Patient Health Suffers Amid Pandemic
Healthcare Shortages

Donavyn Coffey

November 25, 2020

Delayed healthcare brought on by the pandemic is taking its toll on patients, a survey of primary care doctors shows. 

Over half (56%) of responding clinicians reported seeing a decline in patient health because of delayed or inaccessible care amid the pandemic, according to the results of the latest survey by the Larry A. Green Center and the Primary Care Collaborative. The survey was conducted in mid-October and the results were published online last week.  

In addition, 37% of respondents said their patients with chronic conditions showed "noticeably worse health resulting from the pandemic." And a resounding 85% said patient mental health had worsened. 

"I think it's worse than we thought," said Rebecca Etz, PhD, co-director of the Larry Green Center. "It's the outcome of not sufficiently sending resources to primary care either before or during the pandemic." According to Etz, survey respondents noted substantial increases in patient weight gain as well as weight loss, anxiety and depression, sleep issues, domestic abuse, and poor oral and eye health, among others.

One clinician from Pennsylvania wrote, "Patients are becoming sicker during the pandemic. I'm seeing more uncontrolled diabetics and new diabetics. They prefer telehealth yet [have] no access to glucose monitoring or a blood pressure cuff. I am concerned about patients' isolation and mental health. People are delaying care."

Now, with COVID numbers peaking across much of the country, many clinicians are trying to close the gap in care with telehealth — something they're more prepared to do now than they were in March. Over two thirds of practices are using telehealth for visits to keep up with patients who have stable chronic conditions, according to the survey.  

Over 60% of physicians report using telehealth for mental health visits. But a much smaller number — only 16% of respondents — said their practice had added staff to help manage the rising number of behavioral and mental health cases. About one third (35%) of practices say they're not financially able to take on new staff.

"We've been looking for more ways for patients to do self-support. A big part of chronic disease is health behaviors," Alex Krist, MD, MPH, a family doctor in Fairfax, Virginia and chairperson of the US Preventive Services Task Force, told Medscape Medical News. And unfortunately, on top of limited access to basic care, healthy habits that are essential to managing many chronic conditions have become more difficult and less consistent during the pandemic, he said. 

The survey — the 22nd iteration in a series of surveys the Green Center and the Primary Care Collaborative have conducted — received 580 respondents from 47 states and Guam. Over two thirds of respondents were primary care physicians (MDs and DOs). Over half were owners, partners, or employees of a private practice, 66% of which were family medicine practices. And one fifth of respondents provided care in a rural area.

Funding and support for primary care has been wildly insufficient, Etz told Medscape Medical News. If that doesn't change, patient health, clinic staffing, and public health strategies amid the pandemic will continue to suffer. "When you think of the COVID vaccine, who do you think is going to be sending that out?" Etz asked. "If we don't bolster primary care now how are they going to handle that."

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