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Obamacare, You're Fired - December 2016 - Subscribe to Outpatient Surgery Magazine

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all of your surgeons to agree on using one type of mesh. You'll likely never get down to stocking a single type of mesh for all of your patients. Hernia cases are complex and require different weights and sizes depending on several factors, like the patient's weight, where the hernia is located, how contaminated the site is and the surgeon's pref- erence. For example, in your standard inguinal repair, a surgeon may use a lightweight synthetic option. But for cases where there's con- tamination, a biologic may be the way to go, or maybe even the new hybrid bio-synthetic option. You may not be able to limit your inventory to one mesh, but you could try to limit it to 1 or 2 manufacturers. Don't make this decision from the top and expect surgeons to comply. Ask your surgeons which meshes they use and why. Understand how the mesh impacts patient care — no surgeon is going to compromise on that just to save a few bucks. During this conversation you may find they use a mesh simply because that's what they used in their residency and that they are interested in trying other options. Brand names may vary, but types of mesh are often similar to one another, though their prices may vary by hundreds of dollars. An effective way to get your surgeons on board is to show them cost data. They may not like the idea of abandoning their preferred brand, but once you show them an Excel spreadsheet that lays out how their box of synthetic, lightweight mesh is $500 more than one that is identical in appearance and quality, there's a good chance they'll change their minds. If a surgeon is using a biologic simply because he feels it's the best, but doesn't have the data to back it up, it's fair to suggest testing a more affordable option and comparing outcomes. Weighing the cost of the device with patients' outcomes, whether you're talking about her- nia mesh or surgical robots, is the only way to measure the true value 7 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 1 6

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