Doctors face pay cuts, furloughs and supply shortages as coronavirus pushes primary care to the brink

  • In 2016, primary-care physicians fielded 54% of all patient visits to doctors’ offices.
  • Primary care receives less than 7% of total U.S. health-care expenditures.
  • The coronavirus pandemic is now threatening to push already tight budgets into the red.

Dr. Rafael Guillen spends a lot of time on the phone these days. His practice in the Bronx closed its doors in mid-March to protect staff and patients as the coronavirus pandemic escalated in New York City. He calls patients with the virus morning and night to monitor their condition, about 60 people so far.

Guillen’s small internal medicine practice has struggled not only to keep up with the virus, but also to make ends meet financially. Many primary-care practices were already operating on tight budgets, and the pandemic now threatens to push some of them out of business entirely.

Guillen said revenue at his practice is down about 50% from March through May compared with last year as his patient volume has fallen during the pandemic. Many people are simply avoiding the doctor because they fear catching Covid-19 if they need treatment at a hospital, Guillen said. Insurers in the U.S. primarily pay physician practices by office visit — fewer appointments means dwindling revenue. His transition to telemedicine hasn’t been able to make up for the shortfall.

If a swath of primary-care physicians close their doors for good, communities would be left poorly equipped to contain a second coronavirus outbreak that could come in the fall, which would coincide with flu season. Shrinking and disappearing doctors’ offices could lead to future epidemics as sick patients go untreated and children do not receive important vaccines. Guillen warns of a looming mental health crisis as isolated patients express feelings of helplessness, anxiety and despair.


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