NEW YORK - For 15 years, Dr. Margaret Kearns-Stanley has run her own family medicine practice on the Upper East Side, treating patients young and old, sick and well.
“You get to know people intimately,” she said.
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Dr. Kearns-Stanley closed for a couple weeks in mid-March to keep her staff and patients safe as the coronavirus spread.
“But then we opened up to televisits after a couple of weeks,” she explained. “Last week, we just started to bring some face-to-face visits but very limited.”
Her patient volume has plummeted, down 60 percent from before the pandemic. And she’s by far not the only independent medical practice feeling a strain amid the pandemic.
Nearly 80 percent of the doctors responding to a survey by the Medical Society of the State of New York said they now see less than 50 percent of their usual number of patients; nearly three-quarters say practice revenue has fallen by more than half.
Dr. Kearns-Stanley says the appointments she has now are mostly telehealth for sick patients and she gets minimal in-person well-visits.
“It’s tremendous in terms of our reimbursement - a well visit brings in 60 percent more than a sick visit,” she explained.
Dr. Bonnie Litvack, president of the medical society, says financial aid from the federal government is not enough when independent doctors like Dr. Kearns-Stanley face not only dwindling revenue, but also rising costs for items like personal protective equipment (PPE).
“The prices have skyrocketed. They have not benefited from the buying in volume like the government can do,” Dr. Litvack said.
The society has requested that the state require health insurers to provide bonus payments to physicians to cover the increased cost of protective equipment.
Experts say protective gear is just one of the many issues doctors will have to address to get patients back.
“I think an issue that’s going to matter in the short run is what do practices have to do to make people unafraid to come back, and those things carry with them a lot of costs,” said Katherine Hempstead, senior policy adviser for the Robert Wood Johnson Foundation. “Do practices have to extend a lot to invest in PPE, or reconfigure waiting rooms or space people out, or do things to make people feel safe? But these things come at cost,” Hempstead explained.
Dr. Thomas Molnar, a family physician who has maintained his own practice in Briarwood, Queens, for 19 years, says some doctors may be forced to close and join larger health care systems as employees. He believes that would affect patient access.
“[Patients] may have a difficult time getting an appointment, they may have to deal with the front desk to get access to the doctor, and they may have to go through hurdles because the appointments are made by hospital staff,” Dr. Molnar explained. “A lot of things are out of the hands of the [doctor] at that moment because they are employed by the hospital and they have to adhere to policies,” he said.
Dr. Molnar is taking patients for in-office appointments, but he thoroughly screens them before they enter and separates them once inside. Still, he is seeing about 25 percent of the patients he usually does.
If Dr. Kearns-Stanley doesn’t soon see a return of her patients, it could mean she would have to cut staff and maybe eventually close her practice, forcing patients to find care elsewhere. And that, she says, could harm their health.
“Emergency rooms are overutilized when they don't have someone to call,” Dr. Kearns-Stanley explained. “When they have someone to call who knows their story, their outcomes, in my cases, they do well.”