Dear Governor Baker, Lt. Governor Polito and Secretary Sudders:

I am writing you in my capacity as the President of the Massachusetts Society of Plastic Surgeons. As plastic surgeons we provide care for patients across a broad spectrum of disease and diagnoses, including complicated reconstructive procedures following trauma or oncologic surgeries, less urgent but medically necessary procedures such as breast reductions and carpal tunnel releases, as well as purely elective cosmetic surgeries and office procedures. First of all, thank you for all you have done and continue to do to protect our state during this crisis. We applaud and support your cautious and staged approach at reopening, and we support the restriction in Phase I to surgical services of an emergent or urgent nature only, including high priority preventative care. I am reaching out to call your attention to an issue that may impact several of our members in the Commonwealth during the next phase of reopening in the COVID 19 pandemic.

Many plastic surgeons who practice in the community have raised the concern that Phase II of the reopening plan may inadvertently overlook and thereby prohibit some of the services offered by their practices. Specifically, at the transition to Phase II, these doctors seek to resume not only medically necessary procedures of a less urgent, more elective nature but also certain in-office procedures such as lasers or minor surgeries provided that they do not place an undue burden upon the existing health care resources. These types of procedures align with and sometimes even overlap with the services being offered by the re-opening of nail salons and day spas outlined in Phase II. The medical expertise of physicians and nurses in these offices in regard to the prevention of disease transmission and the appropriate use of PPE will act as an additional safeguard against further spread of COVID 19 in the community should you permit this to resume in Phase II. Like many other small business owners, they and their office staff of nurses and assistants have been impacted greatly by the current DPH restrictions. These businesses are facing similar hardships to others around the state and are anxious to begin the process of rebuilding their practices at the earliest possible time in accordance with the best practices to ensure the safety of their patients and their staff. Allowing outpatient office-based procedures such as Botox or filler injections or simple minor surgical procedures which are very unlikely to have any significant impact on hospital resources would enable these practitioners to provide services safely, to employ others in the Commonwealth, and align well with the state’s well thought out re-opening plan. Thank you for your consideration in this matter and for your leadership in this public health crisis.

Sincerely,

Jonathan M. Winograd, MD FACS
President, Massachusetts Society of Plastic Surgeons

Lifei Guo, MD
Secretary, Massachusetts Society of Plastic Surgeons

Simon G. Talbot, MD
Treasurer, Massachusetts Society of Plastic Surgeons

Matthias B. Donelan, MD
Massachusetts Society of Plastic Surgeons

Dear MSPS Members,

I sincerely hope that this message finds you all well and doing your best to cope and to manage the current COVID-19 crisis that has hit our nation and the world. We have all been affected by this crisis in many different and unprecedented ways in both our professional roles as physicians as well as within our communities and our families. Many of us have had to scale back our practices to emergency or urgent care only for the time being, with a transition to telemedicine where possible to increase patient and staff safety. Many of our children are returning home from colleges which have closed or are staying home from schools in our communities until the current crisis passes. And many of us have been personally touched by this crisis with illness in our family members or ourselves.

I do not wish to burden any of you further with an additional message when we are all being inundated daily with new updates as the information continues to roll in from our national and state leaders, from the CDC, from our hospitals and amongst our peers. However, I participated in a conference call for state society leadership with our ASPS President Lynn Jeffers last night, and I would like to share with you some initiatives which have been undertaken by the ASPS which may bear directly on your professional lives at this difficult time. If you receive the news feeds from ASPS, you may already be aware of these.

First of all, if you are in a position to donate any PPE or other needed medical equipment, such as ventilators, the ASPS is now coordinating with FEMA to supervise a clearinghouse for these supplies, which will be collected by the federal government and distributed by them to areas in need. Alternatively, as many of us have already done, you can donate them locally to hospitals in Massachusetts. ASPS is also reaching out to the congressional leadership with two letters which specifically request financial relief measures for practicing surgeons hit hard by the current shutdowns of our ORs as well as legal protections for physicians whose normal mode of practice has been impacted by the crisis. Specifically, these measures include payroll tax relief and direct financial relief for small business owners, Good Samaritan protections for providers offering emergency care even across state lines, protections for retired physicians or those working outside of their normal scope of practice during this national health crisis, and safeguards from frivolous lawsuits for Telehealth care being rendered during this period. It also requests several measures which will ensure meaningful physician participation in Medicare, such as a waiver of the budget neutrality requirements for final E/M until 2026 and a fix of the E/M coding oversight, including reimbursement during surgery global periods. Finally, ASPS is providing links to Headspace, a guided meditation website, which is offering free services for any members interested in participating during the current crisis.

Please stay strong, stay safe, and stay whole. Hope to see you all soon in person at our next meeting!

Jonathan Winograd
MSPS President