“I think financial pressures lead clinicians to focus on areas that are financially incentivized, sometimes despite a lack of best evidence for efficacy. We’re seeing an explosion of lingual frenulectomy and balloon sinuplasty, which have become discussion topics at the national level. There’s a lot of financial incentive for balloon sinuplasty, and I believe the jury’s still out on precise indications and efficacy. We’re also seeing a massive increase in tongue ties and lip ties in the pediatric population, driven by complex factors but also by financial incentives for specialists like pediatric dentists. Fortunately, more practice guidelines and evidence are being generated and more practitioners are now getting on social media to better educate the public on this.”
Explore This Issue
September 2022Dr. Couch: “Maybe we need to folow what our orthopedic colleagues did. They realized that, as more systems wanted to look at outcomes and value, the old model in the fee-for-service world—of seeing only operative cases—wasn’t going to work.
“Orthopedic surgeons are leading the way in saying, ‘We handle musculoskeletal disease.’ I see an analogous mindset and attitude in otolaryngology, where we handle upper-respiratory tract cases in a way that better addresses what that person needs. It’s a way to engage more patients to guide them to the right care. One way to do that is to develop care teams, in which accountable care organizations that have population health responsibility will refer an otolaryngology problem to groups, and that otolaryngology group has a team of clinicians so that the surgeon isn’t seeing all the problems. If someone comes in with a nonsurgical problem, the nurse practitioner or physician assistant will see that patient. We don’t overwhelm the surgeon with every patient. You have a care team that helps you see the right patient at the right time. I think this would expand otolaryngology’s influence in healthcare.”
Issue: Staffing Shortages
Dr. Gantwerker: “The Great Resignation is hitting hard. Right now, we’re recruiting for nurses, nurse practitioners, MLAs, secretaries, call center people, surgical schedulers—everybody. It’s near impossible to get people, especially at our practice, because there are limited work-from-home options. There’s a realization in the workforce that certain jobs can be done from home and that they come with great advantages. They don’t have to take the in-hospital nursing job or work in the clinic; they can take a remote job that may pay better and offer more flexibility.
Is recruitment of people looking for at-home work experiences being forced upon us? Absolutely. But if we don’t move into the 21st century and start thinking about remote workers, we’re going to suffer from a recruiting standpoint. —Eric Gantwerker, MD, MMSc