Doctor: Elective surgeries need to return, or there will be a 'secondary health crisis'
Dr. Patrick O'Shaughnessy, executive vice president and chief clinical officer at Catholic Health Services, said "procedures that were elective are becoming emergent." Credit: Howard Schnapp
Multiple New York health system executives said they're optimistic hospitals will receive permission from the state to restart elective surgeries starting in the first half of May.
Waiting much longer could lead to devastating outcomes for patients dealing with serious ailments, including cancer and heart disease, executives said.
"Procedures that were elective are becoming emergent," said Dr. Patrick O'Shaughnessy, executive vice president and chief clinical officer at Catholic Health Services, which operates six hospitals on Long Island. "Colon cancer surgeries, joint surgery and cardiac procedures, in some cases, could be delayed. Now it has to be done, safely and effectively, or we will have a secondary health crisis."
In mid-March, as the COVID-19 pandemic escalated throughout metro New York, Gov. Andrew M. Cuomo placed a mandatory hold on what the state calls elective surgeries. On April 22, Cuomo said that ban was being lifted in areas of the state where large COVID-19 outbreaks have not occurred.
Downstate hospitals, including those on Long Island, have not yet been cleared to begin more procedures.
Resuming surgeries also will bolster the bottom line at hospitals. New York health systems said they expect to collectively lose more than $1 billion monthly during the height of the COVID-19 pandemic. Surgeries, along with ambulatory care, are major revenue streams for health systems. Commercial insurers pay significantly more for specialized care such as cancer than for COVID-19 patients.
Health systems are optimistic the state will loosen the reins. When it does, hospital leaders said they will be ready.
As the pandemic increased, Rockville Centre-based Catholic Health Services hired 85 nurses, and added registered nurses graduating from Molloy College's nursing program. Catholic Health also moved doctors and nurses from ambulatory offices to hospitals, and repurposed anesthesiologists to help with critically ill coronavirus patients.
"Now we are reshuffling the deck," O'Shaughnessy said. "We have no plans to downsize back to where we were before the third quarter. But we will redeploy them so they can help with the backlog of non-COVID patients."
New Hyde Park-based Northwell Health, the largest health system in the state with about 72,000 employees, is prepared to move nurses and doctors to support surgeries and ambulatory offices, and could do so quickly, said Dr. David Battinelli, the health system's chief medical officer.
Northwell Health owns and operates 19 hospitals, including 11 on Long Island, and also runs 780 ambulatory centers, 75% of which have been closed.
About 1,400 doctors and nurses at the shuttered ambulatory locations were sent to hospitals for support, and some have started to move back to prior roles, Battinelli said.
"As we feel we can adequately staff at hospitals without the additional support, we move support out," Battinelli said.
Battinelli added that displaced hospital units have started to return. For example, four Northwell obstetrical units that were temporarily relocated to make room for COVID-19 patients are now back to operating as they were before the pandemic.
At the height of COVID-19, mothers delivering — at Huntington Hospital, Southside Hospital in Bay Shore, the Katz Women’s Hospitals at North Shore University Hospital in Manhasset and Long Island Jewish Medical Center in New Hyde Park — were then transferred to postpartum units outside the hospitals to ensure the safety of the moms and babies, and to free up beds for COVID-19 patients.
NYU Winthrop in Mineola also expects to bring its labor and delivery postpartum area to the hospital, a spokesman said. It had been relocated to nearby ambulatory space. The ambulatory space at 777 Zeckendorf Blvd. in Garden City would then restart outpatient surgeries.
Winthrop's endoscopy unit is no longer being used for acute care, and is transitioning into an interim cardiac-cath recovery unit, in preparation to resume cardiac activities, NYU Langone spokesman Jim Mandler said.
"Despite these positives signs, NYU Winthrop continues to be challenged by the number of patients requiring ICU-level care," Mandler said.
NYU Langone expects to see an influx of patients who were afraid to get necessary care during the pandemic, said Dr. Andrew W. Brotman, executive vice president and vice dean for clinical affairs and strategy at the health system.
"We have a real concern that people stayed away because of fear," Brotman said. "In this environment, you can't guarantee to anyone that there won't be an exposure to COVID-19, but we are taking every precaution from PPEs to cleaning facilities.
"Quite frankly, if you have cancer or heart disease or need a medically necessary surgery, we believe we can do it safely," Brotman said.
Stony Brook University Hospital is also prepared to restart surgeries "because you can't keep people on pause forever," said Dr. Margaret McGovern, vice president for health system clinical programs and strategy at Stony Brook Medicine.
