As many states across the country have opened up, and the “new normal” becomes just “normal,” the number of elective surgeries taking place remains lower than the average pre-COVID-19. Despite assumptions that patients would be banging down the doors to get their surgeries rescheduled, this is not how things have played out. The reason is simple. Patients are afraid of contracting the coronavirus.
In fact, The American College of Emergency Physicians reported in April that 29% of adults had delayed or avoided medical care due to concerns about contracting the coronavirus.
This is still lingering in July and is yet another issue surgical practices are facing after a rocky road to recovery since the suspension of elective surgery. Even though the green light has been given and ORs and ASCs are open for business, patients are reluctant to schedule and reschedule surgery due to this fear. Practices now need to figure out how to encourage patients to feel confident to schedule their surgery.
The Return to Full OR Capacity Is Still Months Off
According to research by intelligence company GlobalData, CEOs of large healthcare networks believe elective procedure numbers will not return to pre-COVID-19 levels for another three to six months. And that is probably generous (without even mentioning the 2nd wave).
This was originally proclaimed due to the strict hygiene protocols implemented in ORs and ASCs, resulting in increased time needed to turn over an OR, and thus shortening potential operating time.
GlobalData also predicted a “surge” period in which hospitals will operate at 10–20% above their regular capacity to work through the backlog of delayed procedures caused by the pandemic. Hospitals are facilitating this by opening ORs on weekends and staying open later on weeknights.
However, these projections did not take patient fear into account. The question that now beckons is will there be enough willing patients to fill the vacant block time?
CMS and Hospitals Are Encouraging Patients to Seek Medical Care Before They Deteriorate
Many patients awaiting surgery are apparently faring much better than what their situation and their doctors would have predicted at other times.
According to cardiologist Dr. Sandeep Jauhar writing in the New York Times, most patients with “stable chronic conditions” seem to have done “okay.” Among possible reasons, he says, “Perhaps adopting healthful behaviors, such as smoking less and exercising more. Perhaps the huge increases in stress were balanced out by other things, such as spending more time with loved ones.”
But now that the panic phase of COVID-19 is over, patients should no longer postpone their surgery, especially for more serious issues. “Delaying care out of misplaced fear regarding the safety of hospitals may lead to more severe illness and more complicated care needs.”
That’s something also being encouraged by the Centers for Medicare & Medicaid Services (CMS), who are recommending patients return to medical centers to receive care that had been postponed.
Joining them are hospitals themselves, who have launched advertising campaigns in an effort to bring patients back through their sterile doors.
This push includes patients who are scheduled for elective surgery. Hip replacement surgery might not be a life or death procedure, but delaying it may cause more financial strain on the health system (and the patient) down the line due to deterioration. And that should outweigh the risk of contracting COVID-19.
How Surgical Practices Can Encourage Patients to Schedule Their Surgery
Many practices are still working through the backlog of surgeries, but are experiencing lots of pushback when calling patients to reschedule their surgeries. To encourage patients to reschedule their surgery, practices must explain that delaying surgery can have detrimental effects, and unfortunately, this virus does not look like it’s going away anytime soon. They should also mention the campaigns by the CMS and hospitals (listed above) to reinforce this.
Surgical schedulers should also take the time to explain what their practice, ASC, and/or the local hospitals are doing to ensure increased patient safety so patients feel safe seeking medical help. This should include mask policies, disinfecting procedures, and limiting numbers in waiting rooms.
Other Factors at Play
Healthcare providers must realize there may be other factors at play other than just fear. For those who have lost their jobs or some of their income, it might be that scheduling surgery is no longer a priority given the other financial demands.
For some, with kids home from school and no summer camps or daycare on the horizon, patients may be waiting for a more convenient time to think about rescheduling their surgery.
Then there’s the new way of living that we’re trying to get used to. According to Dave Ramsey, CEO and president of Charleston (W.Va.) Area Medical Center, patient volumes haven’t returned as quickly as anticipated and one reason could be as simple as the hospital implementing a no-visitation policy. People don’t want to be on their own after surgery, or even in the waiting room for that matter.
The Most Important Thing: Be Empathetic
No matter the risk — whether perceived or real — now is the time for increased empathy and sympathy. It’s the time for increased hand-holding, but it’s also a time for honesty. Although some patients will do just fine without immediate surgery, others will get worse and find their conditions increasingly affecting their quality of life.
Hospital staff, ASCs, and surgical practices are all doing their best to make entering their premises as safe as possible. While nothing can ever be risk-free, surgical practices need to put their best foot forward to ensure patients trust them and feel confident to enter their doors again. Patients listened when doctors asked them to stay home. Now patients need to listen when they are being asked to come back.