By Bruce Ramshaw, MD


The 15th Annual Meeting of the Americas Hernia Society will be held in Orlando, Fla., and follows the first worldwide meeting of hernia surgeons and societies held last year in New York City. Now that the hernia surgeon world has finally been brought together, it is time to learn how we can open our organization to many other stakeholders in hernia disease, including the most important stakeholder, the patient, and how we can continue to learn from each other and how to improve the value of hernia care.

You might notice the organization has modified its name to reflect the original intent that this hernia society would represent all of the Americas, not just the United States or North America. With Sergio Roll, from Brazil, presiding as president of this meeting, the society is demonstrating that we truly do represent all of the Americas.

The meeting in Orlando will continue to offer current science applied to hernia disease; basic science work and applied clinical results will be presented by invited speakers and surgeons who have submitted abstracts for oral, poster and video presentations. Although this is not a joint meeting, there will still be representation from many other parts of the world, a continued demonstration that we are now all connected globally.

In addition to surgeons presenting, there will be several other stakeholders making presentations, particularly in the session titled The Patient Matters. In this session, we will hear about some of the emerging efforts in health care to allow the patient to play a more active role in his or her care. A description of a new role for a patient care manager to provide care coordination and local management of a patient’s cycle of care will be included. Also, a patient will describe her role in, and the importance of, a patient-and-family committee for a hernia program.

Another new concept to be presented is a session on learning and improving. The session introduces the concept of clinical quality improvement (CQI). Using the principles of CQI, a clinical program or practice can identify the value of care delivered and identify opportunities for improvement. In a world where the complexity of medical knowledge, techniques, device choices, etc., is increasing at a faster and faster pace, these principles will become more important to apply to our health care system.

Other sessions include topics such as the complex abdominal wall repair, managing chronic groin pain and managing sports hernia, as well as two case presentation panels: complex abdominal wall case presentations and a President’s Panel during which many current and former hernia society presidents will discuss a variety of hernia case presentations, including video case presentations.

The concept of including diverse stakeholders in the discussion and applying the principles of CQI comes from an evolving science just now beginning to be applied to health care. As quantum mechanics has demonstrated the incompleteness of Newtonian physics, the science of complex adaptive systems has been maturing over the past 100 years. Despite this matured understanding of our biologic world, our industries, our organizations and even our thinking have continued to be dominantly driven by the principles of reductionist science, developed during the time of the Renaissance. Applying a new understanding will be challenging, but it is not something we can ignore in light of the unsustainable trajectory of our current health care system.

The problems we face today in understanding and improving the value of hernia care is a reflection of the same problems facing our global health care system. In an ever-changing world, we have created problems that will only be solved once we gain a better understanding of our world as a complex and adaptive system. This kind of “systems thinking” is what Einstein was referring to when he said, “We will not be able to solve our problems using the same thinking we used when we created them.”

The Americas Hernia Society invites you to help collaborate across specialties, engage in dialogue with multiple stakeholders for hernia disease, open your mind to a new kind of science that will help us all learn how to learn and improve the value of care for hernia patients. There will also be plenty of traditional hernia content that you can learn and use to improve your hernia and general surgery practice.

Even if you are not interested in the evolving concepts of patient-centered care and learning how to apply the principles of clinical quality improvement, we would still like your input about how we can do better: to address the needs of the hernia patient, the practicing surgeon who cares for hernia patients, and for the system as a whole. One forum for this will be a Thursday night dialogue on hernia mesh. After brief TED-like presentations, there will be an open discussion between many stakeholders about the value and opportunities for improvement of hernia mesh.

And so, consider coming to Orlando to contribute to creating solutions for our hernia disease and global health care system problems. We need your help and we have a lot of work to do.

Dr. Ramshaw is the incoming president of the Americas Hernia Society and co-founder, chairman and chief medical officer at Transformative Care Institute, and director, Advanced Hernia Solutions, Daytona Beach, Fla.