Trauma surgery is the art of prioritization and efficiency.
When a patient comes to the emergency room, we have to quickly assess their injuries, prioritize those that are most critical, and work efficiently to stabilize them. Sadly, this already difficult job is about to be made even harder due to unnecessary and harmful cuts to Medicare payments.
This spring, I deployed to New York City to assist frontline healthcare workers by triaging COVID-19 patients at a hospital in the Bronx during the initial surge of cases. What I saw was physicians and surgeons of all specialties and from across the country coming together to help their fellow citizens in their moment of highest need.
Unfortunately, our nation’s surgeons and their patients are not receiving that same level of support from their federal government, which fails to understand how to prioritize during a crisis. Rather than stepping in to stabilize a situation, they are set to make it worse.
Under rules announced last month, the Centers for Medicare & Medicaid Services (CMS) is set to cut Medicare payments to surgeons across nearly all specialties, beginning on the first of the new year. For some specialties, surgeons will see payment reductions by up to 9%, which will deal a massive hit to medical practices across the country at a time when they are struggling to manage multiple crises at once. These cuts will hurt patients and reduce their access to quality care.
COVID-19’s strain on our health care is well known by now, but we are only scratching the surface of how deep and long lasting the impact will be.
A survey from the Surgical Care Coalition found that one-in-three private practice surgeons are concerned they will have to shut down due to the financial impact from the pandemic, including both the pause in non-emergency surgery as well as lingering patient fears preventing them from returning to surgical offices. The pause was the right thing to do. But we must also recognize how patients have been impacted by the widespread delay in preventative and emergent care, with untreated conditions left to fester until situations that could have been treated with a minor intervention will now require major surgery.
Not only are surgeons dealing with even more severe cases than before, but they must do so while balancing a budget with painfully reduced payments. In the long term, we are looking at severely limited access to surgical care as private practices go under, hospitals absorb rural physicians, and budget cuts lead to fewer and fewer working surgeons.
In the middle of the worst public health crisis in recent history, surgeons are being asked to run faster to stay in the same place. We are making it work right now, but come January 1, 2021, we are going to have to scramble to figure out how will operate with these huge cuts to Medicare payments.
America’s doctors and patients need Congress to intervene and prevent these cuts from happening. These cuts posed a serious threat even before the pandemic hit, but to implement them now would absolutely devastating to hospitals and physicians ability to provide care. Our most vulnerable patients will bear the brunt of the consequences. Now is this the time to be working to treat the damage to our health care system, not adding new wounds.
Read more about the effort to stop Medicare Payment cuts at surgicalcare.org.
John Zink, M.D., FACS is a trauma surgeon in the San Francisco Bay region. He spent several weeks in April volunteering in New York City during the surge of COVID-19.