What Is the First Step to Fixing Health Care? (See insert at page 4)
GENERAL SURGERY NEWS The Independent Monthly Newspaper for the General Surgeon
GeneralSurgeryNews.com
June 2020 • Volume 47 • Number 6
Many U.S. Hospitals Already In the Red—Then COVID-19 Hit
ABS Certification Linked to Fewer Disciplinary Actions
Rural Hospitals Particularly Affected; Will Government Relief Be Enough?
By JORDAN DAVIDSON
C
By ALISON McCOOK
C
OVID-19 has created a financial crisis for many U.S. hospitals, with no easy way out. The math is simple: During the pandemic, hospitals lost a huge source of revenue from elective surgeries while experiencing a dramatic uptick in costs, as facilities purchase more gear to cope with the surge of infected patients, some of whom are uninsured. “They are Continued on page 8
ertification from the American Board of Surgery is optional, but surgeons are incentivized to obtain it since many hospitals and insurance reimbursements require certification, making it a de facto requisite for many. Certification is not obtained easily, however: Doctors must pass both written and oral exams to demonstrate a thorough understanding of best practices and agility in various surgical situations. Now, a new study has shown that doctors who receive ABS certification are less likely to receive severe disciplinary actions against their medical license. The study, conducted Continued on page 19
Is Surgery Ready For Telemedicine?
Restarting Metabolic And Bariatric Surgery
COVID-19 Pushes Surgeons Toward Virtual Care
Surgeons From U.S., China Share Insights and Lessons Learned
By VICTORIA STERN
By KATE O’ROURKE
T
F
he coronavirus pandemic has transformed the use of telemedicine. Before COVID-19 hit, many surgeons did not consider remote visits an option because of poor reimbursement and concerns about HIPAA compliance. But shortly after the U.S. surgeon general and Centers for Medicare & Medicaid Services asked hospitals and health systems to postpone nonessential surgical procedures in mid-March, many surgeons found themselves in a difficult situation. “No one had much warning about COVID-19 or much time to prepare in an intentional way,”
or bariatric surgeons eager to resume a regular surgery schedule, the COVID-19 pandemic presents unprecedented challenges. During a recent American Society for Metabolic and Bariatric Surgery webinar, experts provided tips and advice for restarting metabolic and bariatric procedures. “We are still learning. Every single day, there is more information coming out, and it’s really important that if we think we know something, to keep our ears and eyes open because our collective knowledge and understanding are progressing so
Continued on page 18
J OURNAL WATCH
4 Summary of Recent Useful Studies ON THE SPOT
12 Dueling Debates in Colorectal Surgery OP IN ION
22 Teleflubbies By Linda Wong, MD
Continued on page 16
REPORT
Clinical Experience With a Non-Opioid Local Analgesic Alternative for Postsurgical Pain Management in the Ambulatory Setting See Insert at page 12
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OPINION
Pandemics and Epidemics What’s Been Plaguing Us By HENRY BUCHWALD, MD, PhD
“I wish it need not have happened in my time,” said Frodo. “So do I,” said Gandalf, “and so do all who live to see such things. But that is not for them to decide. All we have to decide is what to do with the time that is given us.” —J.R.R. Tolkien, ‘The Lord of the Rings’
O
ur time is the time of the COVID-19 pandemic. Daily, even hourly, we are besieged with statistical data, at times inaccurate because of an over- or underestimated variable; sensationalist journalism about an unpredictable death or an astonishing survival; predictions based on assumptions; Continued on page 20