In the wake of this year’s landmark health care reform legislation, one of the most hotly debated topics comes courtesy of the Dartmouth Atlas of Health Care, as politicians, analysts, researchers and physicians grapple over how to resolve the contentious issue of geographical disparities in health care spending.
With the availability of noninvasive procedures that use injectable fillers to do the work surgery once monopolized, more people than ever before are seeking the elixir of youth that comes now at the end of a needle rather than a knife.
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.
Hayes Wanamaker, MD, an otolaryngologist in Syracuse, N.Y., refers to the recovery audit process of insurance carriers as the proverbial camel’s nose under the tent.
When Rahul Shah, MD, then a pediatric otolaryngologist at Children’s Hospital in Boston, and several colleagues first undertook a survey of otolaryngologists’ reactions to adverse events in 2004, they provided a blank form for respondents to write about what had happened. In the more than 200 responses they received, Dr. Shah and his colleagues read an outpouring of emotion.
By now, you’re probably well versed in the clinical aspects of the health reform bill signed by President Obama in March. But what you may not know is that the bill includes a section that could benefit otolaryngologists and other physicians in their role as employers.
I have been a strong advocate of electronic medical records (EMRs) for almost a decade. In fact, I used the phrases “It is the silver bullet for health care reform infrastructure” and “It is the cornerstone for health care reform infrastructure” to describe EMR plans when President Obama was campaigning. However, technology, like fire, can warm your house or burn it down, cook your food or kill you. Likewise, the wrong EMR will escalate inefficiency and raise health care costs. The wrong mandates or the wrong incentives have the potential to paralyze the day-to-day practice of medicine.
The federal government’s proposed rule establishing incentive payments for physicians who “meaningfully use” electronic health records (EHRs) is too onerous and would discourage physicians from participating, some otolaryngologists say.
This issue of ENT Today includes an article on the debate over canal-wall-up (CWU) versus canal-wall-down (CWD) tympanomastoidectomy (p. 5). I remember hearing the same arguments when I was a resident at UCLA, which was also the last time I drilled a mastoid bone; my practice focused on head and neck surgery and pediatric otolaryngology. Over the past 32 years, Drs. Bruce Gantz, Rick Chole (two of my otology colleagues on the Board of Otolaryngology), and other otologist friends have suffered through my semi-tongue-in-cheek comments on why otologists can’t agree on which procedure is better. Although the technology used in both procedures has evolved, the final product of the two procedures, a dry, safe ear, is, as best I can tell, the same as it was when I was a resident. I have been told that one of the main factors considered in the decision regarding which procedure to perform is where the otologist trained.
When Winston C. Vaughan, MD, told his Stanford University patients he was leaving academia to establish a private group practice, they had one question: “Are you taking Kathleen with you?” Their concern attests to the integral role that Kathleen Low, RN, NP, fills as a patient-care provider in Dr. Vaughan’s otolaryngology practice.