Survey of primary care clinicians shows practices strained in response to coronavirus

The Primary Care Collaborative, in partnership with The Larry A. Green Center, just released real-time survey results of primary care clinicians (conducted March 27-30), measuring the impact of COVID-19 on their practices.

This is the third consecutive week of this survey initiative. Results reflect input from over 700 primary care physicians, nurse practitioners, and PAs. Respondents spanned all 50 states plus American Samoa. 22% own their practice, and more than three-quarters (79%) work at a practice with more than three clinicians. Respondents ranged among practice types, including nearly half with majority or more of patients commercially insured, rural (23%), community health centers (29%), and practices associated with an academic medical center (33%).

“This week’s survey shows that pressure on front-line clinicians is intense,” said Rebecca Etz, PhD, Co-Director of The Larry A. Green Center and Associate Professor of Family Medicine and Population Health at Virginia Commonwealth University. “Practices are mostly holding on now, but in this week’s survey, six in 10 clinicians said they were uncertain if their practice will be open a month from now due to the combined pressures of no PPE, clinician and staff illness, and lost income.”

“The quantitative and qualitative results of these surveys are a clarion cry for more health plans to step up and cover telehealth and telephonic visits as Medicare has done,” said Ann Greiner, President and CEO of the Primary Care Collaborative. “Next is to get financial relief to practices that are going under water and to move primary care much more rapidly to adequate prospective payment. Practices under such arrangements can weather these storms and provide higher-value care.”
 
Topline analyses include:

• Nearly 8 in 10 clinicians report their practice is under “severe” or “close to severe” strain due to COVID-19.
  Forty-four percent of respondents classify the level of strain on their practice as “severe” (level 5 on a 1-to-5 scale), and another 35% classify it as “close to severe” (level 4) strain. These combined numbers have largely held steady from week 2.    
• Video and other telehealth capacity is increasing, though it’s still far from standard.
  In week 3, 38% of respondents report that their practice has NO video visits (down from 60% the week before). About half (49%) report that NO e-visits are occurring at their practice (down from 70% the week before).  
• Over half of primary care practices are conducting the majority of their visits by telephone.
  Fifty-four percent of clinicians say that their practice is conducting ≥50% of their patient visits by telephone.    
• Nearly a third of respondents work at practices that offer some visits in the parking lot.
  Thirty-two percent say that at least some visits are being handled in the parking lot outside the office, though only 2% work at practices that are conducting the majority of their visits there.    
• Only a third of primary care clinicians feel sure that their practice has enough cash on hand to function for four weeks.
  Thirty-four percent of respondents answered “yes”, and another 15% said “maybe”. Half answered either “no” (13%) or “unsure” (37%).
• Over a fifth of respondents reported that their practice may need to temporarily close.
  Reasons for possible temporary closure included: “clinician or staff illness” (20% maybe; 2% yes); “lack of PPE/supplies (21% maybe; 3% yes); and “lack of revenue” (16% maybe; 2% yes).

View the executive summary and visit PCC’s webpage for full details and charts.

Experts are available to provide insight and comment on the survey. If you would like to speak with any of the experts listed below, please call or email: Stephen Padre, Primary Care Collaborative Communications Manager, spadre@thepcc.org or 202-417-3911.

Experts:

• Rebecca S. Etz, PhD, Co-Director of The Larry A. Green Center and Associate Professor of Family Medicine and Population Health at Virginia Commonwealth University
• Ann Greiner, MCP, President & Chief Executive Officer, Primary Care Collaborative