Shared Decision Making in Hernia Repair

Abstract

As the digital age of healthcare is evolving, patients are more aware, educated, and concerned about their surgical options due to access to information. Patients undergoing hernia repair are being exposed to the growing litigious environment surrounding mesh via targeted social media marketing and inorganic search engine optimization (paid SEO). As a result, we elected to implement a shared decision making (SDM) process to give our patients an active role in choosing the reinforcement material used in their repair. A cohort of 142 patients underwent the SDM process with 133 (93.7%) choosing the reinforced biologic repair (ReBAR), 8 patients (5.6%) chose permanent synthetic mesh and 1 patient (0.7%) chose a completely resorbable bio-synthetic mesh. Clinical outcomes have been similar before and after implementation of the SDM process. SDM, as has been shown in other fields of medicine, improved patient satisfaction, patient compliance, and decreased anxiety about the treatment plan. We believe that the implementation of a SDM process in hernia repair surgery will continue to result in increased patient satisfaction, reduce legal exposure, and warrants further investigation as the paradigms in the doctor-patient relationship continue to be disrupted by technology and the internet.