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).

We have to take issue with a quote from the article, which fails to properly credit the AAO-HNS/F with trying to make progress in the area of diversity. In particular, we are concerned about the quote “there is a dearth of concrete evidence that the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) has any sense of concern or urgency about addressing the problem. It is not clear that there is a feeling of unease or discontent with the status quo.”

Five or ten years ago, we would completely agree with this. But of all of the otolaryngology organizations, with the exception of the Barnes Society, the Academy has been more active than any other otolaryngology organization in the last several years on this issue. While certainly there is a lot of work still to do, blaming the Academy for the lack of diversity in our specialty is clearly misplaced.

Here is some of the concrete evidence:

• When Rich Miyamoto was president in 2006-2007, he appointed a Task Force on Diversity, which was ultimately fast tracked and became the Diversity Committee after a few months (typically it takes two to three years to become a committee from a task force).
• The importance of this committee has been recognized by our five most recent presidents (Drs. Miyamoto, Denneny, Kennedy, Kuppersmith, Thomas) and our executive staff (led by Dr. Nielsen).
• In 2007, the Academy adopted its first Policy Statement on Diversity that reads:“The AAO-HNS affirms that in order to continue to Work for The Best Ear, Nose, and Throat Care, we must support and encourage diversity in our membership.We acknowledge that culturally effective care is predicated on cultural sensitivity and cultural competence. We are committed to diversity and equal opportunity for our members. The Academy affirms its dedication to diversity by ensuring and developing opportunity for leadership positions within the Academy that are accessible to all Fellows, including underrepresented minorities within our specialty.”
• In 2007, we also made the chair of the Diversity Committee a permanent guest at all Board of Directors and strategic planning meetings and have been looking for ways to increase leadership opportunities.
• We have had multiple articles recognizing the importance of diversity in our monthly publication, The Bulletin, over the past several years.
• We designated time for a miniseminar at the Annual Meeting each of the past three years.
• At least two of our recent presidents (Denneny and Kuppersmith) attended the NMA [National Medical Association] meeting or Barnes Society in the past several years.

While we agree that there is a lot more work to be done, and agree with the concluding sentence “Hopefully the AAO-HNS, along with other societies and otolaryngology educator organizations, can take the steps and expend the energy to create meaningful change,” the Academy can only advocate, as the Academy does not have a direct say in who decides to pursue a career in otolaryngology or who is selected to enter our field. This is within the realm of the RRC [Residency Review Committees] and the individual academic departments, who have direct contact with the medical students and ultimately select the residents.

Never before have we been in a better position to improve the situation. It is going to take leadership, education, and advocacy. We believe the mechanisms are in place for the Academy to assist in these efforts, especially from an educational standpoint, for existing otolaryngologists and potentially for medical students. Additionally, there may be opportunities for advocating with the RRC, academic departments, and specialty society leadership through the Academy.

The AAO-HNS’s Diversity Committee clearly is in a position to start the ball rolling with the Academy leadership and we would encourage Dr. Sims to speak with Duane Taylor, chair of the Diversity Committee, about strategies for helping the Academy move forward.

Keep up the good work!

Ronald B. Kuppersmith, MD, MBA
Immediate Past President, AAO-HNS/F

J. Regan Thomas, MD
President, AAO-HNS/F