gms | German Medical Science

Background and status of (inter)national research: During the Covid-19 pandemic, general practitioners (GPs) and other medical specialists in the ambulatory setting were suddenly confronted with a dynamic pandemic situation on the one hand and a struggle with administrative measures and patient demands on the other hand.

Research question and objective: The publicly funded study Covid-Gams (FKZ: 01KI2099) aimed to capture challenges in the provision of patient health care during the Covid-19 pandemic for physicians working in the outpatient sector in Germany. Further, organizational, interpersonal, and economic challenges of outpatient physicians were identified.

Method or hypothesis: A trend analysis in form of three cross-sectional online survey waves was performed and more than 18,000 outpatient physicians were invited. There were seven outpatient disciplines included: GPs, cardiologists, gastroenterologists, pediatricians, gynecologists, ENT-physicians, and dentists. The first survey wave covered the physicians’ experiences in March and April 2020 and was carried out retrospectively from July until September 2020. The second survey wave was conducted in November and December 2020 and the third survey wave from September until November 2021. Core items were queried in all three survey periods whereas other items were added or removed depending on the dynamics of the pandemic. This analysis shows results of items, that were queried in at least two survey periods.

Results: In total, 4,607 physicians participated in the three survey waves (1,703 in the first, 1,782 in the second, and 1,122 physicians in the third survey wave). GPs constituted the largest share of physicians (40%, n=1,838), followed by gynecologists (19%, n=860) and pediatricians (13%, n=582).

Concerning the provision of patient care, physicians reported that patients’ psychological stress had increased throughout the pandemic (72% in the second survey, 81% in the third survey). They further reported a deterioration of the patients’ physical condition due to a lack of exercise and an increase of obesity. With regard to organizational challenges, physicians reported much less utilization of disease prevention (76%) and follow-up (45%) appointments in November and December 2020 compared to pre-pandemic times. This share declined by autumn 2021 (22%; 10%). From an interpersonal perspective, physicians’ worries to infect themselves, relatives or patients with COVID-19 decreased throughout the pandemic.

Discussion: Generally, results show an adaptation of patient care to the Covid-19 situation. However, physicians see a deterioration in the patients’ health state.

Practical implications: The health status of patients has to be monitored closely to appropriately address patients mental and physical needs that may have worsened throughout the pandemic. Patients might have to catch up on disease prevention and follow-up appointments. Both will result in additional workload for outpatient physicians.

Appeal for practice (science and/or care) in one sentence: Outpatient physicians will have to focus on primary (Long-Covid) and secondary (increased burden of disease) consequences of the Covid-19 pandemic in the future.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc); 01KI2099