To all of our colleagues:
The Washington State Orthopaedic Association (WSOA) wants to make sure you are aware of the AAOS COVID-19 Member Resource Center. The frequently updated page includes a variety of information, including: practice management resources, a telemedicine guide, regulatory updates, advocacy priorities and recommendations regarding elective surgery. In particular, we recommend reviewing correspondence from AAOS to congressional leadership. There is also a list of policy options for states to address COVID-19 that the AMA is compiling.
For a snapshot of state activity occurring across the country, check this Stateside COVID-19 State & Local Government Report. From activating retired physicians and licensure portability, to good Samaritan protections and seeking Section 1135 waivers, states are undertaking a variety of efforts.
Resources also include how distressed small businesses (like medical practices) can apply for loans from the Small Business Administration. Click here for a summary of the third COVID-19 Package, which just passed the House of Representatives and will soon be signed into law. Click here for the Small Business Administration loan programs one-pager that details what is available to small businesses and private practices at this time.
Below is the letter that the Washington State Orthopaedic Association sent to Governor Jay Inslee regarding ambulatory surgery centers.
March 26, 2020
Dear Governor Inslee:
With the rapid spread of COVID-19 cases our health care system will be facing an unprecedented surge in the need for urgent and emergent medical care in the coming weeks. The number of patients that will require assessment for respiratory illness and potential treatment and hospitalization could very easily exhaust our emergency medical resources, hospital and ICU beds and all the components required to manage this pandemic. To make matters worse, there is a national shortage of protective equipment that caregivers for that will need in order to protect themselves from being infected by this potentially deadly virus.
While this is going on, we will still see a number of medically “well” patients with injuries that will need care. These may include fractures, tendon lacerations and other injuries which may require urgent surgical treatment. Although this type of care can be provided in a hospital setting, it may be a more effective use of limited hospital resources to triage these patients to an ambulatory surgical center (ASC). ASCs have already distinguished themselves for the efficiency and low cost of care as well as excellence in safety and patient outcomes.
The Washington State Orthopaedic Association believes that outpatient surgical centers may well play a crucial role in providing needed care during the pandemic when hospitals are being strained to cope with the patients with viral illness. We believe that outpatient surgical centers should be supplied with necessary protective equipment (PPE) to allow them to accomplish that mission. We also believe that surgical centers should make maximal effort to conserve such equipment to the benefit of everyone in the health care system.
The American College of Surgeons addressed this in a March 13 document entitled “COVID-19: Recommendations for Management of Elective Surgical Procedures” by stating that during the COVID-19 pandemic hospitals may “shift elective urgent inpatient diagnostic and surgical procedures to outpatient settings when feasible.” The CDC has also made that recommendation.
WSOA is aware of several ASCs that have largely or completely shut down. There also have been reports of hospitals requesting that privately owned ASCs give up their PPE so as to maximize the hospital supply. While we understand the need for that equipment at the hospitals, we wish to remind that ASCs may well play a very important role in managing the upcoming crisis.
We would also suggest that “cohorting” healthy patients with musculoskeletal injuries at ambulatory surgical centers would decrease the likelihood of disease transmission by separating them from the hospital environment where COVID-19 patients will be screened and treated.
We appreciate your attention to this matter.
Nicholas Rajacich, MD, FAAOS
President, Washington State Orthopaedic Association
The Washington State Medical Association (WSMA), Washington state officials, and the state’s health care community have joined the Centers for Disease Control and Prevention in responding to an outbreak of respiratory illness caused by a novel coronavirus (COVID-19). Initially detected in Wuhan City, Hubei Province, China in December 2019, COVID-19 is now spreading in Washington state and other U.S. locations.
WSMA has a dedicated COVID-19 resource page that features patient and professional resources: www.wsma.org/covid19.
The ACCME has compiled a list of educational resources about COVID-19 for physicians, all of which include CME credit. The education consists of online courses, video, or articles, and most of these resources are free: https://accme.org/coronavirus-resources.
Due to recommendations from county and national health officials, the Regional Educational Outreach Program (REOP) in Spokane has been postponed to a date to be announced.
We are excited to announce that we will be holding our first Regional Educational Outreach Program (REOP) in Spokane on Tuesday, April 28. Please join us for dinner at Anthony’s at Spokane Falls for a lecture from Dr. Keith Mayo, “Evolution of Hip Preservation- a Long Term Perspective.”
Tuesday, April 28, 2020
5:30 – 8:00pm
Anthony’s at Spokane Falls
510 N Lincoln St
Spokane, WA 99201
About Keith Mayo, MD:
Dr. Mayo is an internationally recognized expert in the surgical management of acetabular and pelvis fractures and a pioneer in hip preservation surgery. He graduated from medical school and Orthopaedic surgery residency at the University of Washington and then pursued fellowship training with Professor Reinhold Ganz at the University of Bern, Switzerland in 1983. He worked with Dr. Ganz to develop the innovative techniques of periacetabular osteotomy to address acetabular dysplasia and the surgical hip dislocation for open treatment of FAI. Dr. Mayo had additional training in hip and pelvic fracture surgery with Professor Emile Letournel in Paris before returning to Seattle in 1984 to join the faculty of the University of Washington where he was Clinical Associate Professor at Harborview Medical Center. In 1995, he became a Professor in the Department of Orthopaedics at Wayne State University. In 2015, Dr. Mayo established the Hansjörg Wyss Hip and Pelvis Clinic at Swedish Medical Center where is the Medical Director.
The Washington State Orthopaedic Association is a membership-driven organization which represents the interests of orthopaedic surgeons and the patients with musculoskeletal problems whom we treat here in Washington. We are your advocates in Olympia both in the legislature and, sometimes more importantly, in the regulatory arena. We also serve as the “Boots on the Ground” representatives of the AAOS leadership so that the Academy is kept abreast of important issues here in Washington state, and that information about important issues that come up in other states or in Washington, DC is passed on to orthopaedic surgeons here at home.