Claiming success three weeks post-op. One surgeon’s view.

Hernia Discussion Forums Hernia Discussion Claiming success three weeks post-op. One surgeon’s view.

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    • #11441
      Good intentions
      Participant

      I tried to excerpt the good stuff from this link but it wouldn’t post. Read the blog post and the comments from “Rugger” and you’ll be shocked. Hard to believe that there are surgeons out there who think like this. Claiming success at three weeks, after cutting nerves to ensure “success”. Incredible. “Rugger” seems to be a real, practicing surgeon, but who knows.

      There is a good link to a recent article also. I think I’ve posted it before, but here it is again.

      http://skepticalscalpel.blogspot.com/2018/01/is-chronic-pain-after-inguinal-hernia.html

      https://onlinelibrary.wiley.com/doi/full/10.1002/bjs.10652

    • #16768
      Chaunce1234
      Member

      Yikes. Looking through some of the posted replies on that page from Twitter and the comments are not particularly inspiring.

      On a broader note, I suspect some patients that have a bad outcome or chronic pain end up going to a different provider, rather than returning to the original surgeon. Maybe that’s why some of the doctors insist that they’ve never seen chronic pain, or that at 3 weeks all is perfect. That’s a recurring theme we see on these forums anyway. The obvious problem is then that a patient switching doctors will skew outcome statistics to be lower than actuality for chronic pain, and probably recurrence and other complications too. I’m not sure how to get around that data skewing, aside from something like having anonymized patient follow-up surveys done at 6 months, 1 year, 3 years, 5 years, 10 years, probably through mail.

      You’d think here in the USA the insurance carriers would be very interested in getting accurate data about pain and complication outcomes, because they could then steer reimbursement to the least problematic (and least expensive) repair methods. Managing chronic pain is very expensive, which is probably why many insurance plans do not cover pain management at all. Well, there’d be nothing expensive to manage if the patient didn’t end up with chronic pain in the first place.

    • #16783
      UhOh!
      Participant

      In theory, the insurers are the only ones with even semi-accurate data. Let’s say you have a repair, a recurrence, then chronic pain post-recurrence repair and you saw three different docs for each. All that (likely) stays constant is the insurance, and they know what they’ve been paying for.

      You also wouldn’t really need to do patient surveys here; all you need are surgeons who will collect data on cases of recurrence or pain that they are called upon to fix, even if they didn’t do the original repair, in order to know how often this happens.

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