If you are in a business where costs are both fixed and high, but your number of customers is slashed due to government regulations and public concern about leaving the house, it may not be worthwhile to continue. In more heavy-handed states like California, thousands of restaurants went out of business. In some places, so did doctors.

In the early months of the COVID-19 pandemic, doctors faced reduced revenue, staff who stopped wanting to work, and decreased morale, according to an analysis of billing claims data. The work found that nearly twice as many family physicians stopped work in the early months of the COVID-19 pandemic compared to previous years.

The researchers found that 3.1% of physicians working in 2019 (385 out of 12,247 doctors) reported no billings in the first six months of the pandemic. Compared with other family physicians, a higher portion were aged 75 or older; had fee-for-service reimbursement; had a patient panel size of under 500; and worked less than other physicians in the previous year. The rate at which family physicians stopped working rose from an average of 1.6% for the years between 2010 and 2019 to 3% who stopped working in 2020.

The trend might be worrisome. As regulations and the costs of 'defensive medicine' to help prevent predatory lawyer behavior balloon, more and more family physicians at large groups like Kaiser are osteopaths, and even then it can be challenging to get an appointment. More M.D.s retiring early will erode confidence in medical care.

Caveats are that the data were only from Ontario, other regions may have lasted well, and the absolute number was still small.