The Role of Surgeons in the COVID-19 Era

By Jonathan Springston, Editor, Relias Media

Elective surgical procedures may be off the table during the COVID-19 pandemic, which puts the owners and employees of certain ambulatory surgery centers (ASCs) in a tough spot. But there are options.

In late March, the Centers for Medicare and Medicaid Services (CMS) eased certain regulations, allowing Medicare-enrolled ASCs to convert to hospitals that can provide inpatient and outpatient services. The Accreditation Association for Ambulatory Health Care (AAAHC) notes if an ASC decides to go this route, the facility still would have to meet hospital conditions for participation regarding pharmaceuticals, nursing, respiratory services, and infection control (regulations CMS has not relaxed).

“When converting to hospitals, it is imperative that ASCs determine the scope of services and agree on an accepted level of acuity before converting,” Niraja Rajan, MD, associate professor at Penn State Health, Anesthesiology, and Perioperative Medicine, said in a statement. “Additionally, ASCs should complete a gap assessment, consider space planning, and identify key personnel and roles.”

Similarly, the AAAHC says ASCs could contract with a local hospital, which would allow the hospital to use the ASC space for certain purposes. For ASC leaders who do not feel safe keeping their facilities open, or for those who operate in states in which converting to a hospital is inconsistent with local emergency preparedness plans, a third option may be temporary closure. While closed, an ASC could lease or sell equipment and supplies to frontline facilities in need.

If an ASC operates in a community in which COVID-19 has not been prevalent, does it make sense to convert to a hospital, continue with business as usual, or close the doors until the crisis passes? In communities struggling with capacity, will local and state leaders allow ASCs to provide relief? If surgeons’ normal routines are interrupted (e.g., no more joint replacement procedures for the next two months), what role can they play during the crisis?

In the upcoming June issue of Same-Day Surgery, author Melinda Young will attempt to answer these questions and more. The issue will include a special feature with first-hand accounts from surgeons and ASC administrators on the ground in communities where COVID-19 has pushed everyone to their limits.

For much more Relias Media COVID-19 coverage, click here.