Trio Transitions: The outgoing and incoming presidents share their goals for the society

Another issue is attendance at some of the meetings. Economics just don’t allow us to have our sectional meetings the way we used to; exhibitors and industry no longer support them as they have in the past. We just had a meeting at a very nice place in Phoenix, and I think the attendees thought it was wonderful, but it’s very difficult for the Eastern section to come west and vice versa. That’s a key issue for the society: trying to figure out a way to maintain the camaraderie that occurs between community practitioners and academicians, while putting on a meeting that’s financially viable.

Q: What are continuing issues and challenges for otolaryngologists in general?

A: I think a major challenge is information technology [IT]. The good news is that most of the young people going into otolaryngology are very facile with computers, the Internet and where to get their information. The bad news is that a lot of the IT is controlled by old people like me who aren’t nearly as convinced that this is the best way to go. Most young people now get almost all their entertainment, news and technical information via the Internet and other technology. A lot of people in my age category seldom do that. A big thrust will be to try and bring otolaryngology into the “new information technology age.” A classic example: Borders books recently went bankrupt because so many e-books are being sold. I know the same thing is happening to many medical journals.

We’re also becoming much more multidisciplinary than in the past, when you had practitioners off in the community doing their thing. More and more, otolaryngologists will have to associate themselves with hospitals—and likely become hospital employees. There will still be a few private practitioners left, but it will be more rare.

What’s happened to the field is that there are now many more minimally invasive and in-office procedures. I never used to do any, [but] now I can do most of my procedures in an office setting. My practice has changed so dramatically: We have scopes with camera tips at the end, and I can biopsy patients in the clinic, laser them in the clinic, inject vocal folds in the clinic. We never used to be able to do that. I think patients really appreciate it.

But the problem is that third-party payers and Medicare haven’t figured out how to pay for these things. There’s a gap: I just saved this patient a hospital admission and general anesthesia, but I’m not getting paid enough to make it worth my while to do that. Something has to happen to allow physicians to participate in the savings we generate.