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The Impact of Delaying Elective Surgeries

Fri, December 03, 2021 9:30 AM | Babette Atkins (Administrator)



By John DiPreta, MD, President, New York State Society of Orthopaedic Surgeons

Governor Hochul’s order to begin limiting certain surgical procedures is well-intended policy that unfortunately may do more to increase the suffering of New York’s patient population. The intent of the order is to reserve hospital capacity for potential COVID patient surges. However, as a blanket policy, it fails to consider and incorporate several critical factors.

“Primarily, it’s important to challenge the notion that certain procedures are ‘elective’ — a term that often is misunderstood to indicate that such procedures are ‘optional’ and therefore not critically important to a patient’s health and well being. For many patients, orthopaedic surgical procedures are essential interventions that resolve profound pain and debilitation that undermine both the physical and mental health of those who suffer.

“Unfortunately, due to policies earlier in the pandemic that prohibited ‘elective surgeries,’ and despite enhanced safety protocols and progress in the fight against COVID-19, thousands of patients in New York State with debilitating pain were not allowed to receive treatment, and were also hesitant to engage or re-engage with the healthcare system resulting in delays to care. These delays in surgeries and procedures ultimately resulted in prolonged pain and suffering, significant medical deterioration, and materially impacted patients’ prognoses, morbidity and/or treatment plans. It is important the Legislature, the Executive and regulatory partners understand how detrimental framing ‘elective surgeries’ as optional interventions has become for patients.

“Secondarily, the order unintentionally sends an erroneous signal that accessing healthcare of any kind presents a danger to the patient. Providers have instituted broad and effective COVID-19 protocols that have resulted in demonstrably safe access to care. Nevertheless, we saw volumes across many service lines, including primary care and chronic disease management, fall off significantly as the pandemic evolved. Thousands of seriously and chronically ill patients stopped or limited their pursuit of care vital to their lives and livelihoods. That cost has yet to be fully measured or understood, and should not be exacerbated.

“Lastly, as a blanket state policy the order is generally unnecessary. Providers and hospitals are most knowledgeable about their patients’ needs and their communities’ status and needs, including relative to COVID-19. They should be the ultimate decision makers regarding the appropriate site of service for their patients, keeping in mind quality, safety, and associated risks. With state guidance and coordination, hospitals and ambulatory surgical facilities can best determine the appropriate level of elective cases that can be performed while also maintaining pandemic response readiness.”


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