How has the pandemic affected patient demand across the big 3 specialties? Here's what 3 leaders say

The demand for gastroenterology, orthopedics and ophthalmology procedures is likely to rebound after the COVID-19 pandemic. In the interim, hospitals and surgery centers are addressing patient hesitancy issues as they look to rebound from significant losses accrued during widespread halts on elective procedures that occurred around the nation in the early months of the pandemic.

During the Becker's ASC Virtual Event on Sept. 30, three leaders discussed the future of orthopedics, ophthalmology and GI during a panel discussion. Participants were:

  • Mark Noar, MD, gastroenterologist and CEO Endoscopy Microsurgery Associates in Towson, Md., and CEO of the 3CPM Company
  • Rosario Ligresti, MD, chief of the division of gastroenterology and the director of the pancreas center at Hackensack (N.J.) University Medical Center
  • Lorraine Hutzler, associate program director at the Center for Quality and Patient Safety, NYU Langone Orthopedic Hospital in New York City

Below is an excerpt of their conversation. To view the whole discussion, click here.

Note: Responses have been edited for length and clarity.

Question: In 2019, the outlook for the future demand for gastroenterology, orthopedics and ophthalmology procedures was promising, with demand for orthopedics specifically expected to skyrocket. Industrywide, how has the pandemic changed patient demand trends?

Dr. Mark Noar: There is no question that we had been seeing increases in the number of cases due to a lot of the newer technologies that allowed us to bring patients in that we could not really count on in the past. But still we've seen some challenges and I think pandemic is going to result in some permanent changes such as telemedicine. Payers have realized telemedicine is the way to go into the future and I think they're going to probably start requiring providers to deliver it because it costs them so much less, which will leave physicians with a lot of brick and mortar facilities that they can't pay for and no longer need.

In the field of GI, because people couldn't get colonoscopies done amid COVID-19 surges, we've seen a great recognition that screening colonoscopy is not as beneficial as regular fecal immune testing done on a regular basis. This going to create downward pressure for GIs that rely heavily on colonoscopies for revenue.

Dr. Rosario Ligresti: We definitely saw a drop in patients for both screening tests and diagnostic tests. In my opinion, screening colonoscopy remains the gold standard. I don't think screening colonoscopy will go away 10 years from now, but recently a lot of other techniques have emerged as screening alternatives.

But if patients don't go to see their primary care doctors, they won't even have had the chance to go look at those kinds of techniques. At the end of the day, I think the biggest hurdle we face right now is getting patients in the door. Our patients are still nervous about what they're hearing across the country about having screening procedures or diagnostic tests. We've had patients come in with advanced colorectal cancers who've been going without care since February because of the fear of getting into the hospital and then dying.

Lorraine Hutzler: Telehealth has been key for us. Since the pandemic, we've had over 20,000 telehealth visits. That is an enormously significant increase from where we were before the pandemic. It's easier for our older patients. They don't have to commute into the city for follow up postoperatively — now we can do that over video. So that's something that we're very happy about and that we see as something to stay and something we can use to help reassure hesitant patients.

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