Celebrate the small victories

February 2019 – Vol. 38, No. 1

As we look forward to the new year, there are several defining events for which we need to prepare.

First, the AMA combined CPT/RUC report on altering the E/M system as proposed by CMS this year will be presented at the February CPT meeting. The results of that report and proposal for CPT coding will be discussed and could possibly create significant changes in the way we document and see office patients.

James C. Denneny III, MD, AAO-HNS/F EVP/CEO

Second, the commission formed to look at the future of Board Certification and MOC released its report, recommendations, with a comment period that closed January 15. The recommendations and the resultant responses could well affect the future of the ABMS system as well as CME as it relates to licensing and privileging.

Third, we are optimistic that by the end of the first quarter we will have completed our search for a Reg-entSM partner and will have executed agreements that will allow us to expand our network, increase research opportunities, and begin active clinical trials. We will continue to work with the academic community to incorporate their valuable knowledge and patient populations in the registry.

UPDATE:

On January 14, the AAO-HNS submitted comments on the ABMS Vision Initiative’s Draft Report on Continuing Board Certification. While lifelong learning is essential, the AAO-HNS believes professional self-regulation through continuous learning and assessment must fit within the normal flow of a physician’s practice and be available at a reasonable expense. The letter highlights the Academy’s concerns with several of the Initiative’s recommendations, including the consolidation of ABMS oversight at the expense of individual specialty boards and the expectation that all diplomates participate annually in continuing certification programs. These recommendations would limit the ability for specialty boards such as the American Board of Otolaryngology – Head and Neck Surgery (ABOHNS) to continue with their innovative solutions tailored to our specialty. We look forward to continuing to work with the ABOHNS to achieve the goals stated in the Academy’s letter commenting on the 96-page draft recommendation document.

https://www.entnet.org/sites/
default/files/aao-hns_response_to_
abms_vision_init_jan_2019.pdf

Also, the recently filed American Hospital Association lawsuit against the federal government attempting to reverse “site of service” payment changes made in the FY 2019 final rule will be interesting to watch as will the consolidation in the healthcare industry not only among hospital systems, but also including data organizations, pharmacies, and other venture capital organizations launching commercialized versions of care.

We expect that the audiology sponsored legislation requesting “physician” designation by CMS and multistate licensure will be back on the table. The expected FDA release of proposed regulations for the OTC sale of hearing aids will trigger significant activity resulting from this major policy change affecting the majority of our members.

I was recently in Jackson, MS, where I spoke both to the private community and the academic department at the University of Mississippi. While there, I heard an inspiring talk that encouraged all to recognize and celebrate “difference-making moments” that occur in all facets and stages of our lives. It has become more challenging to do this both in a professional and personal context as schedules become crowded and life’s complexities and uncertainties abound.

Necessity seems to dictate adherence to routines that ensure things move forward, but they don’t allow you to fully comprehend the significance of many things going on around you. It becomes easy to grouse about happenings or events that interrupt or add to these well-thought-out schedules designed to allow us to survive and overlook concurrent happenings that might bring joy to our lives.

At a time when burnout is high, due to multiple factors including the continuing addition of perceptually unimportant responsibilities, along with the unpredictable direction of the healthcare delivery system evolution, the joy traditionally associated with the practice of medicine has significantly declined for many. Unfortunately, that has also carried over to the private lives of physicians as well.

Despite these challenges, there is still an abundance of “moments” associated with professional activities and personal and family interactions that can bring great joy and satisfaction to our lives. The trick is to recognize them as they are happening and celebrate them.

Moments such as a child hearing after myringotomy tube placement, placement of a hearing aid or cochlear implantation, telling patients that their cancer has been eradicated and they are free of disease, the gratitude of a patient successfully treated for benign paroxysmal positional vertigo, helping older patients regain the ability to swallow their own nutrition, and innumerable other scenarios reflect the true mission of physicians. Watching a student or resident as they learn something new or successfully complete a difficult operation, discovering a new concept or treatment, helping a colleague take care of a particularly difficult patient, convincing an insurer to cover a patient’s needed treatment, or defining best care using advanced data analytics. All of these and many more, when recognized, can bring joy and validation to the decision to practice medicine and the years of dedication for mastering the profession.

Equally as important outside of the office: your child’s first step or words, attending a ball game or recital, the first day of school, a graduation, a first romance, a family vacation, or even a simple thank you are worth their weight in gold when recognized.  Take the time to celebrate even the smallest victories, both personal and professional, with your family and staff.