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November 20, 2019

Current Practices in Hernia Screening—Evidence Based or Profit Driven?

Author Affiliations
  • 1Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor
  • 2Surgical Innovation Editor, JAMA Surgery
JAMA Surg. 2020;155(2):99-100. doi:10.1001/jamasurg.2019.4424

These statements are some representative quotes from advertisements promoting hernia screening events. An internet search for “hernia screening” currently returns 13 900 results. Most of these results are advertisements promoted by hospitals, as well as individual surgeons, for events around the country at which members of the general public can get examined by a surgeon to determine whether they have a hernia. The language commonly used in these events emphasizes the fact that if left untreated, hernias can lead to serious, life-threatening complications. “Hernias don’t get better, they just get worse,” states one advertisement. These events heavily feature robotic surgical technology, usually having a da Vinci system on display and inviting attendees to “test drive” the state-of-the-art system.

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    1 Comment for this article
    U.S. economic incentives to perform inguinal screening
    Florence Watts, M.D. | Andrew Young School of Policy Studies, Georgia State University
    Given that the U.S. healthcare system is still predominantly fee for service, there is a conflict of interest for hospitals and surgeons between practicing evidence-based guidelines and financial reward for hernia and other procedures. Although Federal and state governments are attempting to change reimbursement for healthcare providers and healthcare systems to value based care, limited progress has been made. More research effort at all levels needs to occur to change the U.S. health care delivery system to a value based care reimbursement. As we have all seen, exhorting healthcare systems and providers to "do the right thing" is not always an effective method to advance national medical societies practice guidelines.