My medical training ingrained in me the value of physically examining every patient. Back then, only the rare patients with various communicable diseases wore masks. And there was comfort in a doctor pressing his or her hand against a patient’s shoulder for reassurance while auscultating the heart and lungs. The art of practicing medicine relied on the tangible nature of a physical exam. I relished how, during the physical exam, I could meaningfully connect with my patients. In this way, the physical exam was a central tenet to my practicing medicine.
Sarah K. Rapoport, MD, Guest Editor
Then, in March 2020, the COVID-19 pandemic broke out. The fear that harm could result from proximity to others superseded the role of the art of medicine in our patient encounters. In-person office visits transitioned to telehealth over a virtual platform, and we lost the ability to examine our patients properly. How could we be thorough in our diagnoses with such a handicap? How could we, for example, visualize a deviated nasal septum without anterior rhinoscopy? Or assess whether a floor-of-mouth lesion extends onto the lingual surface of the mandible without peering into a patient’s mouth with a headlight?
The gradual return of in-person medicine restored our ability to perform physical examinations of our patients and, in turn, to be thorough in our patient evaluations. However, the lurking trepidation of whether doing so exposes us to harmful diseases inevitably haunts us.
When the way we come together with our patients and treat them is compromised, it strains our ability to perform our jobs. In this September issue of ENTtoday that I’ve guest edited, we investigate some of the challenges we otolaryngologists are currently facing to perform our jobs safely and thoroughly. In “Gun Violence as a Healthcare Issue,” we explore how the increased rates of gun violence in medical settings is jeopardizing otolaryngologists’ sense of security—and how this isn’t the first time our community has faced this concern. And in “Contrast Shortages,” we investigate how the global iodine-based contrast shortage has limited many otolaryngologists’ access to imaging according to medicine’s standard of care. The burden of not having the tools we need at our disposal is a matter we’re likely to continue to face.
Yet even as these grimmer issues swirl around us, we aren’t without the wisdom and example of strong leaders modeling how to elicit positive change in our communities. “When Physicians Take a Stand” shares ways our colleagues across the country are advocating for physician and patient rights. It reminds us that coming together a a community is a critical component of practicing medicine. In this way, we can meaningfully connect without all having to be the same.
I hope that we’re each brave enough to follow these physicians’ examples in our individual communities. I hope you enjoy this edition of ENTtoday, and I look forward to hearing from you as you read it.