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On Sunday night, Tom Banning received an email from a young solo practitioner working in New Braunfels whom he has known since she was in medical school.
"Tom," she wrote. "I am one of these practices that will need to start letting staff go (even though it goes against every fiber of my being, in not being able to financially support my staff during these difficult times). But as my volume has plummeted and virtual visits are not paid at the same rate, we are struggling to maintain financial viability."
Banning, CEO of the Austin-based Texas Academy of Family Physicians, said he is hearing from people constantly. On Monday morning, a community health center in Austin called him "literally begging for masks" for their staff, he said.
The coronavirus pandemic is causing a critical cash flow problem for physicians in private practices and clinical settings. Without the support of a corporate owner, many are worried about their financial viability as appointments are cancelled, elective procedures are postponed and insurance payments for telemedicine are negotiated for patients whose plans are not regulated by the state or federal government.
Banning said TAFP members are seeing a 50% to 70% decline in patient volume.
"When you're operating in a fee-for-service system, which we are, and your revenue is determined by volume, that's highly problematic for your ability to make payroll [and] pay your mortgage," he said.
Samantha Bray, a therapist and owner of Bray Counseling in Westlake, worries that existing patients may cancel appointments because of their own financial hardships as a result of this pandemic.
"I think that businesses across Austin are going to suffer and folks are probably not spending money on things that they feel are not necessities right now," she said.
Bray added that she is unsure if her four-person practice will qualify for small business assistance or other federal support.
According to a March 27 press release from the American Medical Association, the $2 trillion federal stimulus package includes a number of measures that could benefit physicians in private practice, including small business loans up to $10 million to help cover payroll and overhead costs for practices with 500 employees or fewer; $100 billion in direct support to practices, hospitals and other healthcare providers; and possible waivers for telehealth coverage requirements for new patients.
Dr. Linda Villarreal, chair of the Texas Medical Association, said assistance may be hard to access, given demand.
"I would love for President Trump to dial the [Small Business Administration] number and see how quickly he gets an answer," she said.
Physicians are facing a wide range of challenges as a result of the pandemic.
Those who provide what may currently be considered elective procedures—such as ear, nose and throat doctors, orthopedic surgeons, dentists and plastic surgeons—are facing low demand.
Family doctors and those specializing in internal medicine, on the other hand, are on the frontlines of the pandemic, Banning said.
"What's happening is almost criminal," he added. "These physicians are putting their physical health and their financial health on the line and we're treating them like this...There are going to be long-term consequences in burnout, morale and their ability to practice medicine."
These doctors and their staff are also at risk of contracting COVID-19, which could further affect their ability to work because of recommendations to self-quarantine for two weeks.
Without revenue, doctors may be unable to pay their bills or their staff, many of whom may not come into work without pay.
"So yes," Villarreal said. "Offices are closing everywhere."
Tesla CEO Elon Musk announced a record-setting second quarter during an earnings call broadcasted from the Giga Texas construction site in Southeast Travis County on Monday.
The electric carmaker reported more than $1 billion in quarterly net income and the production of more than 200,000 vehicles for the first time despite challenges such as a global semiconductor shortage.
"It … seems that public sentiment towards electric vehicles is at an inflection point, and at this point, I think, almost everyone agrees electric vehicles are the only way forward," Musk said.
Exterior shots taken just a while ago of Giga Texas (while @elonmusk is reportedly at the Gigafactory!) during today's earnings call!
Hope @peterdog15 got to catch the technoking in his video! #fastestinhistory #Tesla pic.twitter.com/WqeDlb5wU3
— Austin Tesla Club (@AustinTeslaClub) July 26, 2021
Despite rising consumer demand and adequate factory capacity, Tesla faces what Musk described as a "quite serious" global semiconductor shortage, which will determine the company's growth rate for the rest of the year.
With increased revenue and production, Tesla is investing in new factories, Chief Financial Officer Zachary Kirkhorn said. These include Giga Texas, the $1.1 billion manufacturing plant that broke ground last summer and is slated to open later this year.
The Giga Texas factory in Southeast Travis County has rapidly increased in size since ground broke last August. (Tesla)
Musk commended the construction team for "incredible progress," transforming what was basically a vacant site into "a mostly complete large factory a year later."
I was at Giga Texas yesterday. Team is making excellent progress. Building will be almost a mile long when complete.
— Elon Musk (@elonmusk) July 25, 2021
Giga Texas will produce the highly anticipated Cybertruck, along with other models, but Musk said scaling its production will be difficult, especially given the supply chain delays caused by the pandemic. "It's going to move as fast as the slowest of its up to 10,000 unique parts," he said.
In other news, Musk said Monday's earnings call would likely be his last regular appearance, only jumping on future quarterly calls when big announcements warrant it.
Tesla Solar recently made news when it announced plans to build the nation's most sustainable residential community in Southeast Austin earlier this month. The newly built homes will feature Tesla solar roof tiles and Powerwall battery storage as well as electric vehicle charging stations.
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The city of Austin released a shortlist of seven candidates for the police chief position left vacant when Brian Manley retired in March.
City Manager Spencer Cronk hopes to announce an appointment by the end of August, which will require City Council approval.
The finalists, chosen from a field of 46 applicants, include:
- APD Interim Chief Joseph Chacon, who previously served as an assistant chief in the department for almost five years
- Anne Kirkpatrick, former police chief in Oakland, California, who was fired last year after a federal monitor criticized her handling of a fatal 2018 police shooting of a homeless man
- Dallas Police Department Assistant Chief Avery L. Moore, who is a 30-year veteran of the department
- Atlanta Police Department Deputy Chief Celeste Murphy, who manages the department's community services division
- Dekalb County Police Chief Mirtha V. Ramos, who previously served as division chief in the Miami-Dade Police Department
- Wichita Police Department Chief Gordon Ramsay, who is a former president of the Minnesota Police Chief's Association as well as one of the first police chiefs of a major U.S. City to call George Floyd's death a murder, as reported by the Wichita Eagle
- Los Angeles Police Department Deputy Chief Emada E. Tingirides, who is also commanding officer of the department's newly formed Community Safety Partnership Bureau, which serves L.A.'s underserved communities
City staff will interview the finalists in the coming weeks, with several community input opportunities to come, according to a Monday press release.
The city conducted a public survey in March and hosted community input meetings in April to learn more about what residents are looking for in their next police chief, which helped shape the selection criteria for the position.
"They want to see the Chief be reform-minded and transparent and have a track record of fostering community involvement and accountability," Cronk said in the release. "The candidates selected show these characteristics in various ways."
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Days after Austin began once again recommending masks in public spaces, Austin ISD announced Monday that kindergarten through sixth-grade classes will have virtual options this fall.
The district will discuss the move in a special board meeting Monday evening starting at 5 p.m., while full details will be released Friday.
Teachers will not have to fret about the new option—no educators will have to juggle both virtual and in-person learning. Instead, certain teachers will specialize in virtual education, according to a press release.
The news comes after a recent spike in COVID cases in Travis County and across the nation. Children typically suffer fewer symptoms of COVID when contracted, but they are now catching the virus more often than their older counterparts without a vaccine available to them and as the more contagious Delta variant is quickly being spread.
While local health officials are recommending everyone wear masks, public school districts are unable to mandate masks due to an executive order issued by Gov. Greg Abbott in May.
Parents have expressed concern about classrooms with masks unenforceable and children under the age of 12 ineligible for a vaccine. Some have even said they would look for alternative schooling if AISD did not offer a virtual option for students.
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