The Beverly Hills City Council voted 4-1 to allow elective surgeries to resume on April 28, following last week’s move by Gov. Gavin Newsom allowing hospitals and health care systems to resume delayed medical care for Californians.
The decision, which amends portions of the City’s March 16 urgency ordinance in response to the COVID-19 pandemic to prohibit all elective medical, dental and surgical procedures, makes Beverly Hills one of the first cities in the nation to reopen medical and dental practices for delayed medically necessary procedures.
“I think we ought to align our ordinance up with state and county guidelines,” Councilman Julian Gold, M.D. urged before the Council vote. Those guidelines do not prohibit elective procedures, but rather encourage their suspension. “I think the time has come to relax our restrictions. Forcing people to delay necessary healthcare is of itself irresponsible.”
Prohibited elective surgeries had included items such as heart valve replacements, angioplasty and tumor removals as well as key preventive care services like colonoscopies.
Councilman John Mirisch, the lone ‘no’ vote, said he was against amending the urgency ordinance to allow elective surgeries to resume in Beverly Hills because he feared unintended consequences. Beverly Hills currently has the fourth highest COVID-19 infection rate in the county according to the Los Angeles County Department of Public Health.
“I would not want to see somebody get sick because they went in and had a boob job or a butt job,” Mirisch said. “To suggest we’re just going to open it up to everything, that’s irresponsible.”
Councilwoman Lili Bosse, who like Mirisch said she too did not want people getting sick as a result of choosing to have a surgery, underscored the importance of not postponing health issues.
“I think it’s more important not to lose the few things that we think should happen that might have been restricted…than to allow the few things that we think might not be appropriate to actually happen,” Vice Mayor Bob Wunderlich said.
Postponing elective procedures and routine visits since mid-March has proved helpful in limiting the opportunity for transmission or exposure of the virus, according to Beverly Hills Policy and Management Analyst Cynthia Owens. In recent days the number of new coronavirus cases has continued to slow in California.
Owens highlighted the effective steps the state took to limit the transmission and impact of the virus by implementing shelter in place orders. Experts had expected a surge of COVID- 19 patients and sought to preserve resources and capacity of hospitals as the pandemic touched down locally.
“To date, the ‘Safer at Home’ and ‘Stay at Home’ orders issued respectively by the County of Los Angeles Department of Public Health and Governor Newsom on March 19, have been instrumental in preventing a surge of COVID-19 patients from overwhelming the state’s health care system,” a staff report authored by Owens stated.
In tandem with the reopening of California’s health care system, the California Medical Association is in the process of codifying several steps that will be instrumental to ensuring the ongoing safety of patients and the health care workforce, including new safety protocols.
A UCLA Health spokesperson told the Courier its hospitals and clinics already have in place comprehensive, effective infection prevention practices, in addition to adequate supplies of face masks and other personal protective equipment to safely provide care. Patients, staff and visitors are all screened for fever and symptoms and provided a face mask before entering facilities. In addition, all patients are tested for COVID-19 before being admitted to the hospital and most are tested before coming in for an outpatient procedure.
“While maintaining capacity and readiness if the number of COVID-positive patients significantly increases, UCLA Health is carefully planning the return of essential surgeries and procedures focusing on those postponed over the past seven weeks because of the pandemic and those that have become time-sensitive for the patient’s condition,” the spokesperson said.
In anticipation of the meeting, the Beverly Hills Chamber of Commerce voiced its support of the City Council expanding the scope of medically necessary care to match the guidelines put forth by the county and state.
“Medical services are a critical component of our economy. We support expanding the scope of medically necessary procedures as long as they can be conducted under property safety guidelines,” Chamber of Commerce CEO Todd Johnson wrote in a letter dated April 27.
The City Council stopped short of defining precisely what constitutes “elective surgery.” Currently a doctor is tasked with defining what constitutes an elective surgery.
Prior to the discussion, Beverly Hills plastic surgeon Lawrence M. Koplin, M.D. sent the Council a letter urging them to help define what is considered “elective” relating to medical procedures and surgeries.
“This definition will be seminal in the process and will save everyone grief and confusion in the aftermath,” Dr. Koplin wrote. “My malpractice carrier, my surgery center accreditation organization and our professional organizations have all stated that this decision is best made by the medical professionals themselves and that we will have support and malpractice coverage throughout this process. What they do emphasize is full preparation and safety compliance in reopening, including office sterilization, personal protective equipment for both staff and patients, and signage describing this process to the patients as well as consent forms.”
Koplin underscored that his office was prepared to reopen as a “haven” of safety.
“The medical and dental community of Beverly Hills is a top-notch and responsible one, and I am certain that other offices will be following similar protocols in preparing to take care of their patients,” he stated.