In the first half of 2020, ophthalmology, otolaryngology, gastroenterology and dermatology were among the hardest hit, according to an analysis of Medicare physician spending by the American Medical Association.
While Medicare spending recovered, it was still 12 percent less than expected by June 2020.
Over a year after the onset of the pandemic, some ASCs have yet to return to normal caseloads.
Five ASC leaders spoke with Becker's ASC Review about the specialties they see struggling to recover.
ENT
Otolaryngology saw a 28 percent drop in Medicare spending on physician services in the first half of 2020.
Ed Downs, RN, is the regional administrator for Northwest Surgery Center Red Oak in Houston and the Memorial Hermann Surgery Center in Conroe, Texas. He told Becker's ASC Review that ENT was the hardest hit at his facility, which he believes is due to "school and daycares being closed."
"Surgeries for tonsils and tubes are nonexistent," he said. "Our sinus procedures have increased; however, all of these patients are being tested prior to surgery and having to self-quarantine."
Paul Johnston, MD, owner of ENT Associates of Southern Indiana in Bloomington, also has seen a volume decrease that is "almost completely ENT related and pediatric in nature."
He said he thinks this decline comes from a combination of kids being at home instead of school and a reluctance to bring children into a healthcare setting.
Interventional pain
Garry Simmons, COO of Greater Victoria (Texas) Interventional Pain Associates, said his facility still is seeing a decline in office-based interventional pain procedures. He estimated a 10-15 percent decline in procedures performed since the pandemic began.
"Being an independently owned practice, we were able to shift hours and employees around without having to terminate or lay anyone off," he said.
This wasn't the case for his clinic's second location in Bellaire, Texas.
Victoria is in an underserved community, while Bellaire seems to have a "pain management provider on every city block." This led to a significant decline in cases and several layoffs at the Bellaire location, he told Becker's ASC Review.
Gastroenterology
Colonoscopies and other GI procedures also were hit hard by the pandemic.
Ashley Cunningham, RN, the center manager of York County Endoscopy Center in Rock Hill, S.C., told Becker's ASC Review that her facility still is experiencing a lower-than-usual case volume.
Her center only performs colonoscopies and esophagogastroduodenoscopies. Her case volume is still lower than it was two years ago, although minimally.
Wendy King, BSN, RN, the director of The Corvallis (Ore.) Clinic Surgery Center, also has seen a decline in her center's GI procedures.
"We used to do 60 percent GI and are currently doing half, which makes me wonder if patients are choosing to put off their colonoscopies," she said.
Ophthalmology
Ophthalmology was the hardest hit in the early stages of the pandemic, with a 29 percent drop in Medicare spending in the first half of 2020.
"Ophthalmology cases have been slow to respond," Mr. Downs said. "We are being told by our surgeons it is due to the logistics of getting patients to and through the office."