Dr. Lawrence John: Covid-19 could devastate medical practices
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We have all seen the images of crowded hospitals overrun with patients infected with covid-19. As a result of covid-19 regulations, another significant health care dilemma is developing, as medical practices witness a significant decline in patient visits during this pandemic.
Government-mandated cutbacks on elective procedures and routine check-ups have forced independent medical practices to temporarily close their doors. The loss of revenue may soon force some practices to furlough staff, and in the worst-case scenarios to go out of business, causing significant access-to-care disruptions once the pandemic subsides.
A study by the American Academy of Family Physicians estimated that 60,000 family practices nationwide could close or significantly scale back by this summer, unless they are provided more assistance to keep their businesses afloat.
The use of telemedicine has offered some limited assistance to help close the revenue gap for some practices.
However, there are signs in Pennsylvania that some commercial health insurers are not reimbursing physicians at the same level they would otherwise pay for “in-person” care. Also, some smaller practices have struggled to set up telehealth systems and workflows altogether.
Delaware County dermatologist Dr. Joseph Laskas told the Philadelphia Inquirer that his patient load has dropped from 130 visits per week to five or six.
“For all intents and purposes, the business is closed, except for everybody’s still on payroll,” he said.. Laskas’ practice is looking for financial assistance from a number of sources to pay its 53 employees. “So far we’ve been doing that, but it can’t go on forever,” he said.
Congress passed the CARES Act in March and those funds are now being delivered to health care providers. However, not enough support is making its way to private medical practices.
As a family physician in Pittsburgh who started my own private practice more than four decades ago, I can attest to the value that independent practices bring to our community’s health.
My practice allowed me to build long-term relationships with generations of patients. These types of relationships between patients and physicians lead to better health outcomes and longer lives, according to numerous studies.
Now more than ever, we will need the stability of independent practices caring for patients. Once the stay-at-home orders are lifted and patients need to follow up on health concerns which they had put off because of the pandemic, it will be critical to have all medical practices financially stable. Losing a physician or further delay in care could certainly put patients at risk as their health care needs require attention.
While physicians worry about how to keep their practices afloat, these physicians also understand, as well as anyone, the importance of maintaining social distancing and the stay-at-home orders remaining in place until our public health experts say it is safe to transition back to our more normal routines.
The Pennsylvania Medical Society and its members support mitigation efforts currently in place. Data suggests that they are working to save lives.
However, more needs to be done to help ensure that our independent medical practices are ready to do their part once the worst of the pandemic has ended. We do not want to replace one health emergency with another health care dilemma.
Lawrence John, M.D., is president of the Pennsylvania Medical Society and a family physician from Aspinwall.