Specialty Unity: Why Be a Member of the Academy?

Douglas D. Backous, MD
AAO-HNS/F PresidentHappy New Year, and I pray that your 2023 was interesting, productive, and rewarding both personally and professionally. Over the past several months, I have been asked by members of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), “What value does the Academy bring to me?” Otolaryngologists in independent private practice, hospital employment, private equity-funded practice, or in an academic medical center face common impediments to practice satisfaction. Increased burden to preauthorize services, fluctuations in the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule, recruiting new physicians, maintaining work-life balance, flexing to changes in graduate medical education, and endorsing the need for personal wellness are just a few of the challenges requiring action from our Academy.

At the interim meeting of the American Medical Association House of Delegates, which was held November 10-14, 2023, in the National Harbor, Maryland, President Jesse Ehrenfeld, MD, MPH, noted that medicine is at a “crisis point.” Burnout, financial challenges in maintaining individual practice structures, and an aging population continue to pressure practicing doctors and other caregivers across our nation. On November 2, 2023, the Calendar Year (CY) Physician Fee Schedule Final Rule was issued by CMS. The conversion factor used to calculate payments to physicians was cut 3.4% ($32.47 from $33.89 in CY2023). Adjusted for inflation, Medicare physician payment has dropped 26% since 2001. We have much work to do together to support our Academy’s advocacy efforts.

More concerning is the number of physicians leaving practice, many in their prime. The September 2023 edition of Definitive Healthcare reported that 71,309 physicians (6% of the total workforce) left active practice in the United States between 2021-2022. Combined with losses in advanced practice providers and nurses, the “knowledge pool” of more experienced physicians and staff mentoring younger generations is being depleted at an unhealthy rate. Creating an environment to encourage otolaryngologists to work until the end of their careers will protect our “ENT Knowledge Pool.” From our current workforce study, Andrew J. Tompkins, MD, MBA, and the task force will provide needed data to enable our AAO-HNS/F Boards of Directors to create focused strategies aimed at ensuring the health of our specialty and our members, as well as protect access to care for all patients.

With a national election looming in 2024, healthcare funding will certainly be debated heavily. I agree with Dr. Ehrenfeld that now is the time for physician groups to come together to ensure that we are not just “heard” but are sitting in the critical planning sessions that will determine the makeup of our health system in the United States moving forward. Uniting our members of the AAO-HNS is essential as we reach out to other specialties to create an even larger voice to protect the house of medicine. The Academy continues to leverage our committee and coordinator structure and convene meetings of other like-minded groups, regulators, corporate partners, and policymakers. The Academy creates a more influential, collective voice for all of us.

The AAO-HNS provides a framework on which all our specialty societies can thrive. On December 2, 2023, the AAO-HNS convened the Specialty Unity Summit. This group is comprised of leadership from each specialty society in otolaryngology and meets twice annually to understand how our Academy can support priorities held by each subspecialty and the American Board of Otolaryngology - Head and Neck Surgery. The following individuals attended the December 2 meeting:

• Bradley F. Marple, MD (Association of Academic Departments of Otolaryngology-Head & Neck Surgery)
• Keith Sale, MD (American Academy of Otolaryngic Allergy)
• Brian Nussenbaum, MD (American Board of Otolaryngology - Head and Neck Surgery)
• Julina Ongkasuwan, MD (American Laryngological Association)
• David S. Haynes, MD (American Neurotological Society)
• William H. Slattery III, MD (American Otological Society)
• Marc G. Dubin, MD (American Rhinologic Society and AAO-HNS Otolaryngology Private Practice Section)
• Selena E. Briggs, MD, MBA, PhD (American Society of Geriatric Otolaryngology [ASGO])
• Steven D. Pletcher, MD (Otolaryngology Program Directors Organization)
• Andrew N. Goldberg, MD, MSCE (The Triological Society)
• Representing the AAO-HSN/F is Troy D. Woodard, MD (President-elect), Kenneth Kazahaya, MD, MBA (Secretary/Treasurer), James C. Denneny III, MD (Executive Vice President and CEO), and me as President. 

Together we identified several opportunities to develop synergies with the Academy. We discussed several industry-related issues and focused on building strategies to fulfill our duty to enhance patient care while preserving important relationships with other physician groups and industry. We reviewed the structure and governance of the evolving AAO-HNSF Otolaryngology Core Curriculum. Work being done by our Geriatric Committee and ASGO target needs in our aging population in the United States; we need to increase awareness of these efforts. Finally, we reviewed the Academy’s role in addressing supply and equipment shortages nationally.

In future columns, I will provide more insight into the importance of our Academy to each of us. Happy New Year, and I look forward to working with you. Together we are one!