From the desk of the EMD: Impact of COVID-19 on U.S. physicians

October 5, 2020

The College has surveyed allergists twice since the start of the COVID-19 pandemic. I don’t need to tell you that the vast majority of you have been impacted in economic and other ways. I thought it would be interesting to examine how COVID-19 is affecting you with data from a survey of physicians around the country conducted in July by The Physicians Foundation of Merritt Hawkins. This organization has been surveying American physicians since 2008, but, of course, never on COVID-19 before. 3,513 responses were received, with 61% in primary care and 39% in specialty care. Males made up 57% of the participants, 40% were females and 3% did not answer. 42% of the physicians who responded to the survey are private practice owners, while the remaining 58% are employed by a hospital, a hospital-owned medical group, a physician-owned medical group or are in some other status.

You can compare your thoughts, your practice, and your patients with the results. I will only cover some of the key findings that I believe will be of interest to you. If you want to read the entire report, you can download it.

First, let’s hit the most disturbing thoughts by U.S. physicians. Nearly 50% of them believe that the coronavirus pandemic will not be under control until sometime after June 1, 2021. I myself would have answered the same way. Even if we get a vaccine by the end of 2020, how long will it take to get the population vaccinated and, even more concerning, how many people will refuse to take it?

I think most of us can agree with the following answers: Close to three quarters (72%) of physicians indicated that COVID-19 will have serious consequences for patient health in their communities because many patients have delayed getting care they need during the pandemic. A primary cause of harm to patients presented by COVID-19, cited by 76% of physicians, is employment changes that may result in patients losing their health insurance.

This next result may be somewhat more controversial. The majority of physicians (59%) believe that opening businesses, schools, and public places presents a greater health risk to patients than prolonging social isolation. Personally, I believe that if we had had a longer lockdown in the U.S., we would not be seeing the death rate that, unfortunately, has occurred and is continuing.

What has happened to physicians’ practices? 8% of physicians have closed their practices as a result of COVID-19, and 43% of physicians have reduced staffs. 72% of physicians have experienced a reduction in income. Of these, 55% have experienced income losses of 26% or more. 37% of physicians saw volume decreases of 25% or less in their practices. By contrast, 41% saw volume decreases of 26%  or more, which may be difficult or impossible for most physician practices to sustain for more than a few months. Of those physicians who applied for Paycheck Protection Program support, 75% indicated they received the support and it was sufficient for them to remain open.

Is anyone leaving practice due to COVID-19? The great majority of physicians (96%) will not leave medicine due to COVID-19 health risks. We don’t know the numbers in allergy, but I have definitely heard from allergists who are only doing telemedicine and no direct patient care. Speaking of telemedicine, this survey found that 12% of physicians had switched to primary telemedicine practice. The majority of physicians (72%) believe its widespread use will not continue unless reimbursement rates for telemedicine visits remain comparable to in-person visits. In fact, I would have thought 100% of physicians would agree with the above statement.

Lastly, something I commented on in a previous editorial on the effects of COVID-19 on the independent practice of allergy: the majority of physicians (59%) agreed that COVID-19 will lead to a reduction in the number of independent physician practices in their communities. I believe these changes are inevitable.

Comparing the results from the College COVID-19 surveys with these, I think the allergy community has been affected in much the same way as our primary care and specialty care colleagues. I still believe this pandemic will pass and the need for our services will continue to grow. The College will be there to support you and your practice today and in the future so you can care for your patients.

Michael Blaiss, MD, FACAAI, Executive Medical Director