COVID-19, Hand Surgery, Orthopedic Surgery and Ethics

COVID-19, Hand Surgery, Orthopedic Surgery and Ethics
COVID-19 arrived in the United States in the late 2019 or early 2020. The nature and the scope of this respiratory disease and its disruption of our way of life and economy has been significant. The disease process affects age groups differently. As we move forward, the risks of illness and mortality are unknown. The entire United States and the world have been changed. Economic and interpersonal interactions have been altered. Travel has been disrupted and families and individuals strive to maintain inerpersonal contact. We worry about those over the age of 65 and with medical co-morbdiites such as hypertension, diabetes, respiratory disease and weight issues. The United States has attempted to practice social distancing and strategies to decrease the spread and flatten the curve. Our healhcare systems were changed to protect the many and to observe social justice by preventing the existing healthcare system from being overwhelmed.

After the initial wave of change and innovation, our states and country will now try to return to a new sense or state of normal. Elective or non emergent surgery is now returning. Non- COVID-19 healthcare will resume as conditions allow. Our office will take care to minimize and mitigate risks of spread and to allow for personal healthcare in a safe (as possible) environment. in light of the pandemic, recent social unrest and Black Lives Matter, we will strive to allow for shared decision making, beneficence, non maleficience, autononomy and promote social justice.

We plan to have a schedule that will maximize privacy and minimize social contact between patients to mitigate the possible spread. We will screen for possible exposure and related travel. The office is small and private. Surgery will be planned considering safety, risks, benefits and possible outcomes. We wil work with Haymarket Surgery Center and Novant- UVA Hosital to obtain testing and care that is relevant and safe in the face of the pandemic. We advocate that non-emergent care can be performed in a safe and transparent manner. We can use secure telemedicine as requested.

The COVD-19 virus is a disruptor in the normal process of healthcare that we have all grown to expect. With disruption and borderline chaos comes an opportunity. We look to work with our patients to find that opportunty to improve their care and maximize safety. We look to improve and allow for growth in our system. We will also work to equalize health care for all populations from our end. We do not support any form of discrimination.

From an ethics perspectve, Dr. Carroll has written recently on topics the ethics of elective surgery in the face of a pandemic. He discussed theoretical cases of care in the face of the on-coming pandemic. He has also reviewed moral distress and injurt in relationshp to the CVID-19 outbreak. He partnered with colleagues at the Johns Hopkins University and the Kellogg School of Management at Northwestern University. These pulications can be found in the Journal of Bone and Joint Surgery and AAOS Now. He encorages all to review these topics.

Our practice commitment to our patients is to provide value, transparency and privacy in a transforming time. We are happy to discuss these issues as asked by our patients.