After a cancelled 2020 meeting, the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) held its annual meeting live at the Los Angeles Convention Center in October. There were 1,800 registrants, down from the normal 12,000 to 15,000, but their presence was felt—not so much in the hotel lobby bars or crowding around the vendor hall, but in the meeting rooms in support of the presenters. And as one of the registrants, especially one who debated about whether or not to go all the way up to the meeting date, I can say it was a great experience and one I’m glad to have attended.
During the pandemic, many AAO-HNS activities have been detailed in monthly magazines and episodic emails. But it’s different to hear about it live, and I was interested in listening to some of the academy’s plans for the upcoming years:
- The “125 Strong” program is a fundraising effort to celebrate AAO-HNS’s 125 years and support a new strategic plan, which places an emphasis on mentorship, inclusive diversity, and clinical excellence.
- Incoming president Ken Yanagisawa outlined his plans to focus on the business of medicine, including the creation of the Private Practice Study Group. Sponsored by the board of directors of the academy, the group will be tasked with engaging private practitioners around the country, will focus on issues pertinent to their work lives, and will identify the academy’s next private practice leaders. (It’s needed and, I hope, will help us address an elephant in the room.)
As this last item suggests, we’re at a crossroads when it comes to employment models. In full disclosure, I’m the chair of an academic department, and I hope what comes next won’t be overly colored by my personal bias.
Over the past decade, the percentage of employed otolaryngologists has markedly increased. In response to the expansion of academic and employed staff, many private practices have come together to form “super groups,” mainly for the purpose of contracting and decreasing overhead costs. Similar to what has already happened in the fields of dermatology and ophthalmology, private equity firms are now omnipresent to help invest in these super groups. There are obvious advantages and disadvantages to a model in which a practice is owned and governed by an entity dedicated to maximizing profits and revenue. Time will tell if this will be the norm, but in the meantime smaller practices and rural practices have been left out, and many of them have become discouraged with what’s happening.