pain, who are able to get up and move around, and who never take
pain medications. That's a big advance for hernia repair and one that
represents a fairly recent advancement in thinking. We always used to
assume surgery was going to cause pain and that you just had to man-
age it with pain meds, at least for a few days. We also assumed that it
was going to take a few weeks to get back to activities. Now there's
reason to think we can keep shortening that timeline by using multi-
modal pain management and by collecting and mining data in a way
that fosters continuous improvement.
Shifting attitudes
Ultimately, the improvements we're striving for are about letting go of
the trained belief that we, as surgeons, have to know all the answers
— that everything having to do with patient outcomes is dictated by
our skill and our skill alone. We need to open our minds, focus on
value-based outcomes and realize there are many, many other factors.
We need to team up with patients and with others who can add value.
It's going to take a change in some people's mindsets, but it's neces-
sary if we're going to improve our healthcare system.
Will there be resistance? Sure, but only from those who don't yet
understand. We can't ignore the fact that we can't keep up with all
the information that's out there, that we can't know what's right for
every single patient. It's just not realistic. Gradually, more and more
surgeons are realizing that. I'm seeing it at meetings and in the work
that our company does. More and more surgeons understand that we
all need to collaborate and learn from each other. OSM
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Dr. Ramshaw (ahspatientcare@gmail.com) is co-director of Advanced Hernia Solutions and chief
medical officer of Surgical Momentum in Daytona Beach, Fla.
