https://www.latimes.com/politics/story/2020-03-24/coronavirus-outbreak-primary-care-doctors

The LA times is ahead of other news agencies in what's happening on the outpatient front. Between the lack of adequate PPE and greatly diminished cash flow for front line independent primary care/walk in care type clinics, we may see some closures putting even more strain on ED's at a bad time.

Corporately and hospital owned clinics found in urban areas should weather the storm much better.

Our volume is down 50% the last week. As is our staffing level.

I can't imagine the impact to self-employed surgical subspecialties. And hospital bottom lines.

Independent PCPs were already an endangered species, sadly. We have not done enough to encourage people to go into this field out of med school. The pay just isn't great compared to other practice options and student loan debt makes it that much more difficult to be successful.

Our outpatient surgical suites are completely shut down. Same-day surgery staff is being used creatively to help get them a few hours here and there, but for the most part will be using up their vacation time. For people who are already out or running low on PTO they are SOL. Similar things are happening in the regular ORs. A lot of staff are on paid leave until their balances run out, and at that point they're basically furloughed without pay.

A notice got sent out to regular hospital nursing and ancillary staff as well that they may see hours cut because of the loss of revenue and low patient census.

Our outpatient clinics are still open but I'm sure they are seeing less volume.

I'm headed in for lithotrypsy of a 9 mm kidney stone in 2 hrs. I can't wait to acquire my nosocomial coronavirus infection.

I've got Inpatient census down 25% and Outpatient activity down 60%, total revenue is down 33% for the hospital.

70% of our expenses are salaries and benefits, so we are burning cash at about $1mill per day right now.

There are going to be a lot of healthcare workers out of a job if this goes beyond April

Praying for you and all who are caring for you. God's protection cover you all. Let us know how you do. God bless you.

OK, I am not a medical person and I mean NO disrespect by this.

The governor is predicting such a medical shortage that he has authorized retired nurses and final year nusing students to work in hospicals. Couldn't the staff people who are nurses and any type of doctors work in hospitals if we get to the level they fear-all beds full.

I know people specialize. My niece is a high risk pregnancy practice RN. But that basic training is still there. Or have we become so specialzed that people don't have the ability to answer an all hands on deck need?

I cancelled all of my surgeries for the next 3 weeks. Any cases that I want to get posted have to get approved by the hospital or ASC's anaesthesiologist. I am an ENT, and our Academy sends out warnings every day about the high concentration of virus within the nasopharynx and the fact that we should be delaying any intranasal examination for as long as possible. Same with intranasal surgery (the microdebriders we use aerosolize as they simultaneously irrigate and suction) and to a lesser degree intraoral surgery. Patients frequently cough violently upon extubation, and as of yet there is no way to know who is Covid 19 positive or negative.

Yesterday, I had a patient come to the office with a suspected peritonsillar abscess. I had to inject his soft palate (I normally first spray lidocaine on it, then paint it with viscous lidocaine, and then inject it, but I couldn't do the first two). Between his trismus and the pain of the injection, the disease process' normal interference with clearance of secretions, and his natural gag reflex, he was gagging and coughing all over my. That was fun. I have two telemedicine visits on the schedule for the entire day.

Last week, I told everyone they should not be here if they feel uncomfortable working. My front desk person essentially walked out on Monday because she is afraid she will bring something home to her family. She did it in a fairly unprofessional way that upset the rest of my staff. One of my audiologists said yesterday that she was worried about working because she has lupus. She was seeing very few patients, mainly only servicing patients' hearing aides so they could stay at home and watch and listen to Fox News. We cracked open a bottle of wine and toasted her on the way out. Don't ask.

I am lucky in that I am a semi-old. I have a Medical Assistant who has been with me for 20 years, I WILL NOT let her financially suffer. But we are registering everyone with the Dept of Labor for Partial Unemployment Benefits under the Families First Act, or whatever it is now called. I am a solo practicioner. If I get sick, we are toast. If I stay well, I will just crack open the piggy bank and tap into my personal funds to keep the lights on. One of the groups I work with is furloughing a physician employee that has been with them for two years and hasn't become a partner, as well as an older ENT who works part time. I wouldn't be surprised if the younger person just bolts when the smoke clears. It isn't right that the Partners in the group, who are more able to weather the storm financially, do that to a young doctor with student loans, etc., off of whom they have so far profited. Just my opinion.

Some physicians close to retirement will see this as their exit sign, and some will be working longer than they thought they would have to work. A lot will probably seek refuge as an employee of a hospital or other group. That is the general trend anyway, especially among young doctors seeking their first job.

I was listening to Doctor Radio on XM Satellite Radio this am. The host was playing "Morning Has Broken" and waxing poetic about his Mom telling him, in his youth, "Today is the tomorrow that you were worrying about yesterday". I live in America. As far as I know, I am saturating 100% on room air. I brought in some food from home, and fully expect to eat it for lunch. I will get some exercise after work and be OK. And if I get sick, there are people I know and trust who will take care of me.

I am a dentist and for now, until April 21, we can't do anything but "emergencies". Meaning take out teeth and maybe some root canals for pain and infection. Will be very lean and mean and hopefully it won't go on much after that. All the hygenists are sent home until then.

I get it, I guess, but the whole thing behind "postponing elective procedures" is to free up hospital space. Me postponing a bunch of filling patients or our orthodontist closing down for a month (which he has) , IMO doesn't achieve any of this.

Contrary to what everybody and I guess the governor thinks, the average doctor/dentist who he is shutting down for a month does not have a big giant sack of money to live off of. We have people working for us who are being sent home and laid off if this goes much further.

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I live in America. As far as I know, I am saturating 100% on room air. I brought in some food from home, and fully expect to eat it for lunch. I will get some exercise after work and be OK. And if I get sick, there are people I know and trust who will take care of me.

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Hell of an attitude you carry, doc. Good luck to you.

Most hospitals nation wide are treating zero covid19 patients. Those in super hot zones in NYC are treating a few hundred at a time.

Even those hospitals in NYC have turned away more non-covid patient services (and revenue) than they have seen covid patients.

It's a double edged sword of the worse kind for the hospitals. Some are simultaneously dealing with a horrific clinical experience as their ICUs and vents are being overrun, while also facing the reality that their economic model is being crushed.