As the U.S. healthcare system focuses increasingly on value, otolaryngology practices of all types are trying to come up with new ways to improve efficiency. A group of panelists at the Triological Society Combined Sections Meeting discussed how to continue performing academic work in this environment, better deliver efficient cancer care, use physician extenders in private and academic settings, and use the electronic medical record in private practice.
Explore this issue:March 2018
“Medical practice efficiency is critical in today’s healthcare environment,” said moderator David Eisele, MD, director of otolaryngology–head and neck surgery at Johns Hopkins University School of Medicine in Baltimore. “Third-party payers and regulators have created requirements that have increased our practice costs, created increased physician workloads, [and] caused practice efficiency challenges, with both negative impact on our doctor-patient relationship and reduced reimbursement for our care.”
D. Bradley Welling, MD, PhD, chair of otolaryngology at Harvard Medical School in Boston, said a big challenge in today’s environment is balancing academic work, which is typically something that uses up resources, with clinical activity, which generates resources. “Finding the right balance is not easy,” he said. “If you do too much academic work, the coffers in the department go dry. And if you do too much clinical work, then you don’t meet your responsibilities as an academic department.”
To help with efficiency at his center, physicians and staff measure and set goals for factors such as patient time to appointment, time to be seen after arrival, wait time in the emergency department, number of dropped calls, and operating room utilization, among others. Physicians work toward incentives, including publications, grants, clinical productivity, team goals, and patient satisfaction. There are also early-career incentives, including assistance with child care, he said.
Dr. Welling suggested keeping research clinically relevant and using the OR “as part of your lab.” He also advised “accepting opportunities as much as you can to serve in the area of interest but being careful not to get too distracted by things that really don’t point you in the direction of your science.”
He said that building up an endowment is critical and that it’s probably worthwhile to invest in development professionals. He also said it’s important not to lose sight of the importance of recruiting quality faculty members and providing good patient care.
Cherie-Ann Nathan, MD, chairman of otolaryngology at LSU-Health Shreveport, outlined major challenges facing the cancer field: There are more than 15 million patients in the U.S., with 1.7 million new patients diagnosed each year, and the numbers are expected to grow. Further, these patients are being cared for in a country with one of the highest healthcare costs and worst outcomes among developed countries, with inequalities along racial, socioeconomic, and geographic lines. Cancer mortality rates even vary from county to county. “We definitely have challenges, and it’s critically significant in cancer care because of the rapidly growing demand,” she said.