Otolaryngologist Pioneers New Practice Model: Dr. Russell heralds hospitalist role as others ponder the concept’s staying power

Lifestyle Factors

The concept may have potential fans, according to David Nielsen, MD, executive vice president and chief executive officer of AAO-HNS. Dr. Nielsen said that while there is no current groundswell for the model, he can envision physicians being drawn to it for two reasons.

First, as an aging cohort of otolaryngologists, “my age, the Baby Boomers,” moves to the end of its career, its members may be looking for a less intensive medical role that takes advantage of their experience without keeping them tethered to operating rooms. Second, and, conversely, younger physicians looking for balance in their personal and professional lives could be drawn to the lifestyle advantages that internal medicine physicians like about hospital medicine. These advantages are often credited with helping to fuel the boom in internal medicine hospitalists that has pushed that field to some 30,000 practitioners in a decade and a half. “The conversations that are related to this are probably going to increase,” Dr. Nielsen said.

Workforce Shortage

One driver of those conversations is the potential shortage of ENT physicians forecast by a team of researchers led by David Kennedy, MD, professor of otorhinolaryngology: head and neck surgery at the University of Pennsylvania School of Medicine in Philadelphia. Dr. Kennedy presented research late last year at a Society of University Otolaryngologists meeting suggesting that by 2025, the field needs to increase the number of practitioners from about 8,500 to more than 11,000, a 29 percent increase. He said this figure is based primarily upon predicted population increases.

More disconcerting, according to research from Dr. Kennedy and colleagues, is that “if nothing changes in terms of residents, the scope of the specialty remains and people retire at the preferred age of 65,” the number of practitioners would remain nearly static through 2025.

According to Dr. Kennedy, ENT hospitalists might be one solution to the shortage, with a major caveat regarding their ability to improve efficiency, perhaps by decreasing lengths of stay. “However,” Dr. Kennedy wrote in an e-mail to ENT Today, “a significant part of the coming shortage is going to be geographic, and ENT hospitalists are most likely to be utilized in the largest institutions and major cities, where the coming shortage is likely to have least or no impact.”