The Journal of the American Academy of Orthopaedic Surgeons
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On March 14, 2020, the Surgeon General of the United States urged a widespread cessation of all elective surgery across the country. The suddenness of this mandate and the concomitant spread of the COVID-19 virus left many hospital systems, orthopaedic practices, and patients with notable anxiety and confusion as to the near, intermediate, and long-term future of our healthcare system. As with most businesses in the United States during this time, many orthopaedic practices have been emotionally and fiscally devastated because of this crisis. ⋯ Because the authors represent some of the larger musculoskeletal multispecialty groups in the country, we are uniquely positioned to provide a framework with recommendations to best weather the ensuing months. We think these recommendations will allow providers and their staff to return to an infrastructure that can adjust immediately to the pent-up healthcare demand that may occur after the COVID-19 pandemic. In this editorial, we address practice finances, staffing, telehealth, operational plans after the crisis, and ethical considerations.
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The COVID-19 global pandemic presents a challenge to orthopaedic education. Around the world, including in the United States, elective surgeries are being deferred and orthopaedic residents and fellows are being asked to make drastic changes to their daily routines. ⋯ Educational tools in the form of web-based learning, surgical simulators, and basic competency tests may serve an important role. Challenges are inevitable, but appropriate preparation may help programs ensure continued resident growth, development, and well-being while maintaining high-quality patient care.
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J Am Acad Orthop Surg · Jun 2020
ReviewThe American Board of Orthopaedic Surgery Response to COVID-19.
The COVID-19 pandemic has disrupted every aspect of society in a way never previously experienced by our nation's orthopaedic surgeons. In response to the challenges the American Board of Orthopaedic Surgery has taken steps to adapt our Board Certification and Continuous Certification processes. These changes were made to provide flexibility for as many Candidates and Diplomates as possible to participate while maintaining our high standards. The American Board of Orthopaedic Surgery is first and foremost committed to the safety and well-being of our patients, physicians, and families while striving to remain responsive to the changing circumstances affecting our Candidates and Diplomates.
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J Am Acad Orthop Surg · Jun 2020
ReviewDepartmental Experience and Lessons Learned With Accelerated Introduction of Telemedicine During the COVID-19 Crisis.
Despite the use of digital technology in healthcare, telemedicine has not been readily adopted. During the COVID-19 pandemic, healthcare systems have begun crisis management planning. To appropriately allocate resources and prevent virus exposure while maintaining effective patient care, our orthopaedic surgery department rapidly introduced a robust telemedicine program during a 5-day period. ⋯ Between telemedicine encounters and necessary in-person visits, providers may be able to achieve 50% of their typical clinic volume within 2 weeks. When handling the massive disruption to the routine patient care workflow, it is critical to understand the key factors associated with an accelerated introduction of telemedicine for the safe and effective continuation of orthopaedic care during this pandemic. LEVEL OF EVIDENCE:: V.
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J Am Acad Orthop Surg · Jun 2020
ReviewRecommendations for the Care of Pediatric Orthopaedic Patients During the COVID-19 Pandemic.
The COVID-19 pandemic has necessitated modifications to pediatric orthopaedic practice to protect patients, families, and healthcare workers and to minimize viral transmission. It is critical to balance the benefits of alterations to current practice to reduce the chances of COVID-19 infection, with the potential long-term impact on patients. Early experiences of the pandemic from orthopaedic surgeons in China, Singapore, and Italy have provided the opportunity to take proactive and preventive measures to protect all involved in pediatric orthopaedic care. ⋯ General principles include limiting procedures to urgent cases such as traumatic injuries and deferring outpatient visits during the acute phase of the pandemic. Nonsurgical methods should be considered where possible. For patients with developmental or chronic orthopaedic conditions, it may be possible to delay treatment for 2 to 4 months without substantial detrimental long-term impact.