The Financial Impact of the COVID-19 Pandemic on Neurosurgery Practice in Spring 2020.

Caruso, James P; Swartz, Karin; Mazzola, Catherine; Ban, Vin Shen; Singh, Ravi; Eldridge, Cody; Schirmer, Clemens; Cheng, Joseph; Bauer, Andrew M; Steinmetz, Michael; Adogwa, Owoicho

BACKGROUND The COVID-19 pandemic has changed healthcare delivery across the United States. However, few analyses are specifically dedicated to quantifying the financial impact of the pandemic on practicing neurosurgeons. The authors present a survey analysis to address this need. METHODS The authors distributed a 19-question survey to practicing neurosurgeons in the United States and its territories. The questions evaluated respondents' assessments of changes in patient and procedural volume, salary and benefits, practice expenses, staffing, applications for government assistance, and stroke management. Responses were stratified by geographic region. RESULTS The response rate was 5.1% (267/5224). Most respondents from each region noted a >50% decrease in clinic volume. Respondents from the Northeast observed a 76% decrease in procedure volume, which was significantly greater than that of other regions (p=0.003). Northeast respondents were also significantly more likely to have been re-assigned to non-neurosurgical clinical duties during the pandemic (p<0.001). Most respondents also noted decreased salary and benefits however experienced no changes in overall practice expenses, and most respondents have not experienced significant reductions in nursing or midlevel staffing. These trends were not significantly different between regions. CONCLUSIONS The COVID-19 pandemic has led to decreases in patient and procedural volume and physician compensation despite stable practice expenses. Significantly more respondents in the Northeast region noted decreases in procedural volume and re-assignment to non-neurosurgical COVID-related medical duties. Future analysis is necessary as the pandemic evolves and the long-term clinical and economic implications become clear.