Jeremy Meier, MD, assistant professor of surgery in the division of otolaryngology-head and neck surgery at the University of Utah School of Medicine in Salt Lake City, whose research has found that many surgeons still routinely give antibiotics for tonsillectomy despite a guideline recommending against that practice, said physicians need to be made aware of their outcomes and guideline adherence. “Surgeons need to know their own data and their own outcomes,” he said. “Anecdotally, they may think that they’re providing the best practice, but if they truly were to go back and look at their outcomes, they may see that giving the antibiotics or not really didn’t make a difference.”
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September 2016Dr. Stern said that the nonstop onslaught of emails that physicians receive daily, along with pressure to comply with insurance and quality measures, means that guidelines can get lost in the shuffle. “Every day, I have at least 10 emails of different things that I’m supposed to review,” she said. “I worry that when academies come out with guidelines mixed in the queue of all of these emails that need to be opened up, something has to give. How much are you going to read? Employed physicians have so many additional mandates within their own system to follow, it is hard to find the time to read everything.”
Involving Patients
She said the AAO-HNS is hard at work making sure the guidelines are accessible to everyone—healthcare providers and patients alike. She would welcome a universal electronic health record with guideline information embedded as a way to make sure physicians are informed. but acknowledged that goal is clearly easier said than done
Dr. Stern is now working on making guidelines more accessible to healthcare providers and more easily searchable online. “One of the things that I myself have discovered is that if I try to use lay terms to search some of our older guidelines, they are not as accessible as you’d like them to be to a patient,” she said. “A lot of other things come up first. Patients are our partners in good healthcare and our guidelines are accompanied with great patient-oriented summaries. We need to make sure that the patient can find them easily.”
Dr. Tunkel agreed, noting that guidelines are developed with patient representatives involved and already come with a plain-language summary intended for patient consumption.
Jerry Schreibstein, MD, an otolaryngologist at Ear, Nose and Throat Surgeons of Western New England in Springfield, Mass., who helped develop guidelines on voice improvement after thyroidectomy, said that the difficulty in persuading some patients that guidelines should be followed is a cause for non-adherence “more than we realize.”