ABSTRACT
Introduction: The COVID-19 pandemic has upended regular otolaryngology practices in myriad ways. However, there remains a relative dearth of data quantifying the impact of this pandemic on the clinical and surgical volume of otolaryngology practices at large, urban, multicenter hospital systems. Method: The monthly totals of relative value units (RVUs), surgical cases, patient visits, and paid time off (PTO) in departments of otolaryngology were gathered from January to October of 2019 and 2020. Monthly and yearly values were compared using Wilcoxon signed-rank test. Results: RVU totals of 323,791 and 239,735 were performed from January to October of 2019 and 2020, respectively (P = .018). While overall surgical volume decreased significantly from 2019 to 2020 (6027 cases in 2019 vs 4181 in 2020, P = .008), this was largely due to a decrease in ambulatory cases (5148 vs 3383, P = .006), as inpatient surgical volume did not change markedly (879 vs 798, P = .323). Follow-up visits remained relatively constant (58,163 vs 47,802, P = .222), but significantly fewer new patients were seen (36,172 vs 24,545, P = .006). Increased prevalence of telemedicine visits compensated for the decrease in new patient visits in 2020 (6535 in 2020 vs 0 in 2019), yielding an overall insignificant change in total visit volume (94,335 vs 78,882, P = .192). Personal PTO precipitously declined in 2020 compared with 2019 (683 vs 192, P = .003), as did academic PTO, although to a lesser extent (233 vs 24 days, P = .01). Conclusion: Overall, RVUs decreased by 26% from 2019 to 2020, which is largely attributable to significantly fewer ambulatory surgeries and new patient visits during the COVID-19 pandemic. Increased utilization of telemedicine is a potentially lasting adaptation that has enabled providers to maintain patient care at a time when clinical volume is limited.