Expect some doctors, dentists to shut down offices after COVID-19
Some doctors’ and dentists’ offices and ambulatory surgery centers might never reopen due to the disruptions and long-term changes that will results from the coronavirus pandemic, leaders of health care organizations told a Senate panel in an online hearing Monday.
Dr. Marc Levine, chairman of the Medical Society of New Jersey, said doctors’ offices have gone two months without income or patients and that he hears from doctors, some crying, who aren’t sure they will ever reopen.
“Many of these practices require 100% volume to make a living. At 75 or 85% capacity, they’re losing money,” Levine said. “… I think that the citizens of New Jersey, our patients, unfortunately may be affected by practices shutting down and not coming back.”
Jeff Shanton, president of the New Jersey Association of Ambulatory Surgery Centers, said the old business as usual is gone forever.
“ASCs as small businesses, I can tell you right now there are some that are not coming back from this,” Shanton said. “Centers estimate that it could take a month to a year to recover to pre-pandemic levels, if indeed they ever do. Centers are also projecting that within a period of several months after the opening for electives, they may be up to about 50% of pre-pandemic caseload levels. That doesn’t pay the bills.”
Elective surgeries can begin again next Tuesday, May 26. Emergency care has been allowed, even since the shutdowns were ordered in mid-March, but many people are declining to seek out care.
“I got a call from an ophthalmologist up in northern New Jersey who had an 80-year-old woman who desperately needed eye surgery. It was certainly an emergency. She said to him, and he repeated it to me, ‘I would never go to a hospital or an ASC right now. I’d rather go blind.’ That’s frightening,” he said.
Dr. Tom Rossi, president of the New Jersey Dental Association, said the impact has been devastating and that as many as 1,200 dentists’ offices would be shuttered if industry projections of a 20% closure rates comes to pass. He said the state must respond differently if there is a fall resurgence of coronavirus.
“Should another outbreak occur, we need to be very thoughtful and not just, you know, we’ll close sectors of our economy,” Rossi said. “We have learned that many businesses can open safely and responsibly. We’ve also learned that delaying care for a couple of months can harm our population in other ways.”
Hospital executives also said their facilities have taken a huge financial hit.
The New Jersey Hospital Association said the statewide hospital operating margin plunged from 4.3% to negative 30%, with revenues down 32%, or $650 million a month, largely due to the suspension of elective procedures. Hospital expenses increased 10.6%, or $214 million a month, for supplies and staff.
Barry Ostrowsky, president and chief executive officer of RWJ-Barnabas Health, said the turnaround won’t begin unless a message is effectively communicated that hospitals and other health-care settings are safe. And he said that work can’t be delayed.
“I think if we wait until there’s some announcement about a vaccine, we are unfortunately going to compound the number of people suffering because no longer can people defer some of the challenges they have and some of the conditions,” Ostrowsky said. “And we need to stop that because for the wrong reasons, people will unfortunately suffer.”
Ostrowksy said that “the new future is not the old normal.” That sentiment was echoed by Mike Maron, chief executive officer of Holy Name Hospital, which is examining the use of ultraviolet light as an anti-viral disinfectant because other methods take too long between patients.
“I cannot stress enough as I hear the headlines about trying to get back to normal, the way things used to be, I don’t see that as being a realistic approach. I think we all have to start to define and embrace a new normal. And that new normal is going to be with us for years to come,” Maron said.
Bob Garrett, chief executive officer of Hackensack-Meridian Health, said the health system is now testing all patients and staff for the virus. It has found 5% of patients in hospitals and 3% in nursing home are testing positive for COVID-19, including people without symptoms.
“This should serve as reminder that although it may feel like we can resume back to normal, it’s important that we continue to take special precautions to further prevent the spread of COVID-19, such as masking, rigorous hand hygiene and social distancing,” Garrett said.