Performing international surgical outreach missions to help the world’s most disadvantaged patients overcome the disability imposed by disease is an extremely rewarding experience. Missions are challenging, varying in their length, level of working and living conditions and the surgery performed. Despite the rigors of mission work, there has not been a mission where members of the medical team did not find the experience to be life changing.
Laurie McCombs, 53, has dealt with sinus problems nearly all of her adult life. Clogged sino-nasal passages made it difficult for her to breathe at night, and the congestion caused morning pressure headaches. Over-the-counter and prescription antihistamines muted her symptoms but did not address their cause. At the age of 40, she decided to take the advice of friends who had experienced relief with acupuncture. Now McCombs follows the advice of the acupuncturist, who diagnosed her with allergies to dairy products and yeast, by limiting her intake of breads and milk products. She also continues to take loratadine and has found saline irrigation with the neti pot helpful in clearing her sinuses.
In February, the Centers for Medicare and Medicaid Services (CMS) began rolling out its national Recovery Audit Contractor (RAC) program, aimed at ferreting out improper payments and preventing fraud, waste and abuse in the Medicare system. If you bill for Medicare fee-for-service, you are fair game for a RAC audit. A three-year demonstration of the RAC program, which ended in March 2008, heavily targeted bronchoscopy, injectable drugs and IV hydration therapy. But auditors are rapidly expanding the list, and the permanent program will include adenoidectomies, tonsillectomies, thyroidectomies and other otolaryngology-related procedures.
A push at the national level to fund more comparative effectiveness research could mean more information for otolaryngologists about which treatments work best for a given condition and in which patients.
Using robotic arms, surgeons can now remove the thyroid gland through an incision in the axilla, or armpit, thereby avoiding the large scar on the front of the neck caused by traditional thyroid surgery. The procedure offers no other benefits over the traditional approach developed a century ago by Emil Theodor Kocher, MD, according to head and neck surgeons who perform the robotic surgery. In fact, it takes longer to recover from the robotic surgery, they say, with some patients complaining of chest numbness for months afterwards.
People get face-lifts and other types of cosmetic surgery to look better. They exercise so that they’ll feel better. But few people consider a voice lift, which combines surgery and exercise to make them sound better.
Otolaryngologists understand that even their most loyal patients, with finances ravaged by the lingering economic recession, may postpone or forego endoscopic sinus surgery, tonsillectomy or a chemical facial peel in favor of paying the mortgage.
Donald Palmisano, Esq., MD, believes the key to curing the health care crisis in the U.S. involves respecting the sacredness of the doctor-patient relationship and capping the size of malpractice awards.
Electronic medical records (EMRs) are costly and require significant staff time to implement but have the potential to bring huge benefits to patients and doctors alike, said speakers at the Triological Society’s Combined Sections Meeting held here Feb. 4-7.
The title of this session at the Triological Society’s Combined Sections Meeting held here Feb. 4-7 asked a tough question: Why are otolaryngologists still talking about pediatric tonsillitis, otitis and sinusitis?