Change Is Good, Right?

Change. Funny how a six-letter word can elicit so many emotions—anxiety, excitement, hope, fear. Change, by definition, means to alter, make different (radically or not), replace, shift, or modify, and for many of us, the assumption is that change means progress, moving forward, or improving. Change for the sake of change should not be the goal—similar to conducting wellness surveys just for the sake of conducting them, as Dr. Lindsay wrote in this month’s Editor’s Note. To delve a little deeper into the topic of change, we checked in with some of ENTtoday’s editorial board members to find out what the biggest changes in their practices are, and why.

Emily Boss, MD, MPH

Director of pediatric otolaryngology and a professor of otolaryngology, pediatrics, and health policy and management at the Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health in Baltimore

I’m not sure if it’s the biggest change, but it’s a substantial improvement: Our health system has implemented an AI scribe. It’s fantastic for summarizing the history and assessment/plan, and it’s quickly evolving in descriptions of physical exam and procedures. It has saved me a great deal of angst with documentation and recall at the end of a clinic. It also mitigates the need to pull out the electronic health record and type while speaking with the patient, and it allows me to transition between patients more effortlessly in the clinic.

Subinoy Das, MD

Chief executive officer and medical director for the U.S. Institute for Advanced Sinus Care & Research, in Columbus, Ohio

There’s a significant increase in time having to preauthorize procedures and drugs for patients and appeal denials in payments from insurance companies. Why? Insurance companies have weaponized our guidelines to become the bare minimum of care they will provide, and they require us to document that all aspects of our guidelines have been met. UnitedHealthcare requires us to copy and paste CT scan images to get sinus surgery approved. Insurance companies now arbitrarily deny payment for evaluation and management services if performed with sinus endoscopies.

Eric Gantwerker, MD, MSc, MS

Pediatric otolaryngologist at Cohen Children’s Hospital at Northwell Health in New Hyde Park, N.Y.

For me, the biggest changes have been dealing with the ever-changing hurdles that insurance companies place on us to provide patient care. The prior authorizations, the denials, the request for extra testing but declining to pay for extra testing, authorizing treatment but then refusing to pay for it, etc. It has become a constant battle to try and provide good quality patient care in this climate.