Trends in Physician Supervision of Hyperbaric Oxygen Therapy, 2013 through 2022

Objective: To analyze Hyperbaric Oxygen Therapy Registry (HBOTR) data to determine physician productivity rates and understand the frequency of simultaneous patient supervision in the United States (US).

Methods: Deidentified electronic health record data from all payers were prospectively collected from the HBOTR from 2013 to 2022 and retrospectively analyzed. We estimated the mean number of yearly hyperbaric oxygen therapy (HBO2) treatments per physician per workday. We analyzed physician productivity by counting the number of physicians who administered fewer than two HBO₂ treatments daily on average and the ten most productive physicians.

Results: There were 262,055 HBO₂ sessions provided by 333 physicians at 53 facilities in 34 states from 2013 through 2022. The annual number of patients treated by all physicians, regardless of payer, increased by 51.4% from 2013 to 2019 (n = 736 vs. 1,160) before decreasing by 10.8% in 2022 (994). The mean number of treatments/workday/provider was 3.6 (SD: 3.4); 87.1% of physicians (n = 290) performed <two treatments/workday. Only two physicians (0.6%) performed an average of >8 treatments daily.

Conclusions: HBO₂ utilization has varied over time, but it markedly decreased in 2022, while practice patterns have remained consistent. Physicians across the US have consistently supervised ≤4 HBO₂ sessions per day on average over the ten-year study period. Simultaneous supervision of more than one hyperbaric patient is not a trend observed in the US, and it should not be the basis upon which physician work is valued.