Surgeon General Urges Providers to 'Consider Stopping Elective Surgeries.' Hospitals Push Back.

AHA and other stakeholders say their "ability to respond to patients must not be prevented by arbitrary directives."

The nation's largest hospital associations are pushing back against a recommendation from U.S. Surgeon General Jerome Adams that providers "consider stopping elective surgeries" until the coronavirus threat subsides.

"Our ability to respond to patients must not be prevented by arbitrary directives," the American Hospital Association, the Federation of American Hospitals, the Association of American Medical Colleges, and the Children's Hospital Association said in a joint letter to Adams on Sunday.

"We are concerned about recent comments by government officials that could be interpreted as recommending that hospitals immediately stop performing “elective” surgeries without clear agreement on how we classify various levels of necessary care," the letter said.

The hospital lobby was responding to a tweet from Adams on Saturday that read: "Hospital & healthcare systems, PLEASE CONSIDER STOPPING ELECTIVE PROCEDURES until we can #FlattenTheCurve!"  

Adams, in turn, was responding to recommendations from the American College of Surgeons, which on Friday advised its members to "thoughtfully review all scheduled elective procedures with a plan to minimize, postpone, or cancel electively scheduled operations, endoscopies, or other invasive procedures until we have passed the predicted inflection point in the exposure graph and can be confident that our health care infrastructure can support a potentially rapid and overwhelming uptick in critical patient care needs."

In their letter to Adams, the hospital lobby acknowledged that the coronavirus crisis "may require the curtailment of the least critical or time-sensitive hospital services, but any curtailment must be nuanced to meet the needs of all severely ill patients."

"Our patients will be best served by carefully evaluating and prioritizing gradients of "elective" care to ensure that the most time-sensitive medically necessary care can be delivered by physicians and hospitals," the letter read.

Some health systems are already cancelling elective procedures until the coronavirus threat subsides.

Northwell Health announced on Monday that it will cancel elective surgeries and procedures in its hospitals, but added that the guidelines will not apply to emergency surgeries

"With appropriate screening of patients and when deemed clinically necessary, some planned cases will continue to be performed," Northwell CMO David Battinelli, MD, said in a media release. "Patient care that may appear routine could, if canceled, result in significant negative impact on our patients' health."

On Sunday, Atlanta-based Emory Healthcare announced that it would postpone all inpatient and outpatient elective surgeries for the next two weeks, or longer if needed.

"We are currently contacting all patients and their physicians to alert them of this decision and to offer our support during this time when their cases are being postponed," the health system said in a post on its website.

"While we adhere to the most stringent protocols to ensure infection prevention, we are taking this step to protect our patients and are working to support and preserve supplies, equipment and staffing for the most urgent and time-sensitive patient needs."

Dearborn, Michigan-based Beaumont Health announced Sunday that it "will begin limiting or reducing non-essential surgeries later this week, as the U.S. Surgeon General advised."

"As of right now, Beaumont will not require surgeons to cancel elective procedures on Monday, March 16. However, depending on the circumstances, we could start canceling non-essential surgeries beginning Tuesday, March 17," the health system said on its website.