• Joseph A Weiner, Peter R Swiatek, Daniel J Johnson, Philip K Louie, Garrett K Harada, Michael H McCarthy, Niccole Germscheid, CheungJason P YJPYhttps://orcid.org/0000-0002-7052-0875The University of Hong Kong, Hong Kong SAR., Marko H Neva, Mohammad El-Sharkawi, Marcelo Valacco, Daniel M Sciubba, Norman B Chutkan, Howard S An, and Dino Samartzis.
• Northwestern University, Chicago, IL, USA.
• Global Spine J. 2020 Aug 7: 2192568220949183.

Study DesignCross-sectional observational cohort study.ObjectiveTo investigate preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons.MethodsAO Spine COVID-19 and Spine Surgeon Global Impact Survey includes domains on surgeon demographics, location of practice, type of practice, COVID-19 perceptions, institutional preparedness and response, personal and practice impact, and future perceptions. The survey was distributed by AO Spine via email to members (n = 3805). Univariate and multivariate analyses were performed to identify differences between practice settings.ResultsA total of 902 surgeons completed the survey. In all, 45.4% of respondents worked in an academic setting, 22.9% in privademics, 16.1% in private practice, and 15.6% in public hospitals. Academic practice setting was independently associated with performing elective and emergent spine surgeries at the time of survey distribution. A majority of surgeons reported a >75% decrease in case volume. Private practice and privademic surgeons reported losing income at a higher rate compared with academic or public surgeons. Practice setting was associated with personal protective equipment availability and economic issues as a source of stress.ConclusionsThe current study indicates that practice setting affected both preparedness and response to COVID-19. Surgeons in private and privademic practices reported increased worry about the economic implications of the current crisis compared with surgeons in academic and public hospitals. COVID-19 decreased overall clinical productivity, revenue, and income. Government response to the current pandemic and preparation for future pandemics needs to be adaptable to surgeons in all practice settings.

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