Readying Your Surgical Services for Population Health

Population Health News – NOVEMBER 2015

by Leon J. Owens, M.D., FACS

When preparing for the challenge of population health management, hospitals may overlook the impact of their emergency surgery services; however, it is critically important that administrators and clinicians take a hard look at what’s going on in the surgical suite. There is a perfect storm brewing that is already impacting patient care and hospital efficiencies. If not addressed, the problem can seriously diminish the success of a hospital in the delivery of population health.

There are four reasons why hospitals should conduct this analysis:

  1. There is an acute shortage of surgeons. In fact, more than 10 years ago, a Robert Wood Johnson Foundation (RWJF) survey found that two-thirds of emergency departments (EDs) do not have enough surgical call coverage to meet the demand for emergency surgical care.1 This has proven to be an ongoing problem that has only grown worse. A subsequent study by RWJF of on-call, specialty care found that three-quarters of EDs had inadequate surgical call coverage.2 What’s more, a shortage of 46,100 surgeons and medical specialists by 2020 are estimated.3
  2. The old system is broken. The traditional approach of engaging surgeons in private practice to take ED calls for emergency surgeries doesn’t work that effectively anymore. Most surgeons prefer to concentrate on their private practices and aren’t interested in taking calls in the middle of the night. Consequently, getting ED surgical call coverage often creates tension between hospital administration and a medical staff. In addition, with different surgeons treating patients on an ad hoc basis, there is variation in the delivery of surgical care…

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