Promoting Superior Patient-Centered Hernia Care

Hernia surgery is one of the most common procedures, but the quality of care and post-op treatment can vary widely.

What’s behind these variations, and how can we ensure better care for patients?

In this episode of HealthBiz Briefs, Dr. Michael Reinhorn and Dr. Nora Fullington dive into the challenges of hernia surgery and explain how Boston Hernia is raising the bar with patient-centered care and improved outcomes.

This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.

As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.

🎙️⚕️ABOUT CARETALK
CareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.

🎙️⚕️ABOUT MICHAEL REINHORN M.D
Dr. Michael Reinhorn is a board-certified general surgeon and Fellow of the American College of Surgeons, specializing in ambulatory hernia surgery with a focus on inguinal, umbilical, and epigastric hernias. Based near Boston, his practice serves New England with surgical care provided at Newton-Wellesley Hospital, Boston Outpatient Surgical Suites, and the Surgery Center of New Hampshire. With over 23 years of experience and more than 5,400 hernia operations performed, Dr. Reinhorn is a recognized expert in minimally invasive hernia surgery, emphasizing opioid reduction and value-based care. He consults for the American Board of Surgery, co-chairs the opioid reduction task force for the ACHQC, and represents the Americas Hernia Society on the ACHQC board. A dedicated educator, researcher, and volunteer with The Schwartz Center for Compassionate Healthcare, Dr. Reinhorn is committed to improving patient outcomes and advancing hernia care.

🎙️⚕️ABOUT NORA FULLINGTON M.D
Dr. Nora Fullington is a board-certified general surgeon and Fellow of the American College of Surgeons, specializing in minimally invasive hernia and gallbladder surgery. With over 2,000 operations performed as a hospital-based surgeon, she joined the practice in 2021 and has since completed more than 1,000 hernia surgeries. Dr. Fullington is an expert in open preperitoneal mesh and non-mesh repairs, as well as laparoscopic techniques for patients who benefit from minimally invasive approaches. A national authority on hernia repair, she has published peer-reviewed studies, delivered lectures on improving patient outcomes, and brings expertise in gallbladder surgery to the practice. Passionate about patient-centered care, she ensures every patient feels heard and valued. Dr. Fullington also demonstrates her commitment to humanitarian medicine through surgical mission trips to Haiti and advocacy for humanism in healthcare.

🎙️⚕️ABOUT BOSTON HERNIA
Boston Hernia is a specialized surgical practice dedicated to providing expert care for hernia and gallbladder conditions. With a focus on minimally invasive techniques and patient-centered treatment, the team at Boston Hernia delivers exceptional outcomes through personalized care plans, advanced surgical approaches, and a commitment to reducing recovery times. Serving patients across New England, Boston Hernia is known for its expertise, compassionate care, and dedication to improving the lives of tho

Transcript

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It's true that most people don't speak with their surgeon once their care is over, but I was so impressed by my doctors and their approach to hernia care that I had to invite them on to the podcast. So what are they doing at Boston Hernia that's so special? And to what extent can this model apply to the whole system? For some people, wrapping up in a blanket with a mug of hot chocolate or luxuriating in a hot tub with their family is the best way to spend the month of December. But for others, it's making a list for Santa Claus or dreaming up New Year's predictions. Now, speaking of comfort, therapy is a great way to bring yourself peace that never goes away, even when the season changes. While BetterHelp offers entirely online therapy, it's designed to be convenient, flexible, and tailored to fit your schedule. You just fill out a brief questionnaire and get matched with a licensed therapist, and you can switch therapists at any time for no additional charge. It's really helpful for learning positive coping skills and how to set boundaries, and it empowers you to be the very best version of yourself. So whether you're dealing with stress, anxiety, or just seeking personal growth, BetterHelp connects you with a licensed therapist who can support you on your mental health journey. Make it a great season with BetterHelp. and visit betterhelp.com slash CareTalk to get 10 % off your first month. That's betterhelp, H-E-L-P dot com slash CareTalk. Welcome to Health Biz Briefs. I'm David Williams, president of Health Business Group here with Dr. Nora Fullington and Dr. Michael Reinhorn. Mickey and Nora, thanks for joining me. Thank you for having us. Thank you. What's wrong with her in your repair today? So... Inguinal hernia care is considered a intern level case, an entry level case for most surgical trainees. And so they may do it in their first year of training and then never do it again. And then they go out and practice and maybe do 50 hernia repairs per year. I learned the hard way that I didn't learn how to do a hernia well in my surgical training and had to learn it over 20 year career. so much so that I attended multiple courses, went to different states and even different countries to learn the anatomy. And so I've become good at it. I still learn the anatomy. An average general surgeon has the knowledge that I did when I finished my surgical training and that leads to a lot of variability in care, a lot of more potential for complications and higher cost. So that sounds like a problem. So what's the solution? Yeah, I mean, I think first of all, care should be delivered with the patient as the focus, right? So a lot of times when patients go to have a hernia repair, they go see a general surgeon and that surgeon offers their approach, right? Whether it's robotic or the traditional open surgery. And that approach may not be the best approach for that patient, but it is the approach they do most of the time. So the first step I think is really improving surgeon education so that surgeons are equipped with a sort of toolkit of all different ways to do hernia surgery, and then tailoring that care to the patient, making sure the patient is getting the best possible outcome from what we've done. So, you know, one of the things we find to be really the ideal approach is putting mesh on the inside of the hernia hole and then also getting it there through the least invasive way possible. And we've studied outcomes and kind of generated a data set that shows that patients do better with this type of approach when it's the appropriate approach for them. So paying attention to quality, making sure patients are getting the right surgery, and then delivering that care in a really efficient patient satisfying package. And contrary to popular belief, the least invasive approach does not involve general anesthesia and muscle paralysis. actually involves an open incision to get the mesh behind the abdominal wall, leading to the exact same outcome as laparoscopic or robotic, minus the general anesthesia with reduced post-operative pain and reduced opioids. So in the majority of patients, that is actually best for them. Well, since you're so specialized in hernia, my last question might not be a fair one, but my question is whether the approach that you take with hernias can be generalized throughout the healthcare system and how much so? I think so. think if you measure quality, improve quality, and you're accountable for your quality, whether you do it through your national societies or your local institution, you can demonstrate the quality of your work. And the quality of your work has to do with both the technical skill and the patient experience. And so if you've created a product that has better quality, better patient experience, you figure out a way to price it in a transparent way. It doesn't matter whether it's an invasive procedure or a primary care doctor, you can package a high value product for an episode of care. Well, that's it for the latest Health Biz Brief. If you like what you hear, check out my Health Biz Podcast for a full length interview with Dr. Reinhorn and Dr. Fullington about their lives and careers. Well, thank you so much to both of you for joining me today on Health Biz Briefs.