- The focus on fighting the novel coronavirus has caused volumes of other types of patients to plummet, according to a new survey of physicians by Piper Sandler. Analysts spoke to 160 physicians across 16 specialties in four states — California, Massachusetts, Washington and New York. About half are in private practice.
- According to the survey, patient volumes are down 65% and will likely remain at that depressed level until the end of this month. They are expected rebound, but slowly, and will still be down as much as 12% during the same time next year.
- At the same time, more than half of patient encounters will be through telemedicine through the foreseeable future. And while that will help some practices in the short term, many doctors are considering furloughing or laying off employees.
The COVID-19 pandemic had disrupted virtually every aspect of the U.S. economy, and that includes the nation's physicians. Although some are being reassigned to treat patients in hospitals, many of them are not on the front lines of the COVID-19 battle. Their medical practices have all been gutted as a result, according to the Piper Sandler survey.
As hospitals have received billions in emergency financial aid to keep them operating, the American Medical Association and other physician lobbying groups have asked Congress to provide financial aid in order to help keep physician practices afloat.
The physicians surveyed said the effects of the crisis have been extreme.
"Supplies and shelter in place have severely limited our ability for in office visits and procedures," one physician said. Moreover, patient volumes are expected to rebound only slowly, reaching about 55% of normal in June and 76% of normal in September.
Along with an unprecedented drop in patient volumes, prescription writing has also dropped by 47%. It is expected to be down by a similar percentage in April, reach 80% of normal in September and 90% of prior volumes in March 2021.
Telemedicine is expected to comprise up to 54% of patient encounters in the near future — a more than five-fold increase from volumes prior to the pandemic, according to the survey. To help boost this ability for patients to have access to care not related to COVID-19, CMS has loosened regulations for telemedicine encounters and has also said Medicare will pay for them.
However, the telemedicine push is not expected to be close to the baseline of in-person encounters, which averaged about 121 patients per week among those surveyed by Piper Sandler. One physician who was interviewed said they had seven telemedicine visits lined up for a coming week. Technical issues with both the telemedicine platforms and the ability of patients to respond is also making such encounters take more time, according to the survey.
And there is also some reluctance among patients. "Many patients are choosing to skip their visits rather than have telemedicine," one physician said. "It is unclear as to why they do not want this option. Perhaps they don't want to pay any copays or are worried about hidden fees."
Nevertheless, most of the physicians queried believe that much of the ramp-up in telemedicine services is expected to remain even after the pandemic subsides.
Meanwhile, staff cuts have occurred or are about to occur soon. One practice reported cutting 80% of its staff.
Practices that spoke with Healthcare Dive late last month had similar concerns. "We are seeing huge cuts in our revenue right now," Beverly Jordan, a physician at small rural practice Professional Medical Associates in Enterprise, Alabama, said. "We are working really hard to keep our employees employed. We are working really hard to keep our doors open. But we are having to monitor that bottom line."