Elective Surgery Advisory Update
Dear Florida Orthopaedic Society Membership,

We continue to try to keep our members informed on the numerous announcements and challenges we all face as we stare down the COVID-19 Crisis.  The FOS Board of Directors met last week to continue to press forward in efforts to assist the membership. We hope you are receiving our daily briefings and staying updated with all of the resources on our webpage:  https://www.floridaorthopediccommunity.com/43COVID-19ResourcesandUpdates

One of the major challenges we face is Executive Order 20-72 from Governor DeSantis to discontinue non-essential medical procedures in the State through May 9th.  A copy of that Executive Order can be found here

In an effort to provide our members with some guidance on how to deal with the Executive Order 20-72, the Florida Orthopaedic Society Board of Directors has voted to endorse the American College of Surgeons Guidance COVID-19 Guidelines for Triage of Orthopaedic Patients . This document may serve as a useful resource and documentation as you consider what cases to be performed or postponed and if you serve on a medical executive committee for your hospital or surgery center.


Below is the latest guidance we have received from AHCA on the limitations and implementation of the Executive Order. This was shared by the Florida ASC Society.
I am in receipt of your question concerning neurodiagnostic testing.
 
Executive Order 20-72 states:
A.  All hospitals, ambulatory surgical centers, office surgery centers, dental, orthodontic and endodontic offices, and other health care practitioners’ offices in the state Florida are prohibited from providing any medically unnecessary, non-urgent or non-emergency procedure or surgery which, if delayed, does not place a patient’s immediate health, safety, or well-being at risk, or will, if delayed, not contribute to the worsening of a serious or life-threatening medical condition. Accordingly, all health care practitioners licensed in Florida, including dentists, shall immediately cease performing these elective services.
 
While some specific examples of which procedures should be postponed are also contained within Executive Order 20-72, licensed health care practitioners are tasked with exercising reasonable and appropriate professional judgment in evaluating their patients’ specific circumstances, overall health, and the medical necessity of any procedures performed. Therefore, the Executive Order explicitly leaves total discretion on proceeding with procedures to you, the medical professional, based on your expertise and the specific factual situation of each patient. Only the medical professional can make that determination.
 
Regards,
 
Stefan Grow - GENERAL COUNSEL-AHCA
While many projections show the potential peaks of community infections may occur from 10 to 35 days from now, we are focused on doing what we can to prompt as quick of a recovery as possible.  We are working on a request to the Governor’s Office for consideration of releasing the restrictions on Ambulatory Surgery Centers in those communities where the reported cases are low or as soon as the public health emergency seems to be diminishing.  We strongly believe that surgical services and ASCs can play a major role in helping communities and local economies rebound quickly and opening up those services as soon as possible to let Floridians get back to productive work and life will be important to accelerate our recovery. 
Most projections state the potential peaks of community infections may occur 10 - 35 days from now. So need to temper the appearance of a quiet zone/ town with potential for upswing in community infections in the very near future. 

Please continue to let the organization know if there are additional ways in which we can assist you.  Please look for a survey on the impact of the crisis on your practice to be released shortly as well as an announcement on the availability of PPE from the FOS if your practice is in need.

Sincerely,

Fraser Cobbe
Florida Orthopaedic Society
Tel: 844-234-7800 Ext. 5000
Florida Orthopaedic Society
TEL: 844-234-7800