After CMS Administrator Seema Verma urged hospitals to cancel elective surgeries, many did and have shifted resources to treating COVID-19 patients.
But not all institutions have.
Sacramento-based UC Davis Health is one system where some elective surgeries, considered "essential surgery" are moving forward. Robert Szabo, MD, professor of orthopedics and chief emeritus of hand, upper extremity and microvascular surgery in the department of orthopedics at UC Davis said that some patients have been concerned with having their scheduled procedures, and those surgeries are rescheduled right away. However, others decide to move forward.
"Some have been waiting for surgery and are in a fair amount of distress and are grateful that we are willing to go ahead and treat them and they are informed of and claim to understand the risks involved," said Dr. Szabo.
If patients, staff or physicians show signs of a fever, cough, sneezing or not feeling well, the case does not proceed. All members of the care team and patients wash their hands frequently and keep visitors to a minimum.
"This is a day-by-day decision that may change at any time, particularly if we see that there is a need for resources," Dr. Szabo said. "We are carefully monitoring this and have contingency plans in place for resources including staffing. I think that it is important to distinguish that there are different kinds of 'elective surgery' and we try to make thoughtful decisions."
Robert Masson, MD, is keeping his practice in Orlando open as well. The Masson Spine Institute surgery center is a small facility and he will keep it open to cases for the moment. He also will continue performing cases at the NeuroSpine Center of Excellence at Orlando Health Central Hospital for inpatient surgical care.
"Most of my patients have severe neurological symptoms and pain and are pleading with us to stay open. I personally only see advanced level spine problems, whether they need a decompression only or a decompression reconstruction," said Dr. Masson. "This service policy that we are trying to maintain effects only those with severe functional consequence. Anybody with a routine, non-surgical problem we are not treating at this time. It remains outpatient electively scheduled stuff."
He reports that his volume and requests for service have almost doubled, and he strives to keep the facility and staff safe and clean.
"Anyone with a severe crisis, who is healthy, I am taking to the outpatient surgery center," said Dr. Masson. "Obviously, the nurses caring for the patients are in contact in a clean medical, barrier environment, one to one. No one else violates the three-foot recommendation and we are limiting each patient to one confidante/family member each. We have been focused on 360 degrees of care pathways for years, optimizing input and output of patients through the delivery system. Our patients turn over quickly, from facility entrance to facility exit, so overlap is not a problem. Much of that is fueled by preoperative education and pre-hab to ensure that they are ready for rapid recovery solutions."