Specialty physicians predict more pain ahead in the battle against COVID-19

Special Report: Multi-Specialty Impact of COVID-19 is an independent project being run by Spherix Global Insights to assess the impact of the COVID-19 crisis on dermatologists, gastroenterologists, nephrologists, neurologists, and rheumatologists. Each Friday, over 250 specialists are surveyed about impact, concerns, shifting treatment patterns, and critical practice management changes that are resulting from the COVID-19 pandemic.

The results have been sobering. In the third wave, based on the responses of 252 specialists gathered on April 3, the impact to physicians has been intense and escalating. Notably, office visits are down by at least 80 per cent from normal, and despite the rapid adoption of telemedicine, many note challenges with implementing this service and unclear reimbursement from commercial payers. Although telemedicine consults have seen successive increases each week, it is not coming close to bridging the gap, and some specialties are having a more difficult time than others.

The offset to patient volume is placing enormous financial strain on office-based practices, particularly for dermatologists and gastroenterologists who are heavily reliant on elective procedures. Many have been forced to furlough staff and, in some cases, implement layoffs. With the expectation that this crisis will continue for another eight to nine weeks, many are questioning whether their practice will survive; those in smaller practices are most concerned.

Across all immune specialties captured (dermatology, gastroenterology, and rheumatology), therapy changes of any kind (initiations/switches) are unlikely. Drugs associated with being more targeted regarding their immunosuppression and generally considered as having favorable safety profiles may come off the least scathed. For example, Amgen’s Otezla for psoriasis. Products that require administration by a healthcare professional, such as Sun Dermatology’s Ilumya for psoriasis, also face a challenging scenario.

In summary, frontline healthcare leaders are scared, worried, and frustrated. Collectively they estimate it being eight to nine weeks before things begin to improve and 83 per cent of those surveyed last week expect things to get worse in the next two weeks. In the words of one practitioner, “(My greatest concern is) that it will linger on to some degree for much of the year and dramatically and permanently affect people’s livelihoods, relationships, and dreams.”