye Center, Louisiana room in our Baton Rouge office. We LESSONS LEARNED n [email protected] wanted to do something special to com- When we think of lessons learned n Financial disclosure: None memorate the occasion, after all the dif- from this event, a few things come ficulties everyone had been through. We to mind: CHARLES H. WILLIAMSON JR, had made a video of a skit starring the No. 1: Take care of your staff MBA, MHA two of us and other staff members, and first, before everything else. First n Administrator, Williamson Eye we played the video on a big screen for and foremost, ensure that they Center, Louisiana the whole staff (http://bit.ly/WEFlood). are OK. n Co-owner, Williamson It was a celebratory atmosphere, cutting No. 2: Make sure you are suffi- Management and Williamson Eyewear through the doom and gloom and look- ciently insured. If insurance agents say n [email protected] ing ahead to better times. it’s not required, take another look. If n Financial disclosure: None

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