Surgical Backlog: 6 Challenges Hospitals Face Now

Available for Interviews: Dr. Tammy Penhollow

Dr. Tammy Penhollow is a Doctor of Osteopathic Medicine, specializing in anesthesiology, pain management, and regenerative medicine. Having over 20 years of experience has helped her to cultivate a passion for regenerative medicine and holistic healing. Dr. Penhollow practices at Precision Regenerative Medicine in the greater Phoenix area.


Talking Points from Dr. Tammy Penhollow on
what she can say in an interview on the Issue of Surgical Backlog

  • Addressing the surgical backlog in surgery centers and hospitals across the US is fraught with several challenges, often with competing interests. 
  • Issues include the need to bring back one of the greatest revenue generators in the hospital to help salvage some ability to make a profit, simply break even, or avoid shutting down, as well as to address the long line of patients who had their surgeries canceled or postponed due to the pandemic.

  • How it is done and at what risk benefit ratio deemed acceptable is controversial. As it stands right now, most of the surgeries are being prioritized based on emergent before urgent before completely elective, with the surgeon responsible for the triage assessment. 
  • Patients often have a different perspective regarding the elective nature of their procedure, as they are the ones in pain and the ones hopeful for relief of their pain with a gallbladder removal, joint replacement, or pain procedure. 
  • What determines who gets surgery at what time and where?

6 Challenges Hospitals Are Facing Now

1.  Will the patient require hospitalization overnight or for several days? If so, is the local area experiencing a resurgence in the number of hospitalized COVID-19 cases as a result of re-opening, and are all available beds in the hospital now needed for new cases or can it be used for intended post surgical admissions?  

2. Will the surgery be likely to result in a need for transfusion of blood products? With the severe blood product shortage in the US second to significant reduction in donations during the pandemic, blood banks are noting the supply is not meeting the demand.  Heavy blood loss surgeries are being further postponed until the supply is sufficient.

3. Is this an organ transplant surgery? The surgery is an inherent risk to the recipient, and, in the case of a living donor, both are typically hospitalized (at least overnight for the donor, and for several days/weeks based on the postoperative course for the recipient). Further, some solid organ transplants such as liver transplants require large blood volume transfusions in many instances which is dependent on blood supply. Also, for any transplant patient, they are now on a lifetime of immuno-suppression medications, putting them at risk for acquiring any other infections.

4. Where will the surgery be performed—hospital or outpatient surgery center? If in an outpatient surgical center, with very low to no risk of the patient requiring a transport to an admission to a hospital, then the consideration for taking a hospital bed is negated.  Outpatient surgery centers are often affiliated with hospitals and can be large profit generators for the hospital performing a large volume of cases during a Monday-Friday daytime schedule.  

5. What state regulations/restrictions are in place? Individual Governor’s Executive Orders and guidelines dictate protocol regarding resuming elective procedures. Often many stipulations must be met, including attesting to the ability to prove a continuous 14-day supply of PPE a reliable supply chain and a promise that they will not request federal/state/local assistance for the PPE. Additionally, many states require that all patients must be tested for COVID prior to the scheduled procedure or surgery, and that critical staff members are being tested regularly for COVID. Simple availability of the testing may limit this, as is timely turnaround to results.

6. What other workup will the patient require prior to scheduling? With a delay in the time of original surgery schedule and now, many patients face a possible need for repeat labs, imaging, advanced studies (echocardiogram, angiogram, treadmill stress test), and special medical clearance prior to their surgery. For example, some with cardiac disease require a cardiologist’s clearance, or visit in a preoperative evaluation (POE) clinic to undergoing surgery; in the interval since the original exam, the patient’s health could have changed enough due to deteriorated function from decreased activity and inability to attend structured therapy during the shutdown, thereby making him a higher risk for surgery and no longer eligible for an elective surgery until their health status is optimized.


Interviews: Dr. Tammy Penhollow

Dr. Tammy Penhollow practices at Precision Regenerative Medicine in Scottsdale, Arizona, where develops individualized treatment plans for musculoskeletal and spine interventions with PRP and bone marrow aspirate using image guidance, as well as micro-needling with PRP for skin, hair and anti-aging conditions. She also stays active in teaching as an Instructor in Anesthesiology for the Mayo Clinic College of Medicine and Science and as a Supplemental Consultant for the Department of Anesthesiology & Perioperative Medicine at the Mayo Clinic in Phoenix.

A former active duty US Naval Officer, Dr. Penhollow has lived, practiced, and has been deployed around the US and overseas. She embodies the lifestyle she recommends to her patients and is an active hiker, gardener and yogi as well as a French trained home chef and an aspiring sommelier.

Jo Allison
Managing Editor
Director of Public Relations
Success In Media, Inc.

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