Clinicians who can easily adapt may find more opportunities to maintain their income in the midst of a layoff or a systemic crisis like COVID-19 compared to those who remain stagnate and resist change. As you know, several of our colleagues were forced to re-strategize their methods for income earning during this COVID-19 season. What was once considered recession and depression proof, healthcare has recently faced financial challenges that resulted in massive strategic realignments and layoffs even before COVID-19 struck. Reimbursement changes cut profits in healthcare when coding became complexity based and not time based for assessments . In September, 2019, for example Children’s Healthcare of Atlanta announced that it would close 6 of its 9 outpatient rehab facilities, layoff their therapists, and require that they reapply internally to any remaining open positions. School districts are also facing cuts as states announce budget deficits related to the financial impact of COVID-19.

Whether it is a school setting or an outpatient clinic, occupational therapy practitioners have had to make quick decisions for maintaining or supplementing their income when faced with the physical closure of their workplaces. Some created or found new financial opportunities without issue. Several, as we know, found reprieve after learning that their work would transition from face to face practice into digital services. Unfortunately, many clinicians still found themselves on the hunt for new jobs as their school positions came to a close, or their clinical hours were significantly cut. To make matters worse, clinicians are learning of impending furloughs and layoffs within their medical setting and school districts. This means that even permanent employees are questioning their job stability the same way per diem, contract, and travel therapists are as budgets are cut across sectors. Even unemployment benefits have become an unreliable source of income due to a backlog of claims needing processing across the United States. It’s prudent that occupational therapy practitioners and other clinicians formulate a back-up plan and a back-up to the back-up plan in order to supplement or replace their typical forms of income. Here are some strategies that occupational therapy practitioners can do while they ride the wave of the COVID-19 financial impact.

Sell What You Can or What You Don’t Need- Literally! I am a minimalist by nature, but became one even more so when I became a traveling occupational therapist in the mid 2000s. At that point I owned a house. Got furniture for the house, and decorated the house. My weekend days were spent thinking about what things to buy to fill up space in the house. I was in graduate school working on my thesis while continuing to work as a contractor. My state had cut Medicaid funding and public school salaries, resulting in contract jobs drying up and private therapy clinics closing down.
I found myself worried about money and the lack of consistent employment while I finished my master of public health degree. I looked around my house and thought about what I could sell that would cushion the financial blow until I could get full time work again. I realized none of my belongings really mattered to me anymore. I hadn’t opened my textbooks since getting my OT degree. Honestly, I used the internet for most of my school and work resources. I decided to cut back on expenses by minimizing my commute; so I switched jobs. Eventually, I moved to a smaller and cheaper place, paid off my car, and donated most of my belongings before my first travel assignment. I realized my prized possessions were photos of my family, human connections, and transportation. It was easy to let go of stuff as I took on additional travel contracts throughout the country.
So when it came time to make adjustments with COVID-19, I took swift action as the world shut down. I sold my car, donated many items, and sold lots of items on Facebook Marketplace. As a side note, I also called my credit card companies and negotiated a lower interest rate and cleared all of their balances. I contacted my car insurance company and changed my policy as well.
Selling your car might be too drastic and not a realistic option for you, but I do encourage you to take the time to look at your belongings and consider how often you use items in your home. If you don’t need it-sell it. How many recipes are you really going to make from that cookbook vs finding your recipes online? Do you really need that outfit, dish set, or gardening tool for the very rare occasion you might have the energy and the time to use it? You’d be surprised what people are willing to buy that you no longer need.
After you decide on what you want to sell, it’s pretty easy to complete the transactions from there. In the past you used to have to use garage, estate, or yard sales to decrease your household clutter or as I call it “dust collectors” around the house. These took planning and advertising that can tie up your whole weekend. They also usually involved the whole family or friends just to execute properly. These activities are not the best approaches in a COVID-19 era in which social gatherings with strangers is not advised. Luckily, Facebook Market Place, Ebay, OfferUp, Craigslist, letgo, and a number of other APPS are viable ways to clean out the house and earn money at the same time. All you have to do is take photos of the item, set the price in the APP, and post online when you are ready. After that you can resume your normal routines until you get inquiries about your items.
Besides selling my car, I also managed to sell some dolls and dishes as well. Another thing to consider selling are board games and puzzles you no longer use. I had the most inquiries for Connect Four, Risk, and a whole set of random games that my family outgrew. Some of my top sellers were baking dishes and gardening pots. Who knew that our cake pans and mixing bowls would be so popular? We sold out of our gardening buckets within 24 hours. You can practice social distancing by using Venmo, PayPal, the Cash APP, or cash in an envelope for payment. You can also leave the items on the porch or deck, so you don’t have to make physical contact with the buyer.
Design a Course on Teachable or other Venue- Obviously selling knick-knacks in your home won’t replace all the income a clinician earns on a yearly basis, so you may need to come up with other substantial options. Creating an online course is a great way to get your knowledge or interests out there while earning some money doing it. Do you have a special therapy approach that you haven’t seen offered in a continuing education platform? Lindsey Vestal is an occupational therapist who designed a pelvic floor course for occupational therapists. Now is the time to get it out there and see if your approach connects with other people as well. Pilot a class and get feedback now, so that you can refine your class in time for a post COVID-19 future.
Of course you need to choose a subject that you know well, in order for people to recommend it to their colleagues. You will also have to put a lot of effort into it on the front-end, but the good news is that you can earn some passive income over an extended period of time as long as people continue to be interested in the topic. Although I tend to gravitate more towards clinical and educational content when I create materials, I have found that most occupational therapy practitioners have creative talents outside of the clinic. If you are one of those creative clinicians then go ahead and pilot a class on baking, birdwatching, surfing, jewelry making, or gardening. I know I would sign up for Soul Food Vegan Cooking if I found a virtual class. So if you have some vegan recipes that stimulate your palate please share with us. Needless to say, there is always someone willing to pay for your knowledge- if you know what you are doing. Now is the time to jump out there and just do it.
Advocate for Mental Health and Self-Regulation for the Whole Family- Under normal circumstances life can be hectic. Obviously, COVID-19 has put a huge financial, educational, mental, and emotional strain on everyone. This is the time for OTs to shine in our less well-known areas of training for mental health, self-regulation, and co-regulation. Unfortunately, domestic violence, crime, and coping challenges increase when people’s sense of identity and self-worth change because of role changes and job loss. Fathers may have difficulty coping when they are now responsible for helping the kids with digital learning and day to day caring while the mothers continue to work. Two income households may become strained when both contributors get laid off. Occupational therapists can design schedules and routines that integrate positive adaptive and coping activities into the client’s day in order to prevent domestic abuse, maladaptive behaviors such as out of control online shopping to fill a void, and to facilitate positive emotional regulation within the home.
Occupational therapy is grounded in analyzing people’s habits, routines, and roles. Our training integrates the knowledge of how emotional status creates neuro-physiological responses that can be minimized through sensory-motor and mindfulness strategies practiced in a calm state. Although we are trained in psycho-social dysfunction, these skills are rarely celebrated outside of pediatrics. The fact is however, that there are not enough behavioral health resources in place to meet the needs of our communities. This is the time to get outside of the box of conventional practice and promote your skills like a business person and not only as a clinician. Bridge that gap on mental health resources by designing your own protocols. You have the knowledge. Our training, more than any of the other rehab professions takes a deeper dive into psychosocial dysfunction, assertiveness training, self advocacy, and self-regulation. Furthermore, we understand how these sensory-based strategies can actually change the mindset, which then in turn changes the behavior. Put that knowledge to use and get your programs out there.
For those of you worried about payment, keep in mind that you don’t have to provide services that are only covered by insurance. Instead target private pay. Design a wellness and prevention module for behavioral health and adapt your pediatric strategies for adults. Market your services to senior communities, religious institutions, work places, preschools, and parenting organizations or websites and private insurances. Our communities are traumatized. Even if your household and neighbors are still managing well financially, the new stressors of working at home with toddlers, or while having to facilitate your child’s education has made many parents feel stressed out. Teaching parents mindfulness, co-regulation, and self-regulation strategies not only helps the adults, but positively impacts what our children will model as well. Just be mindful of how you are marketing your services based on the regulations in your state. That being said, insurances have contacted colleagues of mine in order to expand the behavioral health programs the insurance company offers their adult and pediatric clients. You never know who is looking for the services you may have to offer.
Update or Launch a Website & Contact Insurance Providers- If you do have a special program that meets a community need in the midst of COVID-19 , it is very important to get your product represented in the virtual world. Incidentally, I happen to serve as part of the Medical Corp for disasters in my state. I receive requests regularly for mental health trained volunteers. The need is there. I would love the opportunity to direct our public health agencies to resources that my occupational therapy colleagues have designed. Unfortunately, they are few and far between. But if you are unemployed or now have reduced hours, now is the time to present your skills in the digital realm. Our communities need you and we need to know how to find you.
A digital platform is a way to get your contact information shareable to others. This may be a different concept for people with successful private practices. As my colleagues and I can attest to, most of our business success came from word of mouth and not a website. As true as that may be, a digital platform is a way for others to get your contact information, view your resources and products, and learn about you before contacting you. It is also a way for organizations, such as insurance and healthcare providers to find you when they are looking for your type of business to expand their own programs. One colleague of mine got a new contract from a hospital- based developmental clinic because she was a virtual therapy provider Pre-COVID-19 and was able to integrate new clients without a delay.
Another consideration is for you to create a digital business card. I use the Haystack App . But there are plenty of others. (I don’t get any perks for mentioning their name). In this era of avoiding handshakes, working from home, and social distancing a contactless business card is a must.
Get Out of Your Comfort Zone and Diversify. As one of my colleagues always says “Be ready. Stay ready.” I am a big advocate for clinicians being able to work with different populations and conditions. Never, has it benefitted me more than this COVID-19 era. Although, I primarily work as an occupational therapy consultant, I was able to secure virtual positions in adult and pediatric care because of my abilities to treat hands, do oral motor and feeding assessments, and work in pediatrics. Surprisingly, none of these positions are in the public schools. In addition, they were all new opportunities for me. Meaning, I wasn’t working with a company that simply transitioned their services online. These were all new openings I applied to and interviewed for between March and April. My diverse training allowed me to competently interview for occupational therapy openings focused on worker’s compensation, feeding, and life skill interventions. That being said, it is extremely important to be versatile with your technology skills as well. Surviving this era of worldwide crisis requires that you be able to adapt to different digital platforms such as: Zoom, Goto Meeting, Google Meet/Class, Microsoft Teams, Theraplatform, BlueJay, Blink, Skype, Schoology, and a slew of others. It is okay to not have experience with each one of them because some companies have designed their own programs with an EHR (Electronic Health Records) component. What is most important, however, is to show that you can and are open to learning.
What else have you or your colleagues done to maximize your income opportunities during this pandemic? Please share any other digital resources you use to promote yourself digitally. We’d love to have your input on ways to help us stay financially savvy in a crisis.
Staying Healthy & Savvy,
M. Andrianna Cary The Savvy Therapist
thesavvytherapist.com