BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic dramatically altered the delivery of surgical care .
METHODS Members of the Southeastern Surgical Congress were surveyed regarding system adjustments, personal impact, and productivity losses . Subgroups were analyzed for disproportionate impact across practice models (academic/employed/private), practice communities (urban, suburban, rural), and practice case-mix categories (broad general surgery, narrow general surgery, specialty practice, hospital-based practice).
RESULTS 135 respondents reported that 98.5% of surgeons and 97% of hospitals canceled elective cases . Practices and hospitals reduced staffing dramatically . Telemedicine was utilized by most respondents . Hospitals variably implemented system changes, developed tests, and set up diagnostic centers . Most surgeons anticipated resumption of practice and hospital activity by July 1 , 2020 . More than one-quarter reported worsened financial status and personal well-being . Interestingly, family/personal relationships were improved in more than one-third . Most surgeons anticipate reduced year-end case volumes, clinical productivity, and salary . In subgroup analyses, academic surgeons were more likely than employed and private-practice surgeons to use telemedicine and to work in hospitals with in-house COVID-19 testing . Private-practice surgeons expected decreased financial status, case volumes, relative value units (RVUs), and salary . More rural surgeons anticipate reduced salary than urban and suburban surgeons . Surgeons in narrow general surgery practice reported more furlough of employees than specialty surgeons, hospital-based surgeons, and broad-based general surgeons . Narrow-practice surgeons and specialists were more likely to report RVU reductions and improved family/personal relationships .
DISCUSSION The COVID-19 slowdown affected surgeons throughout the southeastern United States . Variations between different practice models, communities, and case-mix categories may help inform surgeons in the future.