Specialists in private practice have been hit hard by COVID-19, with new Australian data revealing they are battling plummeting patient numbers, falling income and rising stress levels as a result of the pandemic.

More than half of private specialists have relied on the Federal Government JobKeeper scheme to support practice staff and one in 12 predict their practice could close or be sold in the next six months, according to new data from the long-running MABEL (Medicine in Australia: Balancing Employment and Life) survey.

A new report, The impact of COVID-19 on GPs and non-GP specialists in private practice, draws on an online survey of 2235 GPs and non-GP specialists conducted in mid-May to reveal the wide-reaching impacts of the pandemic on doctors’ workloads, income, stress levels and practice organisation.

Falling income

Four in five specialists reported their monthly income fell in May compared to before the pandemic, with the figure even higher among surgeons and anaesthetists (94%), due to the cancellation of non-urgent elective surgery across Australia.

One third of surgeons and anaesthetists said their monthly income was cut by more than 50%.

Patient numbers plummet

While 76% of specialists made use of using MBS-funded telehealth consults, almost four in five saw patient numbers drop. The average weekly patient load was just 35 patients in May 2020 – down from 56 patients per week reported in the 2018-19 survey data.

Only 7.1% of specialists reported an increase in patient numbers compared to before the pandemic.

Medicare data also reflect the reduction in patient demand, with a 34% fall in operations, a 43% fall in face-to-face attendances, and even after the introduction of new telehealth items, a 15% drop in total specialist attendances in April compared to March 2020.

The fall in patient demand saw specialists work less – an average of 35.4 hours per week in May 2020, compared to 41.9 hours per week reported in 2018-19.

Stress more common

However, stress levels increased, with 61% of specialists and GPs reporting feeling stress more often than usual between mid-April and mid-May.

Overall, 6.5% of specialists said they felt very financially stressed and a further 20.6% felt moderately financially stressed about their private practice due to the pandemic. Those in large private practices were the most likely to be affected by financial stress.

Concern over access to personal protective equipment (PPE) was also linked to higher stress levels, with around one-third of specialists dissatisfied with their ability to access PPE.

Changes in practice operations

The report revealed that many specialists changed the way their practice operates in response to COVID-19.

Just over half of (51%) reported their practice had applied for the Federal Government’s JobKeeper payment subsidy for their employees – compared to 18% of GPs.

Over half of specialists (53%) also said they had reduced the hours of work for practice staff, with 29.5% encouraging staff to take unused leave, and around 8% laying off staff.

Specialists also reported they had deferred payment on business loans (8.5%) and taken on additional loans/debt (11.8%) – more than double the rates reported by GPs.

Overall, 8.4% of specialists thought their practice might be sold or closed in the next six months as a result of COVID-19. Those aged 65 and over were the most likely to predict they might sell or close, suggesting the pandemic could bring forward some doctors’ decisions to retire.

As for the how doctors feel about the future, specialists were less pessimistic about patient demand bouncing back than GPs.

The survey found that 35% of specialists expected patient numbers to return to normal in the next six months, while 31% expected patient numbers to remain the same as now initially, then return to normal.

The report, prepared by Professor Anthony Scott at the Melbourne Institute: Applied Economic & Social Research at the University of Melbourne, concludes that there is no clear indication about if and when conditions will return to as they were pre-pandemic.

“As with other areas of the economy, the health sector faces some uncertainty about the near future. Changes in whether and how people interact with the healthcare system depends on how people respond to the lifting of lockdown measures in the short-term, but also the extent and duration of economic hardship caused by the pandemic in the longer term,” it says.

“The pandemic has led to new ways of working, organisation, efficiencies and models of care for patients. It will also likely accelerate some preexisting trends in the sector … though we face much uncertainty, new opportunities have also been presented to improve efficiency and health outcomes in the Australian healthcare system that should be embraced.”