Has Otolaryngology Subspecialization Gone Too Far?

by Tom Collins •

Not only are there differences in the availability of subspecialists between large cities and small towns, but there can also be big differences in the number of subspecialists from one academic center to another. At many academic centers, there are no general otolaryngologists to see patients who might need that kind of a physician, and that means that physician assistants have more of a role in that regard.

“At UAB, we had three generalists, and now we’re down to one and we’re recruiting,” said Dr. Waguespack. “We are using physician assistants and nurse practitioners, and traditionally they have been locked in with the head and neck folks or they’ve been locked with otology. I think we’re trying to rethink that.”

Ultimately, the marketplace itself will help define how specialized otolaryngologists continue to become, said Dr. Waguespack. As subspecialization evolves, a sense of unity has to be retained, he added. “If [otolaryngologists] represent 1% to 1.5% … of U.S. physicians,” he said, “we have to speak with as much of a unified voice as possible.”

Tom Collins is a freelance medical writer based in Florida.

Take-Home Points

  • Whether otolaryngology subspecialization increases research productivity or the quality or quantity of research in the field remains unclear.
  • Some otolaryngologists believe that subspecialization advances research and technology, concentrates experience, and exposes patients to more focused attention.
  • Good general otolaryngologists in many parts of the country are hard to find, and some communities—due to the small size of the population—cannot support subspecialists.