The COVID-19 pandemic has affected our book of business in many ways. Protecting ourselves, our staff, and our patients with proper PPE has been expensive. We have decreased our clinic capacity to allow for proper air exchange following an aerosolizing procedure, and the economic fallout of the pandemic has caused many patients to take a pause on their healthcare. But over the past five years or so, there appears to be a trend that has pre-dated the pandemic and only now has become so much more obvious: Where are the surgeries going in otolaryngology?
Explore This IssueMay 2021
As otolaryngology has become one of the most competitive specialties to match in, the vast majority of applicants are attracted to the field by the intricacies of the head and neck anatomy and the prospect of performing surgery that makes a real difference in patients’ lives. And, in many cases, these medical students will go on to become residents and then attendings, many of whom will practice in the community and have a predominantly office-based practice. Will these new otolaryngologists be satisfied with a limited surgical schedule?
Biologics have decreased the need and indication for revision nasal polyp surgery. Advances in immunotherapy will likely have an effect on surgical volumes for head and neck cancer. Antibiotics and advances in hearing aid technologies have slowly chipped away at middle ear surgery numbers. The wearing of masks and social distancing have dramatically reduced childhood tonsillitis and middle ear effusion. Many pediatric otolaryngology practices are down by more than 30% from their pre-COVID volume, and questions remain on how many tonsillectomies and tubes will be needed in a society where mask wearing is routine. Will our future work lives revolve around the medical management of rhinitis, vertigo, and dysphagia?
Before you crumple up your issue of ENTtoday in frustration, I’d like to remind you that our specialty has been here before—in fact, many of the procedures we do today have evolved through innovation and the acquisition of new skills. We’ve recreated ourselves multiple times, and we will do so again. We’re already seeing signs of this: New creative techniques to address airway stenosis. Delicate procedures for facial nerve reanimation. The use of the robot and endoscope to minimally address head and neck and skull base pathologies.
More now than ever, as we leave the pandemic behind, we must make the push to further innovate and acquire new skills. The good news is our next generation of otolaryngologists are unbelievably smart, more diverse in thought, and extremely driven. Our specialty will indeed look different, and that’s just fine with me.
Please be well, and I look forward to talking soon.