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.
Health Reform to Insure 32 Million: Are you ready for them?
The new health system reform law is expected to reduce the number of uninsured Americans by 32 million people, and that means more paying patients for physician practices. Many doctors, however, worry that the law’s lack of Medicare payment reform and medical malpractice caps will exacerbate a looming physician shortage. This raises questions about how successful the law will be in increasing health care access.
Show Me the Evidence: Comparative effectiveness research could aid treatment decisions
A push at the national level to fund more comparative effectiveness research could mean more information for otolaryngologists about which treatments work best for a given condition and in which patients.
Quality Over Quantity: Accountable care organizations link physician payments to hospital outcomes
Beyond the handful of long-established and well-integrated sites being labeled as de facto accountable care organizations (ACOs), advocates are seizing the moment and pushing for a bold vision of what role ACOs will play in the movement to reform the health care payment system across the country.
‘ObamaCare’ Pits Generalists Against Specialists
President Obama has made an astonishing discovery: We’re not producing enough primary care doctors, he recently told Congress. Although this may be news to the president’s minions, physician groups, legislators, insurers, and patients are all well aware of the dearth of generalists.