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.
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.
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.
Performing international surgical outreach missions to help the world’s most disadvantaged patients overcome the disability imposed by disease is an extremely rewarding experience. Missions are challenging, varying in their length, level of working and living conditions and the surgery performed. Despite the rigors of mission work, there has not been a mission where members of the medical team did not find the experience to be life changing.
Diana C. Ponsky, MD, assistant professor of otolaryngology-facial plastic and reconstructive surgery at Case Medical Center in Cleveland, Ohio, went to medical school wanting to be a pediatrician. She happened upon otolaryngology “by accident, by scrubbing into a very fascinating cancer case. I was hooked,” she now recalls.
It’s a fact: An increasing number of American women are entering medicine. In the U.S. today, half of matriculating medical students, and 28 percent of all practicing physicians, are women.
In the more than ten years that Paul Levine, MD, FACS, has served as chair of otolaryngology and head and neck surgery at the University of Virginia in Charlottesville, he has heard his share of complaints about high-powered surgeons who are difficult to work with.
SAN DIEGO-Trauma care in the United States is on or heading toward life support. Although this may sound hyperbolic, it points to a need, seen by many otolaryngologists and other surgeons, to raise awareness of the growing gap between the numbers of people in need of trauma services and the accessibility of getting those services.
Hearing aids-external electronic devices used to help individuals with hearing loss-traditionally consist of a microphone, an analog-to-digital converter, a digital signal processor, a digital-to-analog converter, and a receiver that delivers an acoustic signal into the external auditory canal. In 2008, 97% of all hearing aids sold used digital processing. Catherine V. Palmer, PhD, provides a review of current digital hearing aids.
In a recent debate-style panel, five otolaryngologists addressed topical clinical issues relating to the pediatric airway ranging from adenotonsillectomy in children with obstructive sleep symptoms, to whether cidofovir should be used as a standard treatment in children with recurrent respiratory papillomas.