3.8 Article

The impact of the COVID-19 pandemic on professional practice and patient volume in medical practices: A survey among German physicians and psychotherapists

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ELSEVIER GMBH
DOI: 10.1016/j.zefq.2021.08.001

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COVID-19; Physicians; Psychotherapists; Patient volume; Telehealth; Health services research

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This study examines the impact of the COVID-19 pandemic on outpatient care in the German state of Brandenburg, focusing on physician and psychotherapist experiences during the first lockdown period. Results show a reduction in patient volume, economic losses, and a shift towards telehealth usage. Despite challenges, outpatient providers demonstrated flexibility and adaptability in responding to the pandemic, with telehealth becoming increasingly important in the post-pandemic era.
Introduction: This study examines the consequences of the COVID-19 pandemic on outpatient care in the German federal state of Brandenburg during the first 'lockdown' between 22 March and 4 May 2020, focusing on the burden for physicians and psychotherapists in outpatient practices and on alternative ways to provide care, in particular telehealth. Methods: We conducted an online cross-sectional survey among outpatient health care professionals. The responses of n = 277 physicians and n = 87 psychotherapists were included in the analysis. Frequencies are shown; the relationship between categorical variables was examined using the chi(2) test; we used a qualitative content analysis for free text answers. Results: Almost all (96 %) physicians and 59 % of the psychotherapists reported a patient volume reduction since the COVID-19 outbreak. Cancellations were most often initiated by patients rather than physician offices. Among the physicians, routine check-ups and preventive care consultations were cancelled most frequently, and patients also appeared less frequently in open consultations. 72 % of the physicians and 29 % of the psychotherapists reported economic losses. While personal patient-physician contact was reduced, the use of telehealth has increased since the COVID-19 outbreak: during the first 'lockdown', two thirds of the psychotherapists (66 %) and 14 % of the physicians used telehealth for the first time. The COVID-19 pandemic contributed to a positive change in attitudes towards telehealth; this trend was significantly stronger among psychotherapists than among physicians. Discussion: The reduction in patient volume shown in this study is confirmed by outpatient billing data analyses. Clinical routines changed due to COVID-19 and led to a growth in telehealth usage. By facilitating formal billing options, the increased use of telehealth can also be promoted after the pandemic. Conclusion: Shortly after the COVID-19 outbreak, outpatient physicians and psychotherapists were faced with various challenges: Through their spontaneous and flexible response to the COVD-19 pandemic, outpatient providers were able to maintain their work despite high stress levels. Telehealth is becoming more important as a result of COVID-19.

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