-
Using real numbers to shine a light on the magnitude of the mesh problem
Sorry for the over-posting, I tried to edit a word in another topic and got “green-screened”.
https://www.herniatalk.com/10303-mesh-question-for-doctors
quote drtowfigh:The majority of patients fortunately do not clinically react to the mesh.Those that do react must get their needs addressed by a specialist, as it’s an uncommon problem and specialists are the ones who see this problem more often and have an algorithm to address how to manage it (including need for surgery).
Hello Dr. Towfigh. Is using words like “majority” and “manage” really appropriate for this situation? It seems to be justifying the use of mesh, even though there are other hernia repair methods available that seem to give better results. 51% is a majority. That leaves 49% that do have a bad reaction.
What is the fundamental reason that mesh is used for hernia repair? It doesn’t seem to be that it’s best for the patients, on average. The results of a mesh reaction are terrible and tortuous. If you factor that in the situation is even worse. It seems that the industry is trying to save their “investment” in this new technology, forcing patients to “pay” with their own well-being. It’s counter to the reason that people become doctors, to help people, taking the Hippocratic oath at the end of their training. I can’t comprehend what is happening.
If the community of surgeons could start using real numbers, and accepting the fact that mesh might not be the wonder material that it seemed to be in the early days, or that maybe people have gone too far with mesh and need to pull back, there might be fewer patients needing to have their surgeon-caused problem to be managed. There is no mystery.
I really appreciate this forum and how you’re keeping it going. But we need to start using real numbers so that people understand the magnitude of the problem. Planning to manage problems that were created by the use of mesh seems unconscionable, especially when it is used on people that were otherwise very healthy.
If the industry is going to handle the situation by increasing “informed consent’ then the use of real numbers is even more important. Tell people the odds, that there’s a one in six chance that they might wish that they had chosen a non-mesh repair. They might have to have the mesh removed and there’s a chance that they will still feel discomfort and/or pain, for years afterward. That would be true informed consent.
Maybe I just don’t understand what it means to be a physician. Apparently, times are changing, see link below. No offense intended, I mean that sincerely, I know that it’s a difficult field with much happening these days. All the more reason though, to clearly expose these things before they grow.
-
3 Replies
-
As I mentioned in my post, we don’t have numbers to quote you. In the US, we don’t have a national system that mandates gathering such data. There isn’t even a good chilling code for mesh reaction or mesh-related complication. The AHSQC attempts to gather mesh-specific complications, but not enough surgeons are entering their data into it.
This, I am not able to provide you with numbers. What I do know is what I see. I suspect, based on my experience, that true mesh reactions or allergies are in less than 1% of all patients. The mesh-related complications have been reported to be in around 12% of patients. These are gross population numbers and likely vary within patient subgroups.
And the article you you post basically addresses how much burnout there is among physicians in the US. It’s a stressful job. Many quit, become drug addicted, or commit suicide because of their job stress.
-
More, from the original link.
-
Here is a telling quote from the article I linked above. Apparently, more people just see “being a doctor” as another high-paying profession. Mesh over-usage seems to be just a symptom of a larger societal problem.
“Younger physicians may have less faith in the Hippocratic Oath, which has a patient focus, because they feel it no longer holds in today’s healthcare environment in which many needs compete for their attention. According to the poll, only 12 percent of physicians under age 34 said they were always able to put patients first, compared to 40 percent of physicians age 65 and older. Many younger physicians also indicated they felt the oath’s patient focus added to burnout. Forty-seven percent of physicians ages 34 and under felt the oath contributes to burnout compared to 27 percent of those over age 65, according to the report.”
Log in to reply.