How Will the Affordable Care Act Impact Otolaryngology?

Gordon Sun, MD, MS, an otolaryngologist and medical director at Partnership for Health Analytic Research in Beverly Hills, Calif., agreed that the expansion of quality measures will be essential to keep specialists engaged. “If you set a whole bunch of criteria for outpatient practices to follow to improve quality, but none of them are relevant to your practice, how are you going to be able to meet these guidelines?” he asked. “You cannot.”

“The more quality indicators we have that are applicable to otolaryngology, the more relevant all of the ACA language will be to our subspecialty.”

—Emily Boss, MD, MPH

Along with quality of care, experts say the ACA is also increasing the focus on keeping patients engaged and informed. “There will likely be a shift in emphasis to what’s called patient-centered access,” Dr. Boss said. Because it’s been used more in primary care settings, she said, it’s not yet clear how a concept that includes providing patients with more complete access to their medical records or to immediate advice—via e-mail, for example—will affect subspecialists like otolaryngologists. “It may mean more information for the patient but a little bit more burden on providers to try to explain what sometimes might be inconsequential results or findings,” Dr. Boss said.

Another lesson from the ACA, Dr. Sun said, is that otolaryngology trainees and residents would benefit from greater education and exposure to policy-related issues. “We need to be more involved in either establishing policy or having our voice be heard by people who do establish policy, so that when you’re done with training you have at least helped guide the ship, and you know as best as you can where things are headed,” Dr. Sun said.

Educating otolaryngologists on public policy may not only give them a better idea of what to expect, but also help them effect change. “You have to be able to plan. And if we’re passive as a specialty, then we’re not going to be able to plan effectively, and decisions may be passed down that we may not be particularly happy about,” Dr. Sun said. “But since we weren’t involved in the first place, there’s going to be relatively little we can do other than to respond and react, rather than to be proactive.”

Bryn Nelson is a freelance medical writer based in Seattle.