Fear remains a factor: Safety cited as top reason for patients deferring care amid the COVID-19 pandemic

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders what were their patients’ top reason for deferring care amid COVID-19. The majority (87%) cited “safety,” 9% responded “job/insurance loss” and 4% reported “other.”

The most common “other” responses were:

• Bans on elective surgery amid the pandemic (31%)
• Unwillingness to comply with safety requirements (25%)
• Visitor restrictions in the clinic (19%)

The poll was conducted July 21, 2020, with 697 applicable responses. 

COVID-19 Recovery: Patient Engagement Flowchart

A source of truth in a time of misinformation

The knowledgeable and calming reassurance from trusted physicians, nurses, clinical staff and other employees likely suffered in the early months of the pandemic, due to lack of in-person visits or just being drowned out by a typhoon of voices. As noted by Tara Haelle, senior healthcare writer for Forbes, the uncertainty around COVID-19 was fuel for the fires of anxiety. 

By May, 75% of people reported not knowing anyone who had been infected with COVID-19, so any reactions and behaviors were based on indirect experience, according to market research done by Rob Klein, founder and chief executive officer of Klein & Partners. That means relying on the media, politicians and any number of sources, often with conflicting messages.

“There’s a level of frustration of, ‘I don’t know what to believe,’” Klein says. “Consumers are not really trusting those sources, so you as a provider — never before have you been this trusted.”

Learn more: How is the Coronavirus Impacting Healthcare Perceptions and Behaviors?

Pre-COVID-19, nurses and medical doctors represented two of the three most-trusted professions among Americans, per Gallup’s annual survey. As patients begin to return to clinics, practice leaders should remind everyone in the organization of what the Gallup poll confirmed: “Medical professions in general rate highly in Americans’ assessments of honesty and ethics, with at least 6 in 10 U.S. adults saying medical doctors, pharmacists, and dentists have high levels of these virtues.”

Communicating effectively to bring patients back

MGMA consultant Adrienne Lloyd, MHA, FACHE, chief administrative officer, Duke Eye Center, Duke Medical Center, recalls that during the Great Recession, the economic downturn had such broad impact on healthcare that “people started considering colonoscopy screenings to be elective,” despite the crucial nature of such screenings to catch serious issues before they worsen.

Lloyd said similar situations are occurring in hotspot areas of the COVID-19 pandemic in which practices are seeing a big drop in volume, even as states and cities reopen. “Part of that is probably fear of COVID, part of it is people have lost insurance,” Lloyd added. “Part of it is [patients] paying out of pocket or, if you haven’t met your copays, it seems like something I can wait until January to do.” 

JaeLynn Williams, CEO, Air Methods, noted on a recent MGMA Insights podcast that people still are facing life-threatening conditions — chest pains, drug symptoms, enflamed appendixes, gallbladders — yet “they’re all staying home out of fear.” 

“The main reason is that people just don’t know. They don’t know that they can and should get care, so I think the public communication, community outreach, those are really critical to get out there and to combat what I think is a really widespread misconception that the emergency department should be avoided,” Williams said.

Lloyd recommends these approaches in helping to win over reluctant patients:

• Communicate changes made to your physical clinic space, including what to expect upon arrival and any new processes for screening employees and cleaning the facility at regular intervals.
• Emphasize how social distancing guidelines are met in the office.
• If your practice has adopted a “just-in-time” patient rooming system (e.g., patients waiting in a car until they are notified via phone or app that the provider is ready to see them), let those patients know you have proactively taken steps to save them time.
• If your practice has reconfigured clinic flow to place highly trafficked rooms closer to the front of the office, let patients know that you have taken steps to minimize exposure from check-in to checkout.
• Emphasize which telehealth services are available, where applicable, to remind patients you can still see them if they are hesitant to come into the office.

Additionally, Lloyd recommends making sure a member of the care team is prepared to discuss these changes and answer patient questions to put a human face on your efforts, rather than relying solely on website, patient portal, email and other communication efforts.

Patient engagement best practices and sample scripts

MGMA Stat 

Would you like to join our polling panel to voice your opinion on important practice management topics? MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at: mgma.com/stat. 

Additional resources 

• MGMA COVID-19 Recovery Center — Operational resources and stories for responding to the pandemic 
• MGMA Stat: COVID-19 polls — Find the latest COVID-19-related MGMA Stat data stories 
• Insights podcast: “‘So where are they?’: Patient education, PPE critical as Americans delay care in droves”
• Access the MGMA COVID-19 Recovery Toolkit 
• MGMA Consulting