This is proving to be a year of extremities for surgeons and other professionals who support the surgical field – one with new challenges and big opportunities. 

This is proving to be a year of extremities for surgeons and other
 professionals who support the surgical field &ndash; one with new challenges
 and big opportunities. The COVID-19 pandemic all but halted elective surgeries
 in the U.S. last year, resulting in an overall
 <a
 href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/cutting-through-the-covid-19-surgical-backlog"
 target="_blank"
 >35% decline</a
 >
 in surgical volumes from March 2020 to July 2020.



 When stay-at-home mandates went into effect shortly thereafter, emergency
 department visits
 <a
 href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/cutting-through-the-covid-19-surgical-backlog"
 target="_blank"
 >declined</a
 >
 by more than 40% in April compared to 2019, which may have led to fewer
 patients presenting with indications for surgical intervention.



 While these factors led to declines in surgical revenue and drops in patient
 intake, the result is a backlog of necessary and elective surgeries and a
 return of higher revenue gains. For example, the Journal of Bone and Joint
 Surgery estimates a cumulative backlog of more than
 <a
 href="https://journals.lww.com/jbjsjournal/Fulltext/2020/07010/SARS_CoV_2_Impact_on_Elective_Orthopaedic_Surgery_.10.aspx"
 target="_blank"
 >1 million</a
 >
 joint and spine surgeries by 2022. According to a recent
 <a
 href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/cutting-through-the-covid-19-surgical-backlog"
 target="_blank"
 >survey by McKinsey &amp; Company</a
 >, even if hospitals were to operate at 10% above their baseline volumes,
 &ldquo;around 20 months would be required to work through the pent-up demand
 from 2020.&rdquo;


<h2>Cardiac &amp; Orthopedic Backlog.</h2>


 Heart surgeries among U.S. adults dropped by a dramatic 53% in the past year
 caused by the pandemic. The
 <a
 href="https://www.washingtonpost.com/coronavirus/?itid=lk_inline_manual_1"
 target="_blank"
 >decline included</a
 >
 65% fewer elective surgeries and 40% fewer nonelective surgeries, with all
 types of heart operations experiencing a decline, including coronary artery
 bypass grafting, aortic or mitral valve replacement, a combination or
 something else.



 The postponement of elective surgeries also greatly impacted the orthopedic
 surgery sector, with a projected
 <a
 href="https://journals.lww.com/jbjsjournal/Fulltext/2020/07010/SARS_CoV_2_Impact_on_Elective_Orthopaedic_Surgery_.10.aspx"
 target="_blank"
 >backlog</a
 >
 of more than 1 million orthopedic surgeries in the U.S. Meanwhile, orthopedic
 surgeons generate the
 <a
 href="https://www.beckersspine.com/orthopedic/item/49665-30-orthopedic-surgeon-pay-bonus-demand-insights.html"
 target="_blank"
 >fourth-highest revenue</a
 >
 for hospitals and on average, bring in $3.29 million every year.



 With the combination of high surgical demands and the dependency on
 specialized surgeons to meet those demands, the biggest challenges facing
 healthcare organizations and practices is a lack of available talent and the
 possibility of provider burnout.


<h2>Surgical Professions in Short Supply, High Risk of Burnout.</h2>


 According to the recent McKinsey survey of healthcare executives, the biggest
 factor in meeting the pent-up demand for surgical procedures will be workforce
 availability, followed by inpatient bed availability and OR room capacity.



 This isn&rsquo;t surprising given the U.S. was already facing a projected
 shortage of physicians, particularly among surgical specialties. In fact, by
 2033, there is a
 <a href="https://www.aamc.org/media/45976/download" target="_blank"
 >projected shortage</a
 >
 of between 17,100 and 28,700 physicians in surgical specialties. One of the
 biggest drivers of these shortfalls is the aging and retirement of surgical
 physicians, with
 <a href="https://www.aamc.org/media/45976/download" target="_blank"
 >58% and 60%</a
 >
 of orthopedic and thoracic surgeons over the age of 55, respectively.



 With too few surgeons available to meet pent-up demand, there is a real
 concern of physician burnout. This concern is heightened given that 60% of
 healthcare executives plan to extend typical hours of operation each day to
 increase surgical throughput. Without careful staff planning and adequate
 resources, hospitals and facilities may face higher burnout levels which can
 then lead to more medical mistakes.


<h2>Innovative Staffing Can Solve Demand &amp; Burnout Issues.</h2>


 For healthcare organizations facing staffing shortages or provider burnout,
 there are several alternative staffing solutions to consider as a way to help
 the facility meet surgical demands in the immediate and long term.



 One way to maintain continuity of surgical procedures and scheduling is to
 bring in locum tenens surgeons who can support the permanent surgical team
 with backlogged or pent-up demand for services. Not only does this approach
 help to meet patient demand and maintain revenue generation, but it can help
 build flexibility and variability into costs, utilizing locum tenens staff as
 needed based on demand fluctuations.



 Another solution to consider is to engage physician assistants (PAs). These
 specialists can work as surgical first assists in a number of subspecialties,
 ranging from general surgery to cardiology, orthopedics and more.



 PAs are widely viewed as part of the solution to the country&rsquo;s physician
 shortage. In fact, according to recent
 <a
 href="http://prodcmsstoragesa.blob.core.windows.net/uploads/files/Press%20Release_2017%20Statistical%20Report%20by%20Specialty.pdf"
 target="_blank"
 >data</a
 >, two of the highest PA-per-physician ratios were occupational medicine at
 621 PAs per 1,000 physicians and orthopedic surgery at 537 PAs per 1,000
 physicians.



 In addition, the COVID-19 pandemic caused a rise in the use of telemedicine
 and it pointed to a need for remote treatment options across a broad range of
 specialties &ndash; including surgery. Robotic surgical tools like the da
 Vinci and Ion are offering new alternatives to surgical teams to remotely
 perform surgery. PA first assists are trained on various technical skills
 including the use of the da Vinci Robotic Surgical system, which according to
 research have shown lower patient stress levels and lead to better patient
 outcomes. As telemedicine and robotics play a larger role in the
 surgeon-patient relationship in 2021 and beyond, PA first assists will also
 play a more vital role.



 As a trusted staffing partner to leading healthcare organizations across the
 U.S., Cross Country Locums continually monitors and analyzes key market
 dynamics of the surgery sector. To learn more about current labor trends for
 surgeons and PAs,
 <a href="https://www.crosscountrylocums.com/lp-surgery">download</a> our
 latest Market Snapshot.

From Cancellations To Backlogs: Meeting Pent-up Surgical Demands