From Cancellations To Backlogs: Meeting Pent-up Surgical Demands

Cross Country Locums
June 29, 2021 02:45 AM (GMT-05:00)
CCL Trends

This is proving to be a year of extremities for surgeons and other professionals who support the surgical field – one with new challenges and big opportunities. The COVID-19 pandemic all but halted elective surgeries in the U.S. last year, resulting in an overall 35% decline in surgical volumes from March 2020 to July 2020.

When stay-at-home mandates went into effect shortly thereafter, emergency department visits declined by more than 40% in April compared to 2019, which may have led to fewer patients presenting with indications for surgical intervention.

While these factors led to declines in surgical revenue and drops in patient intake, the result is a backlog of necessary and elective surgeries and a return of higher revenue gains. For example, the Journal of Bone and Joint Surgery estimates a cumulative backlog of more than 1 million joint and spine surgeries by 2022. According to a recent survey by McKinsey & Company, even if hospitals were to operate at 10% above their baseline volumes, “around 20 months would be required to work through the pent-up demand from 2020.”

Cardiac & Orthopedic Backlog.

Heart surgeries among U.S. adults dropped by a dramatic 53% in the past year caused by the pandemic. The decline included 65% fewer elective surgeries and 40% fewer nonelective surgeries, with all types of heart operations experiencing a decline, including coronary artery bypass grafting, aortic or mitral valve replacement, a combination or something else.

The postponement of elective surgeries also greatly impacted the orthopedic surgery sector, with a projected backlog of more than 1 million orthopedic surgeries in the U.S. Meanwhile, orthopedic surgeons generate the fourth-highest revenue for hospitals and on average, bring in $3.29 million every year.

With the combination of high surgical demands and the dependency on specialized surgeons to meet those demands, the biggest challenges facing healthcare organizations and practices is a lack of available talent and the possibility of provider burnout.

Surgical Professions in Short Supply, High Risk of Burnout.

According to the recent McKinsey survey of healthcare executives, the biggest factor in meeting the pent-up demand for surgical procedures will be workforce availability, followed by inpatient bed availability and OR room capacity.

This isn’t surprising given the U.S. was already facing a projected shortage of physicians, particularly among surgical specialties. In fact, by 2033, there is a projected shortage of between 17,100 and 28,700 physicians in surgical specialties. One of the biggest drivers of these shortfalls is the aging and retirement of surgical physicians, with 58% and 60% of orthopedic and thoracic surgeons over the age of 55, respectively.

With too few surgeons available to meet pent-up demand, there is a real concern of physician burnout. This concern is heightened given that 60% of healthcare executives plan to extend typical hours of operation each day to increase surgical throughput. Without careful staff planning and adequate resources, hospitals and facilities may face higher burnout levels which can then lead to more medical mistakes.

Innovative Staffing Can Solve Demand & Burnout Issues.

For healthcare organizations facing staffing shortages or provider burnout, there are several alternative staffing solutions to consider as a way to help the facility meet surgical demands in the immediate and long term.

One way to maintain continuity of surgical procedures and scheduling is to bring in locum tenens surgeons who can support the permanent surgical team with backlogged or pent-up demand for services. Not only does this approach help to meet patient demand and maintain revenue generation, but it can help build flexibility and variability into costs, utilizing locum tenens staff as needed based on demand fluctuations.

Another solution to consider is to engage physician assistants (PAs). These specialists can work as surgical first assists in a number of subspecialties, ranging from general surgery to cardiology, orthopedics and more.

PAs are widely viewed as part of the solution to the country’s physician shortage. In fact, according to recent data, two of the highest PA-per-physician ratios were occupational medicine at 621 PAs per 1,000 physicians and orthopedic surgery at 537 PAs per 1,000 physicians.

In addition, the COVID-19 pandemic caused a rise in the use of telemedicine and it pointed to a need for remote treatment options across a broad range of specialties – including surgery. Robotic surgical tools like the da Vinci and Ion are offering new alternatives to surgical teams to remotely perform surgery. PA first assists are trained on various technical skills including the use of the da Vinci Robotic Surgical system, which according to research have shown lower patient stress levels and lead to better patient outcomes. As telemedicine and robotics play a larger role in the surgeon-patient relationship in 2021 and beyond, PA first assists will also play a more vital role.

As a trusted staffing partner to leading healthcare organizations across the U.S., Cross Country Locums continually monitors and analyzes key market dynamics of the surgery sector. To learn more about current labor trends for surgeons and PAs, download our latest Market Snapshot.

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