More than half of Minnesota’s physicians say the coronavirus pandemic has triggered delays in medical care for their non-COVID patients, and a third say those delays have caused harm to some patients, including a few deaths.
Not surprisingly, the doctors also report a huge increase in telehealth (the delivery of health care through phone or video calls) since the start of the pandemic. A large majority of the doctors say this alternative to in-person visits is meeting the needs of their patients, and most believe its use should continue.
Minnesota’s doctors are worried, however, about how the next wave of the COVID-19 pandemic will affect the delivery of care to their patients, as well as the survival of their medical practices.
These are some of the key findings from a study, “Minnesota Physicians Respond to COVID-19,” released Wednesday by the Minnesota Medical Association (MMA). For the study, a representative group of 641 Minnesota physicians were surveyed between June 16 and July 13, 2020. (A second survey reported on in the study was completed by 92 medical practice administrators.)
“Given how quickly the health care world is changing during this pandemic, we realize these results are just a point in time,” says Dr. Keith Stelter, president of the MMA, in a released statement. “But they do confirm a lot of what we’ve been hearing anecdotally — even for patients without COVID-19, their health is suffering, the pandemic has accelerated use and acceptance of telehealth by both patients and physicians, and there are serious concerns about what happens with the next wave.”
In the survey, 53 percent of the physicians reported that delays in medical care had resulted in some of their patients experiencing adverse health outcomes. Almost one in five (19 percent) said patients had delayed routine or preventive care, and a similar share (17 percent) said their patients feared seeking care because of the potential of being exposed to the COVID-19 virus.
Five percent of the doctors reported that these delays in care had led to a patient’s death.
“Patients are afraid to come back for visits, testing, etc. I am concerned that people may not be getting the care they need,” said one of the surveyed doctors. “Also, there are patients on clinical trials that are hesitant to come back for visits, so this is impacting clinical research.”
“Several elderly patients have put off their patient appointments and had significant worsening of their pain issues,” said another. “Also, many had injections for pain rescheduled and are having increased use of opioids due to worsening pain.”
A surge in telehealth services
The survey also revealed that telehealth services grew by 833 percent since the start of the pandemic. In 2019, only 3 percent of doctor-patient encounters in Minnesota were “virtual” visits. In March 2020, that proportion jumped to 28 percent.
More than 80 percent of the physicians surveyed indicated that their patients are satisfied with receiving medical care this way and that it is meeting their patients’ needs.
“Most of what we do is talk to people,” said one doctor. “Telehealth is a lot like doing house calls. I am a guest in their home, and the patient is much more comfortable. I hear the sounds of their life. Many of my elderly patients have difficulty leaving their homes.”
“It is odd for us all not to be face to face,” he added, “but it is fine. I think that many people are also learning that much of what they consider ‘urgent’ is not.”
About three-quarters of the surveyed physicians said they’d like to continue providing telehealth services, but many stressed that improvements are needed if this health-delivery method is going to benefit all Minnesotans.
“We’re glad to see the expanded use of telehealth,” says Stelter. “However, not all patients can currently access it. Many Minnesotans don’t have access to broadband. Variation in technology platforms can also drive patient comfort and use. For telehealth to be truly helpful everyone needs to have the ability to use it effectively. This is yet another example of the health care disparities that exist in Minnesota.”
A large majority of the surveyed doctors said they were worried about whether their medical practice or the organization for which they work will be able to financially withstand a second wave of the virus.
“More than a third of administrators and physicians noted the need for additional financial support should Minnesota experience a second wave of COVID-19,” the report points out. “They also highlighted the need for more PPE, payment parity for in-person and telehealth services, and clear communication, policies, and plans from government and organization leaders.”
Overall, the state’s medical practices saw the volume of their services and their revenue decline by more than 45 percent between March 16 and May 10, compared to the same period last year, the survey revealed.
As for how Minnesota’s physicians view government responses to the pandemic, the verdict is missed. A large majority (80 percent) rate the Minnesota government’s response to COVID-19 as “good” or “very good.”
And the federal response? Three quarters (76 percent) of the physicians said it has been “poor” or “very poor.”
FMI: You can read the MMA report on the survey on the organization’s website.