An Evaluation of Neurosurgical Practices During the COVID-19 Pandemic.

ABSTRACT Objective To understand how the COVID-19 pandemic has affected the neurosurgical workforce. Methods A survey consisting of twenty-two questions assessing respondent’s operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Results There were 457 respondents throughout the United States and Puerto Rico representing all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost half (49.1%) of respondents had to downsize their practice staff, office assistants, nurses, schedulers, etc. Overall, 43.6% of survey responders had experienced a decline in income, while 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic as compared to their colleagues. Conclusion The COVID pandemic will likely have a lasting effect on the practice of medicine. Our survey results describe the early impact on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume which leads to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.