Mark Tantorski, DO, a spine surgeon with Premier Orthopaedics in West Chester, Pa., outlines best practices for the return to elective surgery and the technology that has helped his practice the most during the COVID-19 pandemic.
Note: Responses are lightly edited for style and clarity.
Question: What are your best practices for resuming elective surgery? Since the restart, what has worked and what hasn't?
Dr. Mark Tantorski: Resuming elective surgery over the past month has certainly been a challenging process. From the onset of the pandemic, social distancing, the use of personal protective equipment and telemedicine have all been shown to be very effective tools in allowing me to maintain contact with patients. As we move forward during the pandemic, there are two main factors I have looked at to determine scheduling surgical cases. First, is the urgency in the need for surgery. Individuals with relatively recent onset of neurologic impairment are a priority. Second, is the patient's overall health. Individuals with no comorbidities, who require little to no medical optimization prior to surgery, have also been scheduled for surgical intervention.
Q: What technologies have been the best time and money savers for your practice during the pandemic?
MT: Telemedicine has had a profound impact in both saving time and money during the COVID-19 outbreak. This has given me the ability to interact with a reasonable number of individuals over a shorter period during the day, requiring the office to be open for a shorter period of time, and with that, a decreased need for ancillary staff. As we begin to return to some normalcy, the use of telemedicine continues to play a role in my office hours.
Q: What strategies is your practice implementing to improve its financial standing?
MT: As with most businesses, our company was not immune to the negative financial impact of the pandemic. A small number of staff were furloughed and some had hours decreased, but we are currently back to full complement. As we trend toward normalcy, we have continued to implement safety strategies that, combined with rigorous screening and disinfecting protocols, have allowed us to significantly increase the numbers of individuals we see in the office while providing the patient a sense of security. We have received positive feedback from patients regarding these measures.
Q: What advice do you have for spine patients delaying surgery due to COVID-19 concerns?
MT: Delaying surgery due to the pandemic is quite reasonable. We have been able to monitor the degree of the outbreak in our area, which has allowed us to ensure the appropriate resources necessary and determine if the number of individuals contracting COVID-19 is increasing, plateaued or decreasing. As the numbers have plateaued in our area, additional factors — including the degree of pain or neurologic involvement as well as comorbidities — play a large role in determining when to proceed with surgery.