Transition into the post-COVID era: Evolving physician practices and expectations

Recently, there has been growing speculation and conversation around various COVID-19 therapeutic and vaccine candidates, with communities looking forward to returning to “normal life.” However, it is also increasingly likely that what we return to will be a “new normal” in many ways. For many physician practices, changes presumed to be temporary just a few months ago may in fact become part of more permanent changes to their practice structure.

Throughout the pandemic, Charles River Associates (CRA) and our research partner Dynata have conducted a series of surveys to understand physician perceptions of the pandemic’s effects on their daily practice, including current and potential future changes. In the most recent iteration of this survey, we asked physicians about what they have seen in their practice recently and their expectations for the future. A total of 140 physician responses were collected, representing a mix of pulmonologists, oncologists, neurologists and urologists, with each specialty bringing their own perspective on the effects of COVID-19.

In this article, we focus on key areas of impact assessed from the perspective of healthcare professionals, including changes related to their practice environment, their prescribing patterns, and their target patient population. Overall, 84% of all physicians surveyed anticipate there will be changes in the way they practice post-COVID-19, citing likely trends such as fewer in-person patient visits and fewer visits from sales representatives. As the pandemic plays out, societal habits and norms are shifting, and the impacts of these changes will likely permeate into healthcare practices across a range of specialties.

In terms of the practice environment, the COVID-19 pandemic appears to have accelerated the use of telemedicine, and most physicians (61%) reported that they expect reduced in-practice patient visits to continue even after the pandemic ends. Many physicians associate the trend of reduced in-person visits with the emergence of telemedicine and the convenience it provides to patients; some further note that patients may delay non-essential treatment or visits. In addition, some physicians (14%) believe that current control measures, such as the use of personal protective equipment, social distancing, and COVID-19 screening, will continue beyond the pandemic phase.

COVID-19 may also be affecting the way physicians prescribe medication – in our sample, 61% of physicians report they have adjusted their prescribing decisions due to the pandemic. This was mentioned most often by oncologists (77%) and least often by urologists (46%). Changes included shifting prescribing toward therapies that require less in-person contact and therapies with less frequent dosing. Specialty-specific nuances were reported as well – for example, oncologists most often mentioned prescribing therapies with longer dosing intervals (43%), while neurologists often noted a shift toward more established therapies (37%), potentially making it easier for them to manage adverse events or titrate therapies.

Physicians are also adjusting to the impact of COVID-19 on their target patient population, including patient anxiety and personal finances. More than half of the surveyed physicians reported higher patient anxiety due to COVID-19, and most pulmonologists (77%) and oncologists (66%) also reported that patients often contact them with COVID-19-related concerns or questions, further reflecting these patient concerns. Financial anxiety is likely exacerbating patient anxiety. Many physicians reported seeing an increase in issues related to financial difficulties among their patients. For example, physicians noted financial issues such as:

• patients discontinuing or skipping medications due to cost (45% of physicians);
• patients no longer being able to afford prescribed medications (41% of physicians);
• patients losing insurance (e.g., through non-employment) (40% of physicians); and,
• patients requesting cheaper medications such as generics (35% of physicians).

As the pandemic’s toll on the economy continues, physicians will likely see themselves having more difficult conversations with their patients surrounding medication management and affordability. Being aware of these trends can help physicians prepare their practices to better address such issues. For example, practices may collaborate with pharmaceutical companies to make it easier to help patients find and enroll in financial support programs.

Patients are not the only ones experiencing financial difficulties as a result of COVID-19. Physicians in our survey are also worried about their own financial standings, with 60% of urologists and nearly 50% of oncologists and neurologists concerned about changes in their own professional compensation. About 33% of urologists and 25% of neurologists are also concerned about the financial health of their practice, with worries about potential layoffs or even a shutdown of their offices. Not surprisingly, with the daily number of new COVID-19 cases remaining high in the U.S., pulmonologists appear to be least worried among survey respondents about financial risks to themselves and their practice, with only 23% reporting concerns about their professional compensation. Shifts in patient habits (such as delaying treatment) due to the pandemic are likely contributing to physician concerns regarding practice profitability and wages.

As physicians look to adapt to the new environment, education from and communication with pharmaceutical companies and other industry stakeholders is a key element to consider. Many physicians expect to make significant changes in how they source information to optimize treatment of their patients. Based on our survey findings, 44% and 64% of physicians expect to use sales representatives and in-person conferences less often, respectively, as sources of medical information. Respondents expect to more often review articles published in peer-reviewed journals (43%) and websites (46%) to gather new information that can help them in practice. This shift in channels provides an opportunity for other pharmaceutical industry professionals aiming to communicate with physicians to optimize their approach for physician convenience and comprehension.

Overall, our survey findings highlight some key changes in physician practices as a result of COVID-19 and demonstrate ongoing shifts in daily practice. In recognition of potential systemic changes in the delivery and access of healthcare services, physicians will continue to adapt their practices to the new environment to address both internal and patient concerns. Acknowledging and preparing for these trends can better position healthcare professionals and their practices to succeed in the post-COVID-19 era.

Kristen Backor, PhD, has been designing, conducting, and executing market research for over 15 years. Backor’s business consulting engagements focus on customer insights work, including qualitative and quantitative market research with a variety of stakeholders (from consumers to physicians). In her capacity as Head of the Market Research Center of Excellence at CRA, she provides guidance and oversight for projects concerning customer insights and qualitative and quantitative research assessments.

Billy Wang is an Associate at CRA who has been helping clients define COVID-19 focused strategies since the beginning of the pandemic. Billy also has primary market research experience in the fields of oncology, lung, and neurological diseases. Prior to joining CRA, Billy has had two years of industry experience and holds a Master of Science degree from MIT.

The views expressed herein are the authors’ and not those of Charles River Associates (CRA) or any of the organizations with which the authors are affiliated.