Below is the “official communique” that we developed with the FMA. The only addition to make is that the Board of Medicine is OK with any procedure to excise or treat suspected cancer, as that is necessarily a serious condition that will worsen if not treated.

Please make sure to exercise your member benefit and contact Chris Nuland, FGS Legal Council for a free consult. He can be reached at (904) 355-1555.

Clarification on Executive Order 20-72

The Governor’s Executive Order applies to all physicians performing any procedure in a hospital, ambulatory surgical center, office surgery center, or in their office. The Executive Order prohibits physicians from “providing any medically unnecessary, non-urgent or non-emergency procedure or surgery which, if delayed, does not place a patient’s immediate health, safety, or well-being at risk, or will, if delayed, not contribute to the worsening of a serious or life-threatening medical condition.”

According to the Department of Health, this order prohibits ANY medically unnecessary, non-urgent or non-emergency procedure performed in a physician’s office, not just those procedures that consume essential resources (such as personal protective equipment).

A “procedure” is any medical treatment or operation, including, but not limited to, injections, ablations, laser procedures, physical therapy, cosmetic procedures, allergy shots, etc.

The provision of in-person medical treatment of any nature is a “procedure” and thus must be postponed if doing so does not place the patient’s immediate health, safety or well-being at risk or will not contribute to the worsening of a serious or life-threatening medical condition.

Physicians can continue to see patients for purposes of evaluation and management, including the performance of a physical examination, in order to determine if they have a medical condition that needs immediate attention. Physicians, to the extent possible, should use telemedicine services to pre-screen patients so that those with clearly non-emergency conditions do not have to come to the office for evaluation. Telemedicine, as previously stated, can continue unabated.

Further clarification from the Department of Health does not appear to be forthcoming. The Department currently will only state that:

“While some specific examples of which procedures should be postponed are also contained within Executive Order 20-72, licensed health care practitioners are tasked with exercising reasonable and appropriate professional judgment in evaluating their patients’ specific circumstances, overall health, and the medical necessity of any procedures performed. Therefore, the Executive Order explicitly leaves discretion on proceeding with procedures to the medical professional, based on his or her expertise and the specific factual situation of each patient. Only the medical professional can make that determination.”

Based on this limited direction then, each physician will have to make a judgment call on whether a particular procedure is necessary to avoid putting the patient’s immediate health, safety or well-being at risk or whether delaying such procedure will contribute to the worsening of a serious or life-threatening medical condition. If the physician determines that an interventional pain procedure, ongoing course of treatment, diagnostic test, etc. is necessary under the parameters set forth above, then the physician can perform the procedure. If the physician determines that the procedure can be safely delayed, the procedure should not be done.