The Academy Flywheel: Accelerating Our Collective Momentum

Rahul K. Shah, MD, MBA
AAO-HNS/F Executive Vice President and CEOIn April 2024, during my interview with the AAO-HNS/F Executive Vice President and CEO Search Committee, I sketched out a concept I called the "Academy Flywheel." Just as farmers once relied on heavy flywheels in their threshers and grain mills—wheels that required tremendous initial effort to overcome inertia but, once spinning, stored momentum and made the work exponentially easier—our Academy can adopt this same principle.

Inspired by Jim Collins' powerful framework from Good to Great, which Jeff Bezos famously applied to Amazon through his napkin sketch, this flywheel represents how our Academy can create and sustain momentum, transforming member satisfaction into growth, growth into resources, and resources back into even greater member value.

When I assumed the role of EVP/CEO in December 2024, I started working to get the flywheel spinning. As I discussed in my inaugural Bulletin column about adopting a Day One mentality, we must actively create inertia and bring together our value proposition through deliberate action and continuous momentum. Today, I want to share how we are collectively making this flywheel spin.

Understanding the Flywheel

The Academy Flywheel operates on a simple but powerful principle: each element reinforces the others in a self-perpetuating cycle. Member satisfaction drives engagement. Engagement increases use of Academy resources. Greater utilization amplifies our collective voice and influence. This expanded influence attracts more members and resources (tangible and intangible). These resources enable us to deliver greater member value, which enhances satisfaction—and the cycle continues, building momentum with each proverbial rotation.

The beauty of a flywheel is that it requires significant initial effort to start moving, but once spinning, it becomes increasingly efficient and powerful. The Academy flywheel has started moving!

We're now in the acceleration phase. Let me share how we're driving this momentum through specific strategies tied to our Strategic Plan goals.

Goal One: Unifying Our Specialty

Our first strategic goal—"Otolaryngology-head and neck surgery is a unified specialty dedicated to high quality, equitable care"—encompasses five objectives. The specific strategies management is implementing include: expanding PAC engagement in dollars and donors; leading a Hill Day to boost member-to-legislator contact; cultivating organizational partnerships that individual practices can adopt; incorporating business of medicine education and data to support reimbursement; assessing diversity through workforce surveys; and creating educational structures with international components and society partnerships.

The results are already visible. Since the start of this fiscal year, our corporate development initiatives have never been stronger and we are recognizing wins in advocacy and reimbursement. (Look for more highlights in the 2025 Annual Report, which will be published December 15.)

Goal Two: Modernizing Your Academy

Our second strategic goal—"The AAO-HNS fosters a global and inclusive otolaryngology-head and neck surgery community"—drives five objectives focused on how we serve you better. The specific strategies that management will implement include: creating a clear value proposition that explains what membership means; contacting large international residency programs; refining our member engagement score; partnering with other societies on coordinated programs; strengthening research through Reg-ENT, CORE, and CPGs; diversifying revenue; modernizing our technology (disclosure – all my bulletin columns are written with the assistance of AI). We are excited to work on developing a leadership development course to ensure we create the next leaders. A key strategy this year with AAO-HNS/F President, Dr. Gene Brown, has been evolving the Specialty Unity Society into "One OTO" with an inaugural strategic kick-off planned for December 2025.

The Acceleration Continues

The flywheel is accelerating. Our culture transformation—built on accountability, spread, and collaboration—is creating the internal foundation for sustained excellence. As our longest-tenured employee told me when I first started, "When I first came here in the early 2000s, the Academy was the place to work." We will reclaim that title to ensure we have the best team to power the flywheel.

But I need your input: What are we missing? What services, programs, or initiatives would make your Academy membership even more valuable?

The Academy flywheel isn't theoretical—it's operational. Every strategy I've outlined is either implemented or in active development. Every initiative feeds the cycle: member satisfaction drives engagement, engagement increases resource utilization, utilization amplifies our influence, influence attracts more members and partners, and increased resources enable us to deliver even greater value.

As I discussed in my industry partnerships column, the African proverb reminds us: "If you want to go fast, go alone. If you want to go far, go together." The Academy flywheel embodies both—we're moving fast through aggressive execution while going far through collective action.

This is what Day One mentality looks like in practice. We're not planning for eventual transformation—we're executing transformation daily. The flywheel's momentum builds with each eligible member who donates to ENT PAC,* each practice that participates in Reg-ent, each researcher that submits their scientific manuscript to our journals, each otolaryngologist who engages in advocacy, each time someone uses our AI assistant, or each registrant to our meetings or Global Grand Rounds.

Your engagement accelerates the flywheel. Your satisfaction drives growth. Your utilization of Academy resources amplifies our collective voice. And that amplified voice creates the influence necessary to protect our scope of practice, secure fair reimbursement, advance our research, and ensure that otolaryngology-head and neck surgery remains the authoritative voice in ear, nose, and throat, and head and neck care.

The flywheel is spinning. Let's accelerate it together.

_{*Contributions to ENT PAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of the American Academy of Otolaryngology–Head and Neck Surgery have the right to refuse to contribute without reprisal. Federal law prohibits ENT PAC from accepting contributions from foreign nationals. By law, if your contributions are made using a personal check or credit card, ENT PAC may use your contribution only to support candidates in federal elections. All corporate contributions to ENT PAC will be used for educational and administrative fees of ENT PAC, and other activities permissible under federal law. Federal law requires ENT PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year.}