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For America's doctors, the greatest public health crisis in a generation has been incredibly bad for business.
Eighty-one percent of physicians report that their revenues are still below pre-pandemic levels, according to a survey from the American Medical Association.
A separate survey conducted earlier this spring found that only one-third of primary care practices had enough cash on hand to operate for four weeks. These financial struggles could drive doctors into early retirement or other careers — and thus exacerbate our nation's existing physician shortage.
They also point to a significant, and often underappreciated, threat facing Americans. An alarming number of patients are afraid to seek routine care because of the pandemic. If this trend persists for many more months, until a vaccine is widely available, the long-term consequences for public health could be disastrous.
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The widespread reluctance to visit hospitals and doctors' offices is understandable, given that coronavirus cases — and deaths — are skyrocketing. But for many people, the risks associated with foregoing medical care are far greater than the risk of possible exposure to the coronavirus.
Consider COVID-19's effects on cancer screening. By the end of May, tests for breast cancer had fallen by nearly 90 percent across the country, while colorectal cancer screenings had dropped by more than 84 percent, according to the journal Oncology. Not surprisingly, cancer diagnoses were down by more than 65 percent in April.
Given the importance of early detection in treating cancer successfully, this drop-off in testing and diagnoses will almost certainly have grave consequences for patients in the months and years ahead.
In fact, a recent study in the British medical journal The Lancet estimated that COVID-related delays in cancer screenings in the United Kingdom will lead to an increase in the number of deaths from lung cancer within five years of diagnosis of between 4.8 percent and 5.3 percent. For breast cancer, these death rates are expected to rise between 7.9 and 9.6 percent; for colorectal cancer, they're projected to rise between 15.3 percent and 16.6 percent.
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Or take cardiovascular diseases. Hospitals across the United States have seen a reduction in the number of patients seeking care for strokes. An analysis of 97 hospitals in 20 states published this month found that stroke hospitalizations fell 39 percent in March and April of this year, relative to the same period in 2019.
The decline in hospitalizations is associated with higher mortality rates for these patients, the same study found. Deaths among those hospitalized for acute ischemic stroke rose by 41 percent.
There's also evidence that fewer heart-attack victims are receiving treatment. One study found that the number of patients who received the standard of care at nine U.S. hospital systems nationwide fell 38 percent in March — "after COVID-19," as the authors put it, compared to the monthly average in the 14 months "before COVID-19."
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Even emergency rooms are less crowded. An analysis published in JAMA Internal Medicine looked at health systems in five states — New York, Connecticut, Massachusetts, North Carolina, and Colorado — and found that ER visits fell between 41.5 percent and 63.5 percent between January and April.
Taken together, these data reveal the pervasive effects of COVID-phobia. But Americans shouldn't be afraid of getting the medical care they need; they should be afraid of what happens if they don't.
Of course, hospitals in some parts of the country are close to being overwhelmed with coronavirus patients. But that's not the case everywhere. And as the AMA survey reveals, many physician practices have plenty of excess capacity.
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All Americans — particularly those with serious health conditions — need to take precautions to minimize their risk of contracting the coronavirus every time they leave their homes. This includes wearing a mask, social distancing and washing hands thoroughly and regularly.
Postponing care until after the pandemic passes should not be among those precautions. In fact, doing so could pose an even greater risk to one's health than the coronavirus.
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