By Benjamin Schwartz, MD, FAAOS, fellowship-trained Adult Reconstruction Orthopedic Surgeon with an interest in healthcare technology and shifting paradigms of care delivery
On March 14th, the Surgeon General of the United States recommended that hospitals stop doing elective surgical cases in response to the growing COVID-19 pandemic. There is no one definition of what makes a surgery "elective," Generally, this means that delaying surgery will not make a noticeable difference in the recovery.
The decision was made after careful consideration of the impact COVID-19 was expected to have on the American healthcare system. The main reasoning was based on the following:
- Maintaining medical supplies.
- Complying with the ideal of "social isolation."
- Making sure enough hospital beds, nurses, and doctors are available to address the crisis.
While they had a choice, many hospitals, surgeons, and surgical centers decided to follow the Surgeon General's recommendation. Soon after, thousands of surgical procedures from various medical specialties across the country were postponed. It included common procedures like hip and knee replacements, routine hernia surgery, sinus surgery, and hysterectomies.
If your surgery was postponed, having a better understanding of what to do next can help with any fear and uncertainty.
What Is Elective Surgery?
The term elective surgery generally refers to procedures for non-life threatening conditions. Or when there isn't a time constraint. (As opposed to emergency surgery.) But otherwise, there isn't an agreed-upon definition of what is and what is not "elective" surgery.
It may be more helpful to think in terms of time-sensitive surgeries where waiting could negatively affect recovery. Versus non-time-sensitive operations, which delaying shouldn't cause harm. (Though a person may be living with chronic pain.) Ultimately, the decision regarding whether or not surgery is elective involves a complex decision-making process.
Common elective procedures include
- Hip Replacement
- Knee Replacement
- Carpal Tunnel surgery
- Arthroscopy (including shoulder and knee)
- Hernia Surgery
- Cataract Surgery
- Cosmetic Surgery
- Routine cardiac procedures (like EKG, regular stress test)
- Removal of non-cancerous skin lesions
- Sinus surgery
- Routine bladder procedures such as suspensions and cystoscopies
- Routine colonoscopy
What Can I Do After My Surgery Is Postponed?
First, contact your doctor's office to discuss if there are other options for treating your condition while waiting to hear back about rescheduling. There may be other treatments such as medications, injections, physical therapy (virtual or self-directed), or in-office procedures that can help keep your condition from worsening. And better manage possible pain.
Confirm with your doctor that delaying surgery will not impact your recovery. Most hospitals and surgery centers are still allowing urgent or time-sensitive operations. However, keep in mind that while you may believe your situation is urgent, most hospitals and surgeons are making the difficult decision to limit surgery to truly non-elective cases.
My Surgeon Is Still Doing Elective Surgery. Is It Safe?
The decision most likely took into consideration each facility's capabilities. Hospitals and surgery centers that are allowing elective surgeries have minimized the risk of exposing you to the coronavirus. If your surgery is still scheduled, there are steps you can take to help keep it safe.
- If you are experiencing any symptoms such as fever, cough, or shortness of breath, let your care team know. Do not show up at the facility.
- If you think you may have been exposed to another individual with COVID-19 symptoms or a confirmed case of COVID-19, strongly consider having your surgery delayed. Symptoms may not appear for days after your exposure. You should phone or email your care team to discuss this.
- Minimize the number of family members or visitors that travel with you to the facility. If possible, limit to one person only.
- When recovering at home, maintain recommendations regarding social distancing. While others may want to check on you during your recovery, doing so risks unnecessary exposure.
- Make sure you have everything you need for after-care at home before leaving the hospital.