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Not long after Gavin Newsom, the governor of California, ordered the state’s 40 million residents to stay home to stop the spread of the new coronavirus, Dr. Greg Morganroth called his team of doctors and said their dermatology group was staying open.

Morganroth is chief executive officer of the California Skin Institute, which he founded in 2007 as a single office in Mountain View. He’s since expanded to more than 40 locations using a financing strategy that’s become exceedingly common in American health care: private equity. In this case, he took out a loan from Goldman Sachs Group Inc. that could eventually convert to an equity stake. CSI is now the largest dermatology chain in California.

But the Covid-19 pandemic put Morganroth in a precarious position. Most medical procedures were characterized as nonessential by government officials and practitioners. Doctors were closing offices, and patients were staying away to limit their potential exposure to the virus.

CSI took a different approach. Morganroth explained his thinking on April 2 in a Zoom call with more than 170 dermatologists from around the country organized by the Cosmetic Surgery Forum, an industry conference. Contrary to what they might have heard, Morganroth told them, they should consider staying open during the pandemic. “Many of us are over-interpreting guidelines,” he said.

For a moment there was an awkward silence. Doctors had thought they were signing up for advice on how to apply for government money that would help them meet payroll while they were shut down; they hadn’t expected to be told not to shut down at all. Morganroth continued: “We are going to be in a two-year war, and we need to make strategic plans for our businesses that enable us to survive and to rebound.”

Back at CSI, the company’s front-office staff was working the phones, calling patients in some of the worst-hit areas and reminding them to show up for their appointments, even for cosmetic procedures such as Botox injections to treat wrinkles. During the videoconference, Morganroth argued that offering Botox in a pandemic wasn’t so different from a grocery store allowing customers to buy candy alongside staples.

“If I had a food supply company and had to stay open, and I had meat, bread, and milk, would I

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