Becker's Hospital Review

28 CMO / CARE DELIVERY Hundreds more physicians died than expected amid pandemic By Ashleigh Hollowell J ust as COVID-19 led to a much higher number of deaths for the public than what would have been anticipated without the virus, during the same time physicians in the workforce saw more than 600 excess deaths among their profession. "Beyond the deaths directly attributable to the virus, we see the extended impact by quantifying the number of physicians deceased beyond what would have been expected under normal circumstances," Lindsey Carlasare, research and policy manager for the American Medical Association and one of the authors of the findings, said in a Feb. 7 press statement. Data from the AMA was used by researchers from Stanford (Calif.) University School of Medicine, University of Southern California in Los Angeles and the AMA itself to calculate the number of excess physician deaths between March 2020 and December 2021, finding 622 more deaths than expected. "Among all active physicians, excess deaths peaked to over 70 in December 2020 and then had a rapid monotonic decrease in 2021," researchers wrote. "ere was no statistically significant excess mortality aer April 2021" Despite the excess of deaths, researchers also found that "within all age groups, physicians had substantially lower excess mortality than the general population." What was found to help lower mortality rates included personal protective equipment use, vaccine requirements, infection prevention guidelines and sufficient staffing, according to the findings. Physician age was also a factor. e results are "not surprising," to some, including leaders like Connecticut state Sen. Jeff Gordon, MD, who also serves as the medical director of hematology-oncology at the University of Massachusetts Memorial Heath-Harrington and the council chair of the Connecticut State Medical Society. As a physician who has practiced for nearly 30 years, Dr. Gordon told Becker's in a statement that physicians' wellness physically and mentally is vital to pay attention to because "existing detriments upon physician well-being became exacerbated" during the pandemic. "As the COVID-19 crisis has become more manageable, hospitals should continue their efforts to promote physician well-being, not lessen them," he said. "It is a longitudinal effort. When the next health care crisis hits, these programs can then be ramped up to support physicians and others who work the front lines. If we do not support the well-being of physicians, then who will be there to take care of the patients in need of care?" n Why some hospitals are understaffing physicians By Mariah Taylor P rivate equity investors are taking over more medical staffing companies, leading to physician cuts being made in emergency rooms to save money and increase profits, NPR reported Feb. 11. More and more third-party staffing companies are deploying this cost-saving strategy: reduce physician labor and replace them with practitioners, such as nurse practitioners and physician assistants, who can perform many of the same tasks for less than half the pay. In a statement to Kaiser Health News, American Physician Partners — one staffing company who employed this strategy — said this is a way to ensure all ERs remain fully staffed, calling it a "blended model" that allows doctors, nurse practitioners and physician assistants "to provide care to their fullest potential." Critics of the strategy fear the quest to save money results in patients being left with lower quality of care and higher medical bills. "It's not just a simple question of if we can substitute physicians with nurse practitioners or not," Yiqun Chen, PhD, associate professor of economics at the University of Illinois Chicago, said in the report. "It depends on how we use them. If we just use them as independent providers, especially ... for relatively complicated patients, it doesn't seem to be a very good use." Private equity investment and the use of midlevel practitioners rose in lockstep in the ER, Cameron Gettel, MD, assistant professor of emergency medicine at Yale, said, and in the absence of game-changing research, the pattern will likely continue. Private equity companies pool money for wealthy investors to buy and flip business in three to seven years. Nearly $1 trillion in private equity funds has gone into almost 8,000 healthcare transactions over the past decade, according to industry tracker PitchBook, including buying into medical staffing companies. Three firms dominate the industry: TeamHealth and Envision Healthcare, both of which were bought by private equity firms, and American Physician Partners, which is 50 percent owned by a private equity firm. Critics worry the pressure to make big profits will influence life-or-death decisions that were once left solely to medical professionals. n

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