Charlotte ER doctor Katie Golden put her NoDa home up for sale almost a year into the pandemic because she couldn’t afford the bills anymore.

“It’s crazy to not to have job security in the setting of the pandemic,” Golden, who’s been an attending in Charlotte since 2016, told me. “It’s never been so unstable as long as I’ve been a doctor.”

Why it matters: After a year in a global health crisis with packed hospitals, it seems counterintuitive that doctors would be struggling to pay their mortgages right now.

• But people have avoided emergency room visits for fear of the virus, and as patient numbers fell, hospitals lost money and cut staff, as the Washington Post recently reported.

What happened: Golden bought her home in 2018 based on an expected income. But as her hours were cut, she started dipping into savings to cover bills and eventually decided to sell. She took advantage of the current sellers’ market and moved into an apartment for more flexibility and a cheaper lifestyle.

Driving the news: Doctors everywhere are feeling the squeeze from reduced in-person patients. Thousands of private practices have shuttered, Post reports.

• One Mooresville-based primary care provider told WaPo: “I sink or swim depending on my revenue. There is no salary. You eat what you kill, and if you’re not bringing any money in, you’re not taking any money home.”
• A report by the American Osteopathic Association estimates two-thirds of doctors have lost income during the pandemic.

The state of play: Full-time ER doctors typically work 14-16 shifts a month. Golden planned to scale back to part-time in March 2020, expecting around eight shifts a month. Once the pandemic hit, she was only able to land 4-5 shifts during the few months.

“I essentially made no money and couldn’t pay my bills,” she said.

Golden said doctors have experienced “a baseline level of constant anxiety” throughout the pandemic, wondering if they’ll catch COVID-19, die from it, or transmit it to a loved one.

“Not really making money doing that is really hard,” she said. “Not because we want to buy expensive cars, but because we want to put food on the table and pay our mortgages.”

Not many ER doctors are salaried; most are paid on a performance model, Golden explained. And many graduate med school with between $200,000 and $300,000 in debt.

And in a pandemic, they treat everyone who walks through the door, whether the patients have insurance or can cover the bill or not.

• Some of that is expected, Golden said, and she considers it a privilege to help people. “But a lot of times it means we don’t get paid for our time and care.”

What’s ahead? Golden has picked up more shifts in recent months, but questions whether the impacts of the pandemic will be permanent, with the rise in tele-health especially.

“We’re questioning if there’s going to be a long-term shift in the way people utilize the emergency room,” Golden said.

Bottom line: Doctors have lost income during the pandemic, and may experience decreasing levels of income far into the future.