America’s Doctors Are Facing a Financial Crisis
Doctors, nurses, clinicians and healthcare providers have never shied away from sacrifice. Across the country, these heroes are putting themselves in harm’s way on a daily basis to save lives, flatten the curve and stem the tide of this virus.
The COVID-19 pandemic is creating an unprecedented strain on our nation’s healthcare system. Every day, we see news reports of emergency rooms stretched dangerously thin. But beyond the headlines, there is a ticking time bomb in our healthcare system that could devastate healthcare providers and patients for years to come.
Even though we are in the teeth of a crisis, overall patient volume has plummeted. Government officials have issued mandates canceling scheduled and elective care. Doctors are experiencing a massive decline in routine check-ups, non-emergency surgeries and other preventative care that keep their practices in business. Much like Main Street America, non-emergency doctors are closed for business.
Counterintuitively, emergency departments are also seeing lower volume than usual. COVID-19 cases are surging, but patients are battling a virus that often requires multiple days of care. Duration and intensity of care have spiked but overall, emergency rooms are seeing fewer patients. Of the patients they do see, a higher portion are uninsured or covered by Medicare or Medicaid, all of which reimburse for care at a loss to providers. Emergency departments are proud providers of the social safety net, but the loss of volume creates real challenges to long term viability.
If Congress doesn’t act, this will cause long-term damage to the American healthcare system and disrupt the ability of doctors to provide care to patients once COVID-19 has passed. Facilities will close. Doctors will lose their jobs. The safety net will be gone.
The hard reality is that practices big and small will struggle to stay financially solvent when we need them most. The American Academy of Family Physicians recently released a study projecting that as many as 60,000 family practices could close or scale back by the end of June. Collectively, these practices employ 800,000 healthcare workers.
Outside Boston, Dr. Kathryn Davis’ OB-GYN practice lost 50 percent of their revenue after state officials cancelled all elective procedures. The 35 nurses, medical assistants and secretaries employed at the practice have either gone part-time or are collecting unemployment. According to Dr. Davis, "It's shocking ... Everyone has been blind-sided."
Large healthcare systems are also being hit hard. Analysts have found that doctors are seeing visits drop by 50 percent on average. Altrius Health, the largest independent physician group in Massachusetts, reports that patient volumes are down 75 percent in just the last month.
Intermountain Healthcare, Utah’s largest medical provider, was forced to cut pay and benefits for its emergency medicine doctors and hospital staff. Appalachian Regional Healthcare in Kentucky was forced to furlough 500 workers due to a 30 percent decrease in overall business.
The shuttering of clinics and the canceling of voluntary procedures will have a ripple effect that will be devastating for years to come. Every canceled mammogram or prostate exam could delay a cancer diagnosis, pushing off crucial treatment that could be the difference between life and death for patients. If doctors go out of business and clinics shutter, our healthcare system will not be able to care for patients once the current crisis has passed.
Preparations for the influx of COVID-19 patients is also straining healthcare systems that must spend valuable resources on limited supplies of PPE, ventilators and other crucial medical devices. Many doctors are also forced into quarantine after treating scores of COVID patients for hours and days on end.
Last month, Congress passed the CARES Act, which provided crucial relief for hospitals but did little for healthcare providers fighting on the frontlines or those who have shuttered their offices and postponed elective treatments.
Congress should increase funding for emergency care related to COVID-19 to offset financial strain and support the doctors fighting this virus. Doctors, clinicians, and facilities specializing in scheduled and flexible care need support while they cannot treat patients.
Doctors are on the front lines of this crisis and sacrificing their own health. As Congress debates another COVID relief package, Washington should offset the financial strain caused by this crisis, support doctors and ensure that patients can receive care, both now and in the future. Our doctors are there for us. Congress needs to be there for them.
Andrew B. Reisman, M.D. is the president of the Medical Association of Georgia (MAG) which represents more than 8,000 physicians in every specialty and practice setting in Georgia.