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With patients fearful, medical visits — and revenues — plummet

Health care experts say people may be putting themselves at risk unnecessarily

Hospitals including Massachusetts General say they have taken extensive steps to ensure that people who need care unrelated to the coronavirus will be protected from it.
Hospitals including Massachusetts General say they have taken extensive steps to ensure that people who need care unrelated to the coronavirus will be protected from it.Pat Greenhouse

Health care visits unrelated to the coronavirus have dropped precipitously in the past month, according to new data — a troubling indicator that many people are going without needed care for fear of contracting the potentially deadly virus.

The sudden drop in business also has severe financial implications for health care providers as they weather the ongoing COVID-19 pandemic.

The report, from Harvard University researchers, shows outpatient visits across the country declined 60 percent in mid-March and stayed low through April.

Some appointments have moved to telemedicine — phone or video calls — but this makes up for just a small share of the decline in in-person visits.

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Hospitals and physician practices have canceled non-urgent appointments to promote social distancing and prevent patients and staff from getting infected with coronavirus — but many in the health care industry now worry that even patients with urgent problems are avoiding care.

Leaders of the Commonwealth Fund, a New York health care foundation that published the new data, called the numbers startling and said they indicate the broader health of Americans is at risk.

Dr. Ateev Mehrotra, an associate professor at Harvard Medical School, and his colleagues analyzed data from Phreesia, a technology company that serves medical practices. He said the findings raise “a bunch of red flags”: If people with chronic illness are avoiding the doctor, they may become sicker and eventually need to be hospitalized, he said.

“People aren’t going to the doctor now," he said "Patients are scared to go in, as well as doctors are discouraging it.”

This also means financial pain for health care providers. “You can understand why so many outpatient practices are really suffering financially, and why they’re laying off people, as well as cutting salaries and cutting benefits,” Mehrotra said.

Hospital leaders have also reported a sharp drop in visits to emergency departments, another sign that people are avoiding needed medical care because they’re afraid to rely on the health care system during the pandemic. Massachusetts is a national hotspot for coronavirus, but state officials and health care providers say they’re still able to care for patients who need to be seen — for coronavirus or other serious issues.

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“The purpose of all that surge planning and response was to ensure that our health care system would not be overrun,” Governor Charlie Baker said at a press briefing Thursday. “People should still call their doctor to talk about their health needs and go to the hospital if they have an emergency.”

Doctors who normally see patients in their clinics have ramped up telemedicine in recent weeks, trying to care for patients virtually. But this accounts for just 15 percent of all the visits that were happening before the pandemic, Mehrotra said.

The sharpest declines in patient visits were in the specialties of ophthalmology, otolaryngology, dermatology, and surgery. Behavioral health, obstetrics and gynecology, endocrinology, and oncology were less affected, according to the data.

Massachusetts Eye and Ear has canceled all non-urgent surgeries, procedures, and appointments, and doctors are seeing only patients who need time-sensitive treatment, such as those receiving injections for macular degeneration. The specialty hospital is just beginning to offer telemedicine visits, said spokeswoman Jennifer Street.

At the large medical group Atrius Health, which includes Harvard Vanguard, patient visits have plummeted 80 percent — and revenues are following, said Dr. Steven Strongwater, chief executive of Atrius. The company has furloughed 1,100 employees but is still open for patients who need to be seen. (Boston Medical Center and Tufts Medical Center also have furloughed workers in the past month.)

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Strongwater said Atrius staff are calling to check on patients whom they know to be sick and are treating patients virtually when possible.

Still, patients are delaying treatment.

“There’s been so much concern about contracting coronavirus that people have literally stayed away,” Strongwater said. “People are just making do. Whether they’ll have a long-term impact or not is really unclear.”


Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.