Stopping Elective Cases

[GassYous]

I heard it is starting again

---

Members don't see this ad.

 

[coffeebythelake]

I heard it is starting again

Starting or Stopping?
Starting to stop them?

 

[CopaceticOne]

Do you mean putting a hold on elective surgeries because of predicted hospital capacity due to COVID?

 

[vector2]

I'm in a top 5 covid state and I'm surrounded by just the dumbest fking citizens. Word is we're stopping elective surgeries requiring admission later this week.

 

[sevoflurane]

I'm in a top 5 covid state and I'm surrounded by just the dumbest fking citizens. Word is we're stopping elective surgeries requiring admission later this week.

Wow

 

[vector2]

Wow

Was just talking to a colleague, their hospital about 40 min from me canceled all elective surgery starting today.

 

[GassYous]

Heard kaiser is thinking of stopping surgeries requiring admission

This is so unnecessary. No wonder we can't do anything about worsening climate change or crumbling infrastruction, Americans can't even be bothered to get a tiny jab to save their own lives.

 

[pgg]

Wow

Did not see that coming

 

[deleted697535]

This is absolutely mindblowing

 

[Guillemot]

I wonder if more and more places will stop doing elective cases as the situation worsens or if one day, like a miracle, it will disappear.

 

[deleted875186]

I imagine it will be very selective, the day surgery and overnight surgical admissions will continue.

 

[narcotics999]

Heard kaiser is thinking of stopping surgeries requiring admission

This is so unnecessary. No wonder we can't do anything about worsening climate change or crumbling infrastruction, Americans can't even be bothered to get a tiny jab to save their own lives.

For Kaiser, the less it does, the more profit it makes.

 

[coffeebythelake]

I heard it is starting again

It may not just because of COVID.

We are currently in the midst of a massive nationwide blood shortage. At my hospital, there have been talks of postponing elective cases with potential for significant blood loss because of this.

 

[Blockit]

It may not just because of COVID.

We are currently in the midst of a massive nationwide blood shortage. At my hospital, there have been talks of postponing elective cases with potential for significant blood loss because of this.

That would not affect us at my current location because all of our surgeons assure us that they will not lose any blood. 🤣😂

 

[vector2]

I imagine it will be very selective, the day surgery and overnight surgical admissions will continue.

Day surgery will probably continue. However here our floor and ICU were already packed to the brim even before the cases started ticking up.

 

[nimbus]

Heard kaiser is thinking of stopping surgeries requiring admission

This is so unnecessary. No wonder we can't do anything about worsening climate change or crumbling infrastruction, Americans can't even be bothered to get a tiny jab to save their own lives.

While 30%+ of our population refuses the vaccine, other countries are begging for it. There is no justice.

 

[pjl]

I plan to push to continue electives regardless. If we must limit somewhat, I’m definitely going to try only doing vaccinated people.

 

[BobLoblaw78]

It may not just because of COVID.

We are currently in the midst of a massive nationwide blood shortage. At my hospital, there have been talks of postponing elective cases with potential for significant blood loss because of this.

Have you guys tried that “bloodless” surgery? I get asked about it every now and then.

edit: credit to blockit since He posted first and I should’ve read before hastily replying.

 

[DocVapor]

Day surgery will probably continue. However here our floor and ICU were already packed to the brim even before the cases started ticking up.

Vascular Surgeon:. "What do you mean I can't do my outpatient combined CEA, AAA, and Bilateral Fem Pop Bypass? My patients do so awesome that being in the hospital makes them worse!"

 

[vector2]

Vascular Surgeon:. "What do you mean I can't do my outpatient combined CEA, AAA, and Bilateral Fem Pop Bypass? My patients do so awesome that being in the hospital makes them worse!"

My favorite during the one of the COVID runs was a bariatric surgeon who was pleading with the periop director that his patients were just as emergent as the open fractures and STEMIs. Because if these chunkos were lost to followup after their surgeries were canceled then these patients would be subject to the scourge of continued diabetes and hypertension and OSA with no feasible way to cure these ailments. True story.

 

[thinkorswim]

Day surgery will probably continue. However here our floor and ICU were already packed to the brim even before the cases started ticking up.

Out of curiosity, what percentage of the population is fully vaccinated in your area?

Asking for a friend…

 

[ucladoc2b]

Vascular Surgeon:. "What do you mean I can't do my outpatient combined CEA, AAA, and Bilateral Fem Pop Bypass? My patients do so awesome that being in the hospital makes them worse!"

They do so well they always come back for more.

 

[coffeebythelake]

They do so well they always come back for more.

Repeat business is the best business

 

[Leon'sMom]

Day surgery will probably continue. However here our floor and ICU were already packed to the brim even before the cases started ticking up.

What % of your current census is Covid positive (for any admission reason)?

 

[Neopolymath]

No talk of stopping electives where I am but then again we didn't hardly shut down in the first place.

This would be a great time for hospitals and insurance companies to grow some balls and mandate the vaccine to receive service or prevent denial of claims. These ****ty insurance companies will deny a claim because of the dumbest things and yet they will pay out the ass for all this ridiculous covid care for these *******es?

 

[vector2]

Out of curiosity, what percentage of the population is fully vaccinated in your area?

Asking for a friend…

Somewhere between 35-40%.

 

[vector2]

What % of your current census is Covid positive (for any admission reason)?

25 hospitalized in an approximately 400 bed hospital. Doesn't include the PUI. We were down to almost nothing a couple weeks ago.

 

[fakin' the funk]

For Kaiser, the less it does, the more profit it makes.

A) applies to literally all insurance
B) still gotta do a minimum amount of service to keep folks on that insurance plan

 

[Ezekiel2517]

I'm in the SF Bay Area, a region w/ a high vaccination rate, and the ICU's in the hospitals I go to are packed w covid pts.

 

[nimbus]

I'm in the SF Bay Area, a region w/ a high vaccination rate, and the ICU's in the hospitals I go to are packed w covid pts.

Same. My community has about a 70% vaccination rate. California “reopened” bars and restaurants on June 15 and they are packed. Since June 15, our hospital system COVID census has quadrupled but the numbers are still small. Same with another major health system in town. Currently our ICUs are packed with non-Covid patients. If COVID patients quadruple again, we’d be in trouble. As Dr. Wachter says, delta+relaxed behavior is a bad combo even with the vaccine.

 

[turnupthegas]

I can’t stomach another halt. Pay took a huge dip last year since electives dipped for a bit never came back full force where I am.

 

[coffeebythelake]

Big question is how many of these cases ij hospital wards and ICUs are unvaccinated vs. Breakthrough cases. That may determine the strategy going forward in terms of halting ORcases.

 

[GaseousClay]

The concern shouldn’t be just breakthrough cases but those that require hospitalization which is super low. So if SF has that huge vaccination rate then it’s a good thing. If vaccinated people are starting to get admitted to icu and dying then we are fkd.

 

[agammaglobulin]

The concern shouldn’t be just breakthrough cases but those that require hospitalization which is super low. So if SF has that huge vaccination rate then it’s a good thing. If vaccinated people are starting to get admitted to icu and dying then we are fkd.

Agree. 'New cases' is not as important as hospitalizations and deaths. Looking at Israels data, the vaccine doesn't prevent infection with delta variant but does still work well against preventing hospitalizations (88%) and severe illness (91%). Those are the metrics we should be watching more than 'new cases'.

 

[Ezekiel2517]

Big question is how many of these cases ij hospital wards and ICUs are unvaccinated vs. Breakthrough cases. That may determine the strategy going forward in terms of halting ORcases.

Essentially all are those unvaccinated

 

[secretasianman]

At the start of covid last year surgeons and pain docs were calling their cases pain emergencies. I think they truly believed what they were spewing. What a joke.

 

[Ronin786]

All this routine testing of vaccinated individuals is silly and a waste of resources. All it does is increase vaccine hesitancy (not that the *****s need any more excuses).

 

[anonperson]

Currently in Southern California.

Elective cases are going forward.

Numbers are increasing as well as admissions but almost exclusively in unvaccinated people. Also, patients are typically younger (30s and 40s).

I'm expecting mortality rate to be lower but these patients suck up a lot of resources in general.

 

[deleted875186]

At the start of covid last year surgeons and pain docs were calling their cases pain emergencies. I think they truly believed what they were spewing. What a joke.

I think truely acute disc herniations are appropriate. Would you rather cancel a 5 min LESI or have the guy show up in the emergency room due to pain when your trying to offload the ED.

 

[GassYous]

Currently in Southern California.

Elective cases are going forward.

Numbers are increasing as well as admissions but almost exclusively in unvaccinated people. Also, patients are typically younger (30s and 40s).

I'm expecting mortality rate to be lower but these patients suck up a lot of resources in general.

Why are they even being admitted?

 

[deleted875186]

All this routine testing of vaccinated individuals is silly and a waste of resources. All it does is increase vaccine hesitancy (not that the *****s need any more excuses).

I agree.

Makes no sense to cancel elective surgical cases. Cancel planned ICU admissions or big cases only.

I would agree with making vaccination mandatory to do an elective case, no testing.

 

[deleted126335]

At the start of covid last year surgeons and pain docs were calling their cases pain emergencies. I think they truly believed what they were spewing. What a joke.

They knew that it was bs. They get paid based on productivity/rvus. They are not blind or stupid.

 

[chessknt]

I think truely acute disc herniations are appropriate. Would you rather cancel a 5 min LESI or have the guy show up in the emergency room due to pain when your trying to offload the ED.

Lol if the Er is busy that guy is gonna sit in the waiting room until he leaves and never be seen. Don’t worry about the Er they triage garbage like that to lowest priority.

also last time I checked lesi has >0% chance of a complication resulting in hospitalization. Why should it get special treatment over any other elective procedure?

 

[fakin' the funk]

Big question is how many of these cases ij hospital wards and ICUs are unvaccinated vs. Breakthrough cases. That may determine the strategy going forward in terms of halting ORcases.

It's a big question, also an easy and obvious one

 

[anonperson]

Why are they even being admitted?

The two patients that I or my partners admitted are both pregnant and had trouble maintaining o2 sats. One is much better after being hospitalized for about a week but will likely get discharged on home O2.

The other is fat and its going to be another few days before she can go based on my best guess.

 

[deleted875186]

Lol if the Er is busy that guy is gonna sit in the waiting room until he leaves and never be seen. Don’t worry about the Er they triage garbage like that to lowest priority.

also last time I checked lesi has >0% chance of a complication resulting in hospitalization. Why should it get special treatment over any other elective procedure?

I guess because I classify severe pain as a less elective procedure.

If we are going to say a LESI for severe radicular pain is elective and we should cancel it, than maybe all labor epidurals should be canceled, after all they have a >0% complication rate, they prolong labor, they require more staff in the OB floor, and some people think there’s a trend towards more instrumented deliveries or even C sections.

I just think there are truely elective things like a hernia, joint replacement, etc, and there are less elective things that should be prioritized

 

[CopaceticOne]

I guess because I classify severe pain as a less elective procedure.

If we are going to say a LESI for severe radicular pain is elective and we should cancel it, than maybe all labor epidurals should be canceled, after all they have a >0% complication rate, they prolong labor, they require more staff in the OB floor, and some people think there’s a trend towards more instrumented deliveries or even C sections.

I just think there are truely elective things like a hernia, joint replacement, etc, and there are less elective things that should be prioritized

I know that my institutions utilize Elective Surgery Acuity Scale to guide go/no-go decisions for cases.

 

[chessknt]

I guess because I classify severe pain as a less elective procedure.

If we are going to say a LESI for severe radicular pain is elective and we should cancel it, than maybe all labor epidurals should be canceled, after all they have a >0% complication rate, they prolong labor, they require more staff in the OB floor, and some people think there’s a trend towards more instrumented deliveries or even C sections.

I just think there are truely elective things like a hernia, joint replacement, etc, and there are less elective things that should be prioritized

Why wouldn’t that logic also apply to severe pain from knee/hip osteoarthritis? Or cancerous growths? Or bad teeth that need to be extracted?

The preggos are already in the hospital is a key difference.

 

[deleted697535]

I guess because I classify severe pain as a less elective procedure.

If we are going to say a LESI for severe radicular pain is elective and we should cancel it, than maybe all labor epidurals should be canceled

Well isnt the evidence base for basically most interventional chronic pain procedures at best moderate and all tied to short term outcomes? Im not a pain guy in the slightest so apologies if im incorrect

Labor epidural patients are already in hospital beds so that's not really related is it? Plus their lobby group would shut down the hospital if anyone suggested that

 

[GassYous]

I guess because I classify severe pain as a less elective procedure.

If we are going to say a LESI for severe radicular pain is elective and we should cancel it, than maybe all labor epidurals should be canceled, after all they have a >0% complication rate, they prolong labor, they require more staff in the OB floor, and some people think there’s a trend towards more instrumented deliveries or even C sections.

I just think there are truely elective things like a hernia, joint replacement, etc, and there are less elective things that should be prioritized

Pain is never an emergency and most of your other points are not valid