ENTtoday

SM14: Otolaryngologists Learn, Network, Teach at Annual Conference

by Thomas R. Collins •

Supervise the Clinic and the OR

It’s important to watch a trainee examine a patient, make a diagnosis, and prescribe therapy. “Failure to supervise under that circumstance is my problem,” he said. Things are not perfect all the time in the operating room, he added. “What our commitment is to our trainees and then, of course, our patients, is [that] you have to forgive yourself if things didn’t go well. But you must, must, remember why. And don’t ever let it happen again.”

Keynote Speaker Pinpoints Physician Role in the Cost of Care

Physicians have great influence on healthcare spending, and a responsibility to help control it, said Susan Goold, MD, MHSA, MA, professor of internal medicine and health management and policy at the University of Michigan School of Public Health in Ann Arbor, who took the stage as keynote speaker at the Triological Society Combined Sections Meeting.

Dr. Goold, whose research specializes in the ethics of healthcare and healthcare spending priorities, described the problems with the state of healthcare in the U.S. in terms of market failures. For one thing, services are often provided without payment. Then, there’s the “myth of consumer sovereignty”—that although people are expected to inform themselves and wisely choose items in the marketplace, when it comes to health insurance, they often can’t imagine the things they’ll need and, therefore, frequently make unwise decisions on insurance.

She highlighted additional failures within the healthcare system: the free riders who get free services and benefit from those who actually pay into the system and the fact that those with an inability to pay tend to have poorer health than the rest of the population.

From the Audience: “We’re going to look at our own practice and our own department … to make sure that we are practicing in a cost-efficient manner. It’ll probably be imposed upon us if we aren’t proactive about it.”

—Charles Elmaraghy, MD, Nationwide Children’s Hospital Columbus, Ohio

Physicians have the power to write prescriptions and order tests and, therefore, have a huge role in what is spent on healthcare and on whom, Dr. Goold said. And that comes with a responsibility. “Physicians can and should consider limited resources when we are advising our patients and making decisions,” she said. “It’s incumbent on us as professionals to make these decisions in a way that recognizes they’re using shared, pooled, and limited resources.”

When many options have a similar likelihood of benefit, she said that simply choosing the less expensive option does little toward making a difference.