In an address to the 2009 Combined Otolaryngological Spring Meetings in Las Vegas, neurosurgeon Harry Van Loveren, MD, chair of the department of neurosurgery at the University of South Florida, coined the term “fogeyphobia” to describe a tendency among older doctors to become reluctant to speak out against new surgical tools and techniques, out of fear of being viewed as old-fashioned.
In June, Congress gave physicians relief from the scheduled 21 percent Medicare pay cut, but only until the end of November. The payment patch, which briefly increases reimbursement by 2.2 percent, leaves doctors in limbo.
Chronic laryngitis is a multifactorial disease with a large differential diagnosis for the patient who presents with hoarseness. Fortunately, the diagnosis of inflamed larynx has improved in recent years.
When describing to the curious the benefits of opting out of both Medicare and private insurance, Gerard J. Gianoli, MD, president of The Ear and Balance Institute in Baton Rouge, La., often recalls one particular example: During one 90-day global period about five years ago, after an eight-hour resection of a skull-based glomus tumor, post-operative ICU care and several days of inpatient care and the usual post-operative office visits, he received a total reimbursement of $500.
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.
A physician who was recently offered a lucrative position with an otolaryngology practice in his community asked me to review his current employment agreement to determine if it contained any prohibitions against accepting the job. His previous employment contract contained a noncompetition clause that, justifiably, caused him and his prospective employer some concern. As it turned out, in his case, and in many others, the noncompetition clause was not as restrictive as it appeared at first glance. The provision was penetrable and my client joined the new practice with a clear conscience that he was not in violation of his previous contract.
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.
With pediatric otolaryngology continuing to evolve, the American Society of Pediatric Otolaryngology (ASPO) is exploring subcertification in the field, saying it is specialized enough that it deserves recognition. The society has approached the American Board of Otolaryngology (ABOto) about the possibility and is working on defining the knowledge base that would be required for a physician to become subcertified as a pediatric otolaryngologist.
ACGME RRC—this litany of letters means little to most otolaryngologists. However, whether you are a private practitioner or an academician, a resident in training or a program director, you should have a basic understanding of the work done by the Accreditation Council for Graduate Medical Education Residency Review Committee (ACGME RRC).