Electrospun Poly-4-Hydroxybutyrate for Hernia Repair; The Role of Physician Education and Incentives in Physician Decision Making

The healthcare system is multi-faceted and complex. It not only includes patients and healthcare workers, but is intertwined with medical devices, drugs, hospital systems, and the bureaucracy of medicine. The technical project focuses on the research and development of medical devices – specifically surgical mesh for hernia repair. The current repair options leave patients with weak abdominal muscles, unable to do significant physical activity. The technical thesis is looking into an electro spun version of a current bioresorbable material used in hernia repair. This material is called poly-4-hydroxybutyrate (P4HB) which degrades safely in the body. The alignment of electro spun fibers is being investigated as a determining factor for myocyte (muscle cell) integration. This research may serve as an early indication that hernia recovery can be improved for millions of people around the world.
The STS thesis explores physician education, which is related to the technical thesis in that it involves the adoption of new medical devices and treatments by surgeons. This education is a vital part of the healthcare system; it involves pharmaceutical and medical device companies sending out representatives to educate physicians on new drugs or medical devices. This physician education can involve a paid dinner to catch the full attention of physicians who are busy seeing patients all day, but has been stretched to include paying for physicians’ trips to conferences and paid vacations in order to encourage the writing of more prescriptions. Drawing the line between what has gone too far in the name of physician education to help patients is a complicated task, as there are many pieces at play in this network. I will be utilizing actor-network theory to analyze how education and incentives, pharmacists, physicians, and legislation form an interconnected network, and how this network was fractured following the implementation of the Physician Payments Sunshine Act as part of the Affordable Care Act of 2010.

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisor: George Christ
STS Advisor: Sean Ferguson
Technical Team Members: John Mead