Barriers to Providing Care
A range of barriers were reported in providing care during the pandemic. Most frequently noted were limited access to in-person visits and nonemergency testing reported by 74% and 66% of respondents, respectively. Provider fear related to the outbreak and concern for their own well-being was reported by nearly 30%, while lack of personal protective equipment (PPE) and financial considerations were reported by 25% of respondents. Technological problems for telehealth visits were noted in only 15% of respondents. Only 7% of respondents experienced no barriers in providing patient care during the pandemic. One respondent noted that between the pandemic and Centers for Medicare and Medicaid Services (CMS) cutbacks on EEG reimbursement, continuing practice appeared difficult.
Respondents also cited the following additional practice-related barriers to providing care: prioritization of COVID over nonurgent care; suspensions of epilepsy monitoring units (EMUs), vagus nerve stimulator implantations, and presurgical evaluation and surgery; reopening logistics; staff cuts; and clinic staffing (eg, childcare challenges and fear of exposure to COVID). Regarding when respondents expected to return services to pre-COVID-19 levels, the answers formed a normally distributed Bell-shaped curve between now and never, centered at approximately 6 months. Only 9% of respondents were not sure. Approximately 5% did not feel their practice would ever return to normal.