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Geospatial Mapping of Orthopaedic Surgeons Age 60 and Over and Confirmed Cases of COVID-19
Tarun K Jella1, Alexander J Acuña1, Linsen T Samuel1
1Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Insights
Older orthopaedic surgeons (≥60) are concentrated in COVID-19 hotspots, posing risks to this vulnerable workforce. This study analyzed the age distribution of U.S. orthopaedic surgeons and compared it to coronavirus disease 2019 (COVID-19) spread.
Area of Science:
- Public Health
- Medical Workforce Analysis
- Epidemiology
Background:
- Elective surgeries are suspended due to COVID-19, yet orthopaedic surgeons are crucial for acute care and COVID-19 patient support.
- Older populations face higher risks from COVID-19, making the age demographics of healthcare providers a critical concern.
- Previous research highlighted a significant proportion of older physicians across specialties, but the age distribution within the orthopaedic workforce remained unexamined.
Purpose of the Study:
- To map the geographic distribution of U.S. orthopaedic surgeons by age.
- To compare the age distribution of orthopaedic surgeons with other surgical specialties.
- To correlate the orthopaedic surgeon age distribution with the geographic spread of COVID-19.
Main Methods:
- Extracted 2018 demographic data from the Association of American Medical Colleges State Physician Workforce Data Reports.
- Identified the proportion of orthopaedic surgeons aged 60 and above and compared with other surgical specialties.
- Utilized Environmental Systems Research Institute geospatial data for COVID-19 cases and U.S. Census Bureau data for state boundaries.
Main Results:
- States with the highest proportion of orthopaedic surgeons aged 60+ (top quintile) include New York, New Jersey, California, and Florida, which were severely impacted by COVID-19.
- The median proportion of orthopaedic surgeons aged 60+ was higher than in most other surgical subspecialties, excluding thoracic surgery.
- The median number of practicing orthopaedic surgeons aged 60+ was 105.5 (interquartile range: 45.5–182.5).
Conclusions:
- This study presents the first age-focused analysis of the orthopaedic workforce during the COVID-19 pandemic.
- States with a higher concentration of older orthopaedic surgeons are experiencing significant COVID-19 burdens.
- Health systems must implement protective measures and workforce strategies to safeguard vulnerable orthopaedic staff providing essential care during the pandemic.
Background:
Although elective surgical procedures in the United States have been suspended because of the coronavirus disease 2019 (COVID-19) pandemic, orthopaedic surgeons are being recruited to serve patients with COVID-19 in addition to providing orthopaedic acute care. Older individuals are deemed to be at higher risk for poor outcomes with COVID-19. Although previous studies have shown a high proportion of older providers nationwide across medical specialties, we are not aware of any previous study that has analyzed the age distribution among the orthopaedic workforce. Therefore, the purposes of the present study were (1) to determine the geographic distribution of U.S. orthopaedic surgeons by age, (2) to compare the distribution with other surgical specialties, and (3) to compare this distribution with the spread of COVID-19.
Methods:
Demographic statistics from the most recent State Physician Workforce Data Reports published by the Association of American Medical Colleges were extracted to identify the 2018 statewide proportion of practicing orthopaedic surgeons ≥60 years of age as well as age-related demographic data for all surgical specialties. Geospatial data on the distribution of COVID-19 cases were obtained from the Environmental Systems Research Institute. State boundary files were taken from the U.S. Census Bureau. Orthopaedic workforce age data were utilized to group states into quintiles.
Results:
States with the highest quintile of orthopaedic surgeons ≥60 years of age included states most severely affected by COVID-19: New York, New Jersey, California, and Florida. For all states, the median number of providers ≥60 years of age was 105.5 (interquartile range [IQR], 45.5 to 182.5). The median proportion of orthopaedic surgeons ≥60 years of age was higher than that of all other surgical subspecialties, apart from thoracic surgery.
Conclusions:
To our knowledge, the present report provides the first age-focused view of the orthopaedic workforce during the COVID-19 pandemic. States in the highest quintile of orthopaedic surgeons ≥60 years old are also among the most overwhelmed by COVID-19. As important orthopaedic acute care continues in addition to COVID-19 frontline service, special considerations may be needed for at-risk staff. Appropriate health system measures and workforce-management strategies should protect the subset of those who are most potentially vulnerable.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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