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Primary care doctors say they're not ready for the next COVID-19 surge

Primary care practices are feeling the pressure on multiple fronts, from a lack of PPE to ever-thinning margins and fewer patients.

Jeff Lagasse, Associate Editor

The COVID-19 pandemic is sticking around for the long haul, and though the virus is currently surging – with 26 states seeing 14-day upward trends in cases and positivity rates–- a larger second wave is expected in the fall. That's bad news for primary care physicians, many of whom say they're simply not prepared for a likely round two.

In a survey conducted by the Larry A. Green Center, the Primary Care Collaborative and 3rd Conversation, when asked to look ahead to the next six months, 30% of physicians feel unready, or "spent," from the demands of the pandemic, while more than 40% were unready for another wave.

The June 26-29 survey encompassed 735 clinicians across 49 states, with 63% in family medicine, 17% in internal medicine, 8% in pediatrics and 6% in geriatrics.

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WHAT'S THE IMPACT?

Primary care practices are feeling the pressure on multiple fronts. Almost half said they don't have enough personal protective equipment, and 61% are actively reusing their PPE supplies. Meanwhile, fewer than half of all practices said they don't have enough cash on hand to stay open, 53% say their patients aren't scheduling wellness or chronic care visits, and more than one-third have laid off or furloughed staff within the past month.

Even telehealth technology, which has experienced significant growth in popularity and usage during the pandemic, can only help to a certain point. The Centers for Medicare and Medicaid Services has issued temporary waivers that relax the rules around telehealth reimbursement and geographic usage, but nearly 70% of practices aren't ready for reduced or terminated payment for such services – which will happen when the national emergency comes to an end, unless Congress takes action.

On a five-point scale, 70% of clinicians said the strain on their practice is at a four or five, while 38% said burnout is at an all-time high. 

A full 83% of clinicians are seeing higher-than-normal rates of emotional and mental distress among patients, and 56% said their patients' health issues are being exacerbated during the pandemic due to a lack of appropriate care. It's even affecting oral health: 25% said there are more dental issues among patients due to the closure of dental practices.

Close to 60% of practices report limitations in making referrals because other medical offices are closed, while 55% have experienced COVID-19 testing delays of three days or more.

THE LARGER TREND

The results show little change from the previous survey from the Larry A. Green Center and Primary Care Collaborative, with May figures showing 84% of clinicians reporting severe or close to severe stress, and 28% saying burnout is at an all-time high.

The stimulus and emergency-response funding from the federal government has blunted some of the losses resulting from the cessation of nonemergency and elective services, but hospitals won't be fully compensated, according to a Moody's report in May.

The U.S. now leads the world in confirmed coronavirus cases, at 2,889,303, as of Monday afternoon, according to Johns Hopkins University data.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com