What your doctor is reading on Medscape.com:
MAY 13, 2020 — Ophthalmologists in small practices and large clinics are trying to protect their patients and themselves from COVID-19 while keeping their practices afloat.
Alice C. Lorch, MD, MPH, chief quality officer of ophthalmology, Massachusetts Eye and Ear, Boston, told Medscape Medical News that much of what they do in ophthalmology is elective, so the numbers of patients have “dropped sharply.”
Many of her colleagues are dealing with similar issues, although the severity likely differs by region and population size as workforces are affected differently. In New York and Boston, for example, “some of our physicians are actually being redeployed to help with other things, and so as a result our workforce is lower, and I think that’s probably not the case in other cities,” she explained.
She added, however, that things are shut down throughout the United States, and that determining how to open things back up without increasing cases again will be an important problem to address.
Business Outlook Uncertain
John D. Dugan, Jr, MD, an ophthalmologist and cataract surgeon in private practice at Eye Physicians in Voorhees, New Jersey, told Medscape Medical News he closed his practice to “essentially all patients in the middle of March upon the advice of state and local governments, and it was really hard to do,” he said. “We are an eight-ophthalmologist practice, and four equity partners have deferred compensation during this crisis.”
Dugan has 40 to 50 employees and had to furlough “a large number” of them, saying it is not possible “to pay them and survive as a practice with no money coming in.” Some employees who have been “instrumental” in working with patients, such as rescheduling appointments, refilling medications, and reordering contact lenses, are still working.
Some subspecialties have been somewhat buffered from the COVID-19 fallout, Abdhish R. Bhavsar, MD, president and director of clinical research, Retina Center of Minnesota, told Medscape Medical News.
“I think general ophthalmology practices are being hit harder since many patients have elective care. In a retina surgeon’s office such as ours, many of our patients require acute emergent or urgent care, so we are still seeing those patients,” Bhavsar explained, who is also a spokesperson for the American Academy of Ophthalmology (AAO).
Continued
“We are surviving, and we are keeping almost all of our employees still employed. We are applying for multiple programs including the payroll protection program and some state emergency funding as well,” Bhavsar said.
To find out how the pandemic is affecting ophthalmologists in private practice, AAO surveyed 2500 members from April 9-13, 2020. Of those, 400 (16%) replied.
Overall, AAO reported that 89% of respondents are applying for payroll protection through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and other sources. Most predict that their practices will be “smaller, financially unhealthy, or both by the end of the year” without significant federal grants and loans.
Only 6% of respondents believed they would be back to pre-COVID levels for size, volume, and financial health.
Elective Visits Canceled, Volume Down
Ophthalmologists are limiting patients they see in clinic to those with urgent and emergent situations and are honing new skills to help patients using telehealth technologies.
At the University of Iowa in Iowa City, for example, they reduced the number of patients they see in the ophthalmology clinic in mid-March and are seeing about 15% of their normal clinic volume, said Keith D. Carter, MD, professor of ophthalmology & visual sciences, University of Iowa.
Practices focused on surgical procedures have been particularly hard hit, according to Julia A. Haller, MD, ophthalmologist-in-chief at Wills Eye Hospital, Philadelphia, Pennsylvania.