Paycheck protection program distribution to otolaryngology practices during COVID-19

Introduction: The COVID-19 pandemic has been a financially challenging time for health care organizations with some ear, nose, and throat (ENT) clinics reporting about a 50% drop in completed scheduled ENT visits during the first wave compared with 2019. In this study, we assessed the economic impact of COVID-19 on otolaryngology practices by identifying businesses that received Paycheck Protection Program (PPP) funding from the Small Business Administration (SBA). Method: In December 2020 a cross-sectional study was conducted using publicly available data published on PPP loans greater than $0.15M by the SBA. Otolaryngology clinics benefiting from this funding were filtered using the following terms: “otolaryngology,” “otolaryngologist,” “sinus,” “head and neck,” “throat,” “ENT,” and “facial plastic.” The study criteria identified 481 clinics that met inclusion criteria following manual confirmation and duplicate removal. Loan amount, business type, geographic region, owner race, owner gender, and the number of jobs per business were recorded for each clinic. Chi-square analysis was performed to determine the significance (P < .05) of each characteristic. Results: There were significant differences in loan distribution based on business type (P < .001) and jobs reported (P < .001). Higher proportions of Subchapter S corporations (60.00%) received smaller loans of $0.15 to $0.35M than limited liability companies (39.13%) and corporations (51.69%), which generally employ more people. Similarly, 100% of loans ranging from $0.15 to $0.35M went to micro and small practices, whereas 33% of medium-sized practices received loans greater than $1M. All businesses employing greater than 250 people (n = 5) received loans of $2M+. Conclusion: This study suggests PPP funding was distributed equitably to applicant ENT clinics with larger clinics receiving larger loans.