Otolaryngologists-Head and Neck Surgeons Urged: Be Part of the Solution in Health Care Reform

The unit of payment needs to change, she said. One proposed way to change the method of payment would be to bundle payments around the episode of care and hold physicians and physician groups responsible for the cost and quality of the bundle of care.

According to Dr. Kane, this type of payment method would discourage physicians from performing services that do not add value to patient outcomes.

A good example of this, she said, is the problem of imaging. We have such a high rate of growth in imaging without any clear changes in outcome, she said.

When we go to the table, we are restricted by the antitrust laws. We’re not protected like the insurance companies and lawyers. What no one has been able to tell the physicians is, ‘How do you tell your mother she can’t have this test?’
-James C. Denneny III, MD

But Dr. Kane’s primary message to the audience of otolaryngolgists and head and neck surgeons was not to simply lay out the numbers and talk about specific issues of health care reform, but to urge these professionals to play a role in helping to provide more affordable health care with higher quality.

Role of Associations to Help Reform Health Care

Dr. Kane said that associations such as AAO-HNS/F can contribute by focusing on two main areas: medical practices and financial practices within their specialty.

One area of medical practice she emphasized was focusing on developing and implementing standards of care within the profession-for example, creating standards for the appropriate indications for imaging.

The association should educate its members on evidence-based medicine whenever possible, she said, as well as devote resources to evaluating comparative effectiveness of different practices so they know whether there is a real value in certain procedures over others.

According to James Denneny III, MD, an otolaryngologist in private practice in Knoxville, TN, and the immediate past president of AAO-HNS/F, efforts are under way within the AAO-HNS/F to demonstrate that treatments used within these professions are actually effective. We have quality initiatives and a lot of outcomes clinical research that are continuing to put out information on some of our most common diseases, he said.

Agreeing with Dr. Kane that imaging is a big problem that is driving up cost with its value yet to be demonstrated, Dr. Denneny said that the association is working on studies to actually show indications for and frequency of scanning procedures.