2 4 • S U P P L E M E N T
T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 1
Outpatient facilities are well-
positioned to capture cases
during the pandemic.
"Procedures have been in
place for months to limit
exposure to the virus, and I
think surgical professionals
are better equipped to per-
form safe surgery," says
Jessica Billig, MD, MSc, a
resident physician of plastic
surgery at Michigan
Medicine in Ann Arbor. She
co-authored a paper pub-
lished in Annals of Surgery
(osmag.net/JfC5hD) that
identifies ways to provide
patient care without com-
promising outcomes:
• Virtual connections.
Telemedicine has accelerated at a much faster
pace than it otherwise would have, points out Dr.
Billig. She says expanding its use to conduct ini-
tial surgical consultations makes appointments
more convenient for patients, who therefore
might be more likely to seek out care.
Surgeons often need to see patients in person
to determine if they're candidates for surgery,
although Dr. Billig says she's able to consult with
patients remotely to diagnose the need to treat
conditions such as carpal tunnel syndrome, which
she assesses based on classic symptomatology.
She's also able to coordinate pre-op tests
through virtual clinical visits and conducts remote
post-op follow-up appointments with patients to
check on the progress of their recoveries.
"Telemedicine has allowed patients who
would have delayed their procedures to get the
care they need," says Dr. Billig. "One of the posi-
tives of this pandemic is that innovations in the
delivery of health care are exploding."
• Expanded schedules. Michigan Medicine has
extended the operating
room hours in the health
system's surgery centers —
from 7 a.m. to 7 p.m., with
some facilities running ORs
until 9 p.m. — and sched-
ules some procedures on
Saturdays to help surgeons
work through the backlog of
cases. "Providers need to
figure out how they'll safely
accommodate a high volume
of cases," says Dr. Billig.
That might involve working
outside of normal business
hours and shifting more pro-
cedures to outpatient ORs in
the community.
• Price transparency.
Many patients experiencing
financial stress due to the pandemic need
access to transparent surgical billing, according
to Dr. Billig. "There needs to be more of a push
to inform patients of the amount they have to pay
out of pocket for their care — and offer solutions
to lessen the financial burden," says Dr. Billig.
She says surgeons can influence where sur-
geries are performed and help direct cases to
outpatient facilities, which often provide more
cost-effective care than inpatient hospitals.
Facilities can also contact patients before their
scheduled procedures to inform them of the
exact amount that's due on the day of surgery,
and set up payment plans for patients who are
unable to cover the amount.
"Your facility needs to maintain revenue
streams, but perhaps you don't need a $5,000
copay from a patient immediately," says Dr. Billig.
"The patient might be willing to pay off the amount
over several months. That would be a better sce-
nario than missing out on the case entirely."
— Dan Cook
ACCESS TO CARE
Key Strategies to Capture More Cases
FINANCIAL ADVISERS Jessica Billig, MD, MSc, believes surgeons
have a responsibility to advocate for cost-effective care and inform
patients about affordable treatment options.
Michigan
Medicine
