Business of Medicine

More of the Same: Why isn’t otolaryngology becoming more diverse?

As America grows and evolves, its face necessarily changes. Our country rests solidly on the idea that life, liberty and the pursuit of happiness should be available to all. Our collective understanding that access to health care and healthy living are essential to that ideal happiness continues to mature. But while the population becomes more diverse and blended, cultural disparities in health care not only persist, they do not appear to be diminishing. Collectively, African-Americans, Hispanic Americans and Native Americans comprise over one-quarter of our population. Yet, in the year 2000, they made up less than 10 percent of the physician workforce. These numbers dwindle even more when we consider surgical subspecialties.

Generation Gap: Combating “fogeyphobia” in the workplace

In an address to the 2009 Combined Otolaryngological Spring Meetings in Las Vegas, neurosurgeon Harry Van Loveren, MD, chair of the department of neurosurgery at the University of South Florida, coined the term “fogeyphobia” to describe a tendency among older doctors to become reluctant to speak out against new surgical tools and techniques, out of fear of being viewed as old-fashioned.

The Opt-Outs: Otolaryngologists extol the benefits of third-party independence

When describing to the curious the benefits of opting out of both Medicare and private insurance, Gerard J. Gianoli, MD, president of The Ear and Balance Institute in Baton Rouge, La., often recalls one particular example: During one 90-day global period about five years ago, after an eight-hour resection of a skull-based glomus tumor, post-operative ICU care and several days of inpatient care and the usual post-operative office visits, he received a total reimbursement of $500.

Anatomy of a Noncompetition Clause: Now’s the time to review your employment contract

A physician who was recently offered a lucrative position with an otolaryngology practice in his community asked me to review his current employment agreement to determine if it contained any prohibitions against accepting the job. His previous employment contract contained a noncompetition clause that, justifiably, caused him and his prospective employer some concern. As it turned out, in his case, and in many others, the noncompetition clause was not as restrictive as it appeared at first glance. The provision was penetrable and my client joined the new practice with a clear conscience that he was not in violation of his previous contract.

A New Look at Informed Consent: Recent guidelines prompt patient-centered approach

Otolaryngologists are likely to see some changes in the way informed consent is handled at the hospitals where they perform surgery. Recent changes from the Centers for Medicare and Medicaid Services (CMS), along with Joint Commission rules, have prompted many hospitals and health systems to get more involved in what previously fell firmly in the physician’s purview.