From Part-Time to Full-Time: The Rise of Otolaryngology in 20th-Century American Medicine

As the second half of the 20th century progressed, academic medical centers transitioned from research grants to clinical practice income as their primary revenue source. As such, specialties such as otolaryngology, which brought in significant clinical revenue, became increasingly important. Otolaryngology solidified its importance by continuing to expand, ensuring a high clinical and surgical volume. What started as a specialty largely dedicated to tonsillectomy and adenoidectomy procedures today has seven subspecialty areas of practice.

Looking to the Future

Philosopher George Santayana said, “Those who cannot remember the past are condemned to repeat it.” I would take this a step further and argue that we must study the past, not just remember it, to continue to advance our field into the future. In the ever-changing medical landscape, remaining stable equates to falling behind as our specialty has in the mid-20th century. As otolaryngologists, we should embrace change—because change will always happen—and continually evaluate priorities within our discipline, as well as the medical profession, to ensure our decisions and goals are well-aligned. Lastly, continuing to innovate in the care we provide patients and the efficiency with which we provide this care will further solidify our importance within medicine.

Dr. Miller is an associate professor and director of the UNC Facial Nerve Center at the UNC School of Medicine in Chapel Hill, N.C.