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

Abstract 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 χ2 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 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.