To wait until a pathology becomes serious before accessing the emergency operating room is a medical care guideline. At least that is what some health care specialists in Pennsylvania believe. They also point out that immigrants are more likely to place themselves near the line of no return. This reality is why the Center for Surgical Health was born.
It is a pioneering multidisciplinary center of its kind. It is located at UPenn’s Department of Surgery. It will provide a new access point to high-quality surgical care. It targets patients who normally rely on the emergency room for treatment.
WHYY journalist Sojourner Ahébée dusted off the dust to shed light on a story. Many people ended up in emergency surgery with pathologies with a history of evolution. Dr. Carrie Z. Morales’ perspective on the issue is revealing.
“ A lot of our patients are undocumented immigrants, and they would just come to the emergency department and then get turned away and told to follow up with a surgeon in an outpatient manner (…) Like they got an infection and they had to have an emergency surgery, which we know has a much higher morbidity and mortality,” said Morales. “And then they would stay in the hospital, get IV and antibiotics. It’s a pretty dangerous situation.”
Morales said the majority of those patients were uninsured. They would not have had access to a surgeon because of their insurance status. As a result, she said, they kept coming back to the ER for surgical care. Until the course of the disease got really bad.
Center for Surgical Health
This reality made Penn Medicine to launch a new project that helps vulnerable patients with access to surgical care. It is the Center for Surgical Health. It will provide a new access point to high-quality surgical care. It impacts patients who normally rely on the emergency room for treatment.
Morales is the associate deputy director of the new center. She teamed up with sixth-year Department of Surgery resident Matthew Goldshore. They wanted to figure out a way to improve access.
“The delay in care, the disjointedness in care, the lack of a surgical home to coordinate and navigate vulnerable, marginalized patients in our communities’ surgical care has led to health disparit[ies],” said Goldshore. “2020 shined a brighter light on systemic bias and health care inequities in our country, further underscoring the importance of establishing a new care model here in Philadelphia to help address surgical gaps.”
The surgical focus
The goal of the Center for Surgical Health is to provide care to patients before their diseases have substantially progressed. “That will prevent surgeons from having to perform high-risk rapid operations on them,” Morales said.
“And we care about decreasing the cost to the health care system. We also really care about that patient not losing a lot of days of work, not losing their ability to provide for their family, not having a ton of pain and distress about the operation,” said Morales.
One Step at a Time
The Center for Surgical Health is made up of Pennsylvania surgeons and residents. The team includes nurses, medical students, social policy and law students. It developed around a few core areas.
It all begins with a surgical matchmaking process. Patients are put in contact with surgeons who respect, understand and value the patients’ lived experience. They will meet them where they are. Then the center provides financial support to patients and makes sure they can access the surgery.
And finally, it delivers social support by linking personal patient navigators up with the patients, to guide them throughout the period from diagnosis to postoperative discharge.
Translated by: José Espinoza