1 in 3 Primary Care Doctors Fears Having to Close Practice Over Coronavirus

May 19, 2020

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Source: San Francisco Chronicle, by Mallory Moench

More than a third of primary care doctors in California surveyed this month by an Oakland foundation worried they will be forced to close their practice or clinic because of financial impacts from the coronavirus pandemic.

The survey of 350 physicians across the state, released Friday, found that 37%, about 130, said they were “very” or “somewhat” worried that they will have to permanently close their doors. Doctors at practices with fewer than five physicians were especially concerned. More than half of those doctors, 63, said they fear they will have to shut their clinic for good.

“These numbers show that clinics of all sizes — and smaller practices in particular — face unprecedented challenges,” said Kristof Stremikis, director of market analysis at the California Health Care Foundation, which conducted the survey from May 8 to May 13 with research firm Truth on Call. “Significant numbers of California’s primary care doctors are concerned that their practices will not survive the pandemic.”

The idea behind the survey was to better understand the financial hit of the outbreak amid the statewide shelter-in-place order that all but emptied doctors’ offices beginning in mid-March, the survey noted.

Although the survey was emailed to about 25,000 primary care doctors across California, the foundation received just 350 responses — but from a mix of large, medium and small practices, as well as about a third serving mainly low-income patients.

The wide-ranging survey asked doctors about their concerns, layoffs in their offices, whether they had enough personal protective equipment for workers, and if they could test all employees and patients for the coronavirus.

As with most sectors of the economy, troubles began for the medical industry when shelter-in-place orders blanketed California on March 19. The state’s health care providers watched as revenue from non-emergency surgeries and the loss of patient visits plummeted, even as costs to combat the outbreak rose.

Results from the anonymous survey indicate that independent doctors are feeling the kind of financial pressure — although on a smaller scale — as larger hospitals, which have slashed staffing costs and taken other drastic measures to try and make up for millions of dollars in losses.

Dr. Lisa Capaldini, a general medicine physician in San Francisco, was not among the doctors surveyed. But she told The Chronicle she has felt financial stresses similar to those described in the survey.

Capaldini said she couldn’t pay her $7,100 monthly rent in May. And since March, she said, her patients and income dropped by more than half.

She operates a small, solo practice and has one staff member. Like 50 of the small practitioners surveyed, Capaldini said she wasn’t worried about closing right now — but she fears the future.

“The longer this goes on and there’s no relief, you just can’t do the math,” said Capaldini.

While Capaldini has been able to keep paying herself and her employee, many primary care practices face a range of other difficulties, the recent survey revealed.

Among the survey’s findings from 350 doctors across the state:

• Have adequate access to personal protective equipment in their office: 243 (69%).

• Furloughed or laid off staff since the statewide shelter-in-place: 131 (37%).

• Considered temporarily closing their clinics in the last month: 114 (33%).

• Reduced staff pay since shelter-in-place: 62 (18%).

• Lack enough COVID-19 tests to meet the needs of employees and patients: 61 (17%).

As the California Health Care Foundation released its survey Friday, Sutter Health, a vast nonprofit health care provider in California, reported it had lost $1 billion in the year’s first quarter.

On Friday, leading health care providers spoke to reporters about financial stress in the industry:

“Some (health care providers) are having to resort to choices no one wants to make — layoffs, furloughs, asking staff to take paid time off,” said Carmela Coyle, president and CEO of the California Hospital Association, on the call.

The federal government has approved more than $100 billion in stimulus grants for hospitals, with $3 billion sent last month to tens of thousands of California health care providers. Those who served the most elderly patients on Medicare last year received the largest chunk.

Federal funds offset 40% of coronavirus-related losses for the UC Health system, Executive Vice President Dr. Carrie Byington said on the call. In March and April, the health system lost $769 million — $632 million due to canceled or delayed procedures and $137 million spent to prepare for COVID-19 — she said. The system received $287.8 million in stimulus money.

“These extraordinary costs will continue in the near term,” Byington said. “Although hospitals are facing a return to essential care, it’s not practical or prudent to expect that our finances will return to pre-pandemic levels this year and next year.”

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