ENT Perspectives

Response from the editor

Dr. Sims has eloquently identified the value of diversity not only in otolaryngology, but also its contribution to the strength of the U.S. as a nation. Drs. Kuppersmith and Thomas have responded to his editorial indicating steps that the AAO-HNS has taken and is currently taking to increase diversity.

Response from Dr. Sims

My Viewpoint was intended to call attention to a problem and inspire us to act with more alacrity.

Change Is Already Here

We read with great interest Dr. Steven Sim’s recent op-ed, “More of the Same: Why isn’t otolaryngology becoming more diverse?” in ENT Today (Viewpoint, Sept. 2010).

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.

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.

A Better Way to Implement EMRs: Why one-size-fits-all won’t work

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.  

Canal Wall Up vs. Canal Wall Down: Symptom of a greater need?

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.