The Burden of Prioritization Decisions

April 27, 2020

Resuming elective surgery is on the horizon for many facilities and while this is the beginning of being able to provide much needed care for so many, it brings with it an added burden on healthcare providers.  According to the authors of a recent article in the Journal of the American College of Surgeons, there will be “an emotional and ethical burden associated with having to make difficult decisions, weighing patient needs in the midst of scarcity of resources and plausible risk of viral transmission to both the surgeon and to other members of the healthcare team.”

I had a conversation with a healthcare provider last week who shared just how difficult it was for her and her team to have to decide which patients were simply “not sick enough or, worse, too sick at this point, to necessitate surgery.”  It was heart-wrenching for them.  This moral dilemma is a new by-product of the times we all face.  Clinicians are accustomed to doing anything and everything for patients to help them recover and heal.  With the ever-growing backlog of “elective” surgery cases, this unanticipated obstacle can cause substantial, long-term impact on staff.

According to the Journal piece, there will organically be an “emotional and ethical workload that will undoubtedly predispose physicians to burnout and inflict moral injury when making these extraordinarily difficult decisions.”  The circumstances facilities face as they begin to resume elective surgeries are enormous.  The process for deciding how to work through the backlog safely, efficiently and equitably must be transparent and rely on objective criteria if we hope to mitigate the moral burden placed on those responsible for establishing the schedule.

Together, we can lift each other up!

-Marcus Perez, EVP

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