INTRODUCTION
Initial uncertainty during the COVID-19 pandemic led most medical organizations to recommend postponing all nonessential visits.1 Unfortunately for patients with newly diagnosed skin cancers, many Mohs surgeries were included in this delay. With most procedures now resumed, it is possible to assess the impact of these recommendations.
An IRB approved 15-question survey was created to assess patient outcomes, practice viability, and physician sentiment. The survey was electronically sent to fellowship trained Mohs surgeons practicing in the United States six months after the onset of the pandemic. Data was collected using redcap software and analyzed using Fisher’s exact tests, with P<0.05 considered statistically significant.
A total of 303 surgeons completed the survey (73% response rate) with an average age of 46.3±10.6 years. Respondents were mostly in private practice (81%) and suburban settings (57%, Table 1). Over 80% of respondents noted a decline in case volume for at least 3 months (Figure 1). Average case difficulty increased following treatment delays for 68.5% of surgeons, and suburban/rural surgeons were most impacted (76.3% vs 59.6% in urban settings, P=0.027). Adverse outcomes following delays were common: 69% reported cases of local tumor spread, 49% reported cases of advancement in tumor stage, and 20% reported cases of regional or systemic metastasis (Table 1). Pandemic delays were felt to be overall harmful to patients (78% of respondents) and contributed to worsened emotional health and anxiety (76% of respondents). At the onset of the pandemic, 45% of surgeons were in agreement with practice restrictions (39% in disagreement). In hindsight, only 29% of surgeons now agree with initial recommendations (58% in disagreement, Table 1). Overall, 39% of respondents had a less favorable view of recommendations now than they initially did (versus 4% reporting a more favorable view). Private practice surgeons more often viewed these recommendations negatively initially (42.2% vs 25.9% in academics, P=0.03) and currently (62.8% vs 35.8% in academics, P<0.001).
Incidences of COVID infection were rare: 8 respondents (2.6%) reported cases of staff testing positive and 7 respondents (2.3%) reported cases of patients tested positive following their procedure. No further spread was reported in these cases. Each
An IRB approved 15-question survey was created to assess patient outcomes, practice viability, and physician sentiment. The survey was electronically sent to fellowship trained Mohs surgeons practicing in the United States six months after the onset of the pandemic. Data was collected using redcap software and analyzed using Fisher’s exact tests, with P<0.05 considered statistically significant.
A total of 303 surgeons completed the survey (73% response rate) with an average age of 46.3±10.6 years. Respondents were mostly in private practice (81%) and suburban settings (57%, Table 1). Over 80% of respondents noted a decline in case volume for at least 3 months (Figure 1). Average case difficulty increased following treatment delays for 68.5% of surgeons, and suburban/rural surgeons were most impacted (76.3% vs 59.6% in urban settings, P=0.027). Adverse outcomes following delays were common: 69% reported cases of local tumor spread, 49% reported cases of advancement in tumor stage, and 20% reported cases of regional or systemic metastasis (Table 1). Pandemic delays were felt to be overall harmful to patients (78% of respondents) and contributed to worsened emotional health and anxiety (76% of respondents). At the onset of the pandemic, 45% of surgeons were in agreement with practice restrictions (39% in disagreement). In hindsight, only 29% of surgeons now agree with initial recommendations (58% in disagreement, Table 1). Overall, 39% of respondents had a less favorable view of recommendations now than they initially did (versus 4% reporting a more favorable view). Private practice surgeons more often viewed these recommendations negatively initially (42.2% vs 25.9% in academics, P=0.03) and currently (62.8% vs 35.8% in academics, P<0.001).
Incidences of COVID infection were rare: 8 respondents (2.6%) reported cases of staff testing positive and 7 respondents (2.3%) reported cases of patients tested positive following their procedure. No further spread was reported in these cases. Each
