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April 15, 2020

What Will “Back to Normal” Look Like for Physicians Once COVID-19 is Contained?

MHT Partners  | Healthcare Investment Bank

As COVID-19 continues to spread across the United States, the nation’s healthcare professionals work tirelessly to treat patients, reduce the spread, and keep the healthcare system running. With social distancing in effect and more physicians working directly to slow and treat COVID-19, most routine physician appointments have been delayed or cancelled. It’s hard to say when physicians will return to normal schedules and corresponding patient volumes, however, it is clear there is significant pent-up demand for non-emergency doctor visits.  This blog examines how several sub-specialties in healthcare could rebound as social distancing efforts are lifted.

U.S.-based orthopedic surgeons perform 1.77 million knee arthroscopies, 200,000 rotator cuff repairs, and 100,000 ACL reconstructions each year1. ENTs successfully complete 500,000 tonsillectomies and 250,000 sinus surgeries annually2. These surgical interventions represent only a fraction of procedures that are vitally important to the well-being of millions of patients but have also been delayed to ensure hospitals retain capacity and to reduce the spread of COVID-19 to patients. With likely 10-15% of annual procedures now delayed or cancelled, physicians across the diverse array of surgical specialties, nurses and techs in those fields, and operating rooms will be in high demand when COVID-19 cases begin to decrease.

Regular check-ups and screenings have also been put on hold for several weeks and potentially longer. Many primary care groups and even select specialist groups, in areas like dermatology, are rolling out telehealth support for patients, allowing for continued appointments, chronic disease management, and prescriptions for acute, non-COVID-related conditions. However, without regular, in-person primary care, some health problems may go undetected in some already at-risk patient populations. For example, type-2 diabetes and high blood pressure are common health issues caught by primary care physicians in a physical setting3 that may be underdiagnosed in the coming weeks. Specialists that rely on referrals will also see lower appointment traffic. Moreover, many regularly scheduled screenings have been deferred or cancelled. For example, there are 17.3 million mammograms3 and 19 million colonoscopies3 in the U.S. annually to screen for breast and colorectal cancers, respectively, most of which will not happen in the coming weeks. Without screenings and routine check-ups, it is reasonable to expect lower numbers of diagnoses of common diseases, including cancers, in the coming weeks. But, when healthcare operations return to closer-to-normal numbers, diagnoses will likely catch-up quickly to track with expected annual totals, followed closely by those patients beginning appropriate treatments.

Meeting the growing backlog of healthcare demand comes with several challenges:

  1. First and foremost, keeping healthcare providers safe and healthy during the treatment of COVID-19 is necessary for meeting any demand for future healthcare. Appropriate personal protective equipment and precautions for providers will help fight this pandemic and preserve their ability to fight future health challenges.
  2. Additionally, with appointments for screenings, check-ups, and procedures plunging in recent weeks, many private physician practices have turned to furloughing or even laying off personnel that are not involved in activities essential to tackling COVID-19. Physician groups will need to ramp their head counts back up to schedule and treat patients once the epidemic passes.
  3. Lastly, appointments will not strongly rebound without health insurance certainty, which is threatened by the recent mass layoffs.

COVID-19 has challenged the healthcare system in an unprecedented manner and will continue to do so as we approach the peak. Once beyond the momentous task at hand, though, physicians, healthcare systems, and stakeholders will need to begin thinking about how to address a large demand for more traditional healthcare services for patients who will be anxious to see their physician again for surgical procedures, screening exams, and even their routine annual visit.

MHT Partners, a leading healthcare services investment bank, welcomes further discussion about the effects of COVID-19 on the healthcare industry (Patrick Krause, pkrause@mhtpartners.com or Taylor Curtis, tcurtis@mhtpartners.com).

(1) U.S. Market Report Suite for Orthopedic Soft Tissue Repair and Sports Medicine
(2) American Academy of Otolaryngology-Head and Neck Surgery
(3) Center for Disease Control

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