The latest version of the Primary Care Collaborative’s survey of physicians reveals that while COVID-19 cases are rising, the strain on practices may be holding steady for now. What’s more, the findings show that patients’ overall health continues to suffer due to the pandemic.
More than 580 primary care clinicians responded to the latest survey, which is the 22nd round of research that took place in mid-October from the Washington, D.C.-based Primary Care Collaborative, a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home.
About two-thirds (68 percent) of responses from this survey came from primary care physicians (MDs and DOs); nurse practitioners represented a fifth (19 percent) of responses, followed by PAs (3 percent). Forty-two percent of respondents are employees in a hospital or health system, followed by 29 percent who are owners or partners in their practice, and 17 percent who are employees at an independent practice.
Key findings from this survey round include:
COVID cases are rising, but the strain on practices may be holding steady for now. Sixty percent of respondents say they have seen a rise in COVID-19 illness in their communities. Yet respondents continue to rate the level of “unusual strain” on their practices due to COVID-19 at around the same levels over the past four survey rounds dating back to late August. Consistently around half of respondents rate their level of strain as a 4 or 5 out of 5. And the percent of respondents rating their strain as low (1 or 2) has ranged between 11 percent and 19 percent.
Patients’ overall health continues to suffer due to the pandemic. Over 85 percent of respondents report that the mental health of their patients has decreased during the pandemic, with 31 percent seeing a rise in patients suffering with addiction. Over a third (37 percent) say their patients with chronic conditions are in “noticeably worse health resulting from the pandemic.” This is due, in part, to visits that are not happening: 56 percent of surveyed clinicians have seen an increase in negative health burdens due to delayed or inaccessible care.
Practices are rising to the challenge by adapting the way they deliver care, but it may not be fast enough. Over two-thirds of practices are using telehealth for visits with patients who have stable chronic conditions, and over 60 percent use telehealth for mental health visits. Twenty-seven percent say they are more involved in helping patients with poor access to food, housing, and employment, and over a fifth have increased connections to community organizations. Still, only 16 percent of respondents report that their practice has added capacity to help patients with mental or behavioral health, despite the increasing burden.
Financial barriers faced by primary care practices may have lessened—for now. Only 6 percent of respondents say they are unable to pay some of their bills. And where reimbursement for virtual visits used to pose significant challenges to primary care, just 7 percent of surveyed clinicians now say that they would like to use video-based care more often but can’t because of low reimbursement. (15 percent say the same for phone-based care). Today, bigger obstacles to practices include trouble hiring new staff (35 percent).
COVID-19 and influenza still loom over primary care. Testing for COVID-19 remains a challenge for primary care practices, with 44 percent reporting that results take more than two days to receive and 26 percent reporting they cannot get patients tested as often as they think they should. Roughly a quarter (23 percent) say low amounts of PPE or reused PPE may them feel unsafe at work. Ten percent say they have no flu vaccine.
