The time is now to demand 21st Century surgery

It sounded like a miracle. One day after undergoing a colorectal operation to remove cancer, the patient was up and about and asking to go home, the surgeon reported. How? A typical patient would still be groggy at this point, the surgeon knew, slow moving and settling in for what would likely be a week-long stay in the hospital.

That more typical experience, in fact, played out the very next day, in the same hospital, with a different surgeon performing a very similar procedure. A large surgical wound, a mound of opioid pain medication and a long road to recovery resulted.

The difference? The first patient had received care according to a clinically-validated protocol, known as “Enhanced Recovery After Surgery” or “ERAS”. The second patient had received the decades-old approach to surgery.

John Greenwood, co-founder of Goldfinch Health and, at the time, a clinical representative for a national surgical robotics company, recalls thinking to himself:

“What if these patients had known?”

“What if they understood they had just played the lottery? One won. The other, unfortunately, didn’t.”

What those patients had been exposed to is a difficult truth in the American healthcare system. Not all providers are created equal.

In the field of surgery, over the last decade advanced, innovative providers have separated themselves from their peers by implementing minimally-invasive surgery as part of broader ERAS protocols. Such protocols can take many forms and include interventions before, during and after surgery. ERAS represents the entire surgical experience re-imagined with patients and their recovery front and center.

Enhanced Recovery first emerged in Europe over a decade ago. Since then, thousands of journal articles have been published enumerating the benefits to this approach across nearly every procedure type.

Patients experiencing ERAS-based care demonstrate:

  • 30% shorter hospital stays
  • 50% fewer complications
  • 90% reduced opioid use
  • Thousands of dollars in savings per surgery
  • Faster return to normal life, including work

ERAS represents the rare initiative in healthcare that satisfies the entirety of the so-called Quadruple Aim:

  1. Better patient outcomes
  2. Lower costs
  3. Improved patient experience
  4. Improved provider experience

Not only that but at a time when our society desperately needs solutions to the opioid crisis, ERAS provides one. In fact, it changes the paradigm entirely.

What if you could change the underlying pain?

That’s exactly what ERAS does.

Surgeons, anesthesiologists and surgical teams have come together across disciplines to implement these care pathways in countries around the world, including the United States. But they have done so sporadically.

As the writer William Gibson once said, “The future is already here—it’s just not evenly distributed.”

Inspired by the potential for these clinically-validated surgical pathways to transform healthcare, John Greenwood and I founded Goldfinch Health. Our charge:  build understanding of and demand for this 21st Century experience in surgery and recovery among consumers and healthcare payers.

Our charge, more simply:  remove the “I wish I had known” from surgery.

When you or someone you know faces surgery, ask questions about ERAS (we have created a surgery worksheet to guide this conversation). Advocate. Seek a second opinion.

We all deserve better than playing the lottery when it comes to something as important as our health.

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