Have patience with revolving medical edicts

Massachusetts hospital officials are once again playing musical chairs with the availability of health services at the state’s medical facilities.

On Monday, hospitals began limiting nonessential prescheduled procedures to preserve resources and capacity.

“The current strain on hospital capacity is due to longer than average hospital stays and significant workforce shortages, separate and apart from the challenges brought on by COVID,” said Secretary of Health and Human Services Marylou Sudders in a statement announcing this latest development.

“COVID hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the healthcare system face remain,” she continued. “This order will ensure hospitals can serve all residents, including those who require treatment for COVID-19.”

And though Sudders tried to decouple this latest rationing of care from the ongoing pandemic, it actually has everything to do with it.

It’s all due, as state officials admitted, to COVID-19’S ripple effects, including staffing shortages across the health-care system that’s eliminated about 500 beds in both medical/surgical and intensive care units.

There is also “an unusually high number of patients with other health problems — many of whom were hesitant to seek treatment during the height of the pandemic and whose health issues have become more serious over time,” said Dr. Kevin Tabb, president & CEO of Beth Israel Lahey Health.

Both of those situations — staff shortages and the pentup demand for medical procedures — are the result of previous decisions made to prioritize COVID-19 care.

With the insurance revenue stream for elective surgeries and doctor visits no longer flowing, hospitals’ bottom lines took a hit, resulting in layoffs and pay cuts.

In an attempt to staunch the hemorrhaging of red ink, the medical community did an about-face approximately two months later, emphasizing that hospitals had the capacity to deal with both the virus and everyday healthcare needs.

Until they couldn’t. In December, when another wave of COVID-19 hit, a public health order requiring postponement of nonessential elective invasive procedures was issued.

Although the administration of Gov. Charlie Baker said the new order didn’t apply to outpatient care, the state’s ambulatory surgery centers expressed confusion over what procedures they could perform.

Greg Deconciliis, who leads the Massachusetts Association of Ambulatory Surgery Centers, told the State House News Service at the time the state guidance still left gaps that could block patients from getting key outpatient care.

“If you have a family history of colon cancer and I was your doctor who was on your colonoscopy, I could make the case that you need to have your colonoscopy, that it’s essential you have your colonoscopy at this time because you have a family history,” Deconciliis said.

That order was rescinded in March 2021, allowing the resumption of elective surgeries.

And now we’re back to square one, with this latest directive limiting nonessential medical care — guidance aimed at preserving capacity for more pressing health needs.

This order will remain in effect until either the governor or acting Commissioner of Public Health Margret Cooke terminates it.

With the pendulum of available medical care continually changing, it’s imperative that patients communicate with their medical providers to stay current with the availability of services affecting their care.

Because as we’ve seen over the last 18 months, uncertainty is the only constant.