R-E-S-P-E-C-T

David R. Nielsen, MD AAO-HNS/F EVP/CEO A wise father once counseled his son, “It’s better to earn respect than to demand it.” Early in my career, I remember seeking advice from my father regarding the challenges I faced in moving to a new area, starting a solo practice from scratch, and feeling like I had to prove myself anew with every patient, hospital, health plan, and referring physician. As a fellowship-trained practitioner, I was using new tools and technology unfamiliar to those who were charged with approving my skills and hospital privileges. My father sagely observed, “It sounds like your trouble is you want a good reputation before you have earned it.” I have never forgotten that. I was humbled to consider the many scientists and clinicians far more brilliant and accomplished than I, with exceptional skills, patience, and understated manner, who labored consistently and tirelessly for decades before realizing the acknowledgement and recognition they deserved. Respect for the members of our specialty collectively has always been disproportionately strong. At a recent multidisciplinary meeting, a CEO colleague from another specialty complimented you, our members, as a surgical specialty that in her perception, and in the minds of her members, always seemed to be the best and brightest in the community, on the medical staff, or on the committee they served. While this compliment is subjective and qualitative, it’s a nice change from the competitive stresses we often feel as a specialty as we mix in the medical/surgical world with overlapping skill sets. This overlap can lead to collaboration and cooperation as related specialists work together and accelerate progress through sharing perspectives and approaches, or it can lead to turf battles with attempts to exclude competition. Many of our members feel they have spent too much of their careers fighting battles over their hospital privileges or the recognition of their training, experience, and medical skills. Such struggles have often been caused by the failure of a few outside our profession to understand the history of otolaryngology—head and neck surgery and the broad scope of services we have provided for more than a century. In the first half of the previous century, clinical research and care for allergies, surgical management of facial traumatic and cosmetic deformities, and surgical care for head and neck tumors, including diseases of the thyroid and parathyroid, were all primarily the purview of otolaryngologists. Over time, scientific advances in antimicrobials, anesthesia, and immunology were made, war and battlefield conditions demanded new approaches, and new specialists arose with parallel skill sets and competing competencies. In the boom of medical science that took place in the last half of the 20th century, turf battles have arisen and still smolder today over some of this clinical territory. We can be proud of the members of our society whose leadership, standards, ethics, and focus on patient-centered care have garnered the respect of colleagues who individually and institutionally have become our allies, friends, and collaborators. While some associations are made up of homogeneously skilled members from the same residency training and specialty background, other societies are organized on treatment of diseases, organ systems or anatomy, regardless of specialty training or background. And too, some AAO-HNS members join societies of other specialties who share in the care of our patients, such as allergists, endocrinologists, general surgeons, pediatricians, plastic surgeons, pulmonologists, and others. When one of our members is elected to leadership in these combined specialty areas, it is a matter of great moment that strengthens our desire to maintain focus on bringing our collective skills to bear on the patient’s problem rather than on arguments with colleagues about the “right to treat.” Several years ago, Gerald M. Healy, MD, a lifelong Academy member and leader, was elected chair of the Board of Regents of the American College of Surgeons and later its president, the first otolaryngologist to fill that role. Gregory W. Randolph, MD, has just been elected chair, Endocrine Surgery Committee of the American Association of Clinical Endocrinologists, whose members include both adult and pediatric endocrinologists and endocrine surgeons. This is the result of years of work and respect gained by consistent excellence. Dr. Randolph is the first otolaryngologist elected to this key position, which helps to set the educational program for these specialty physicians. Increasingly collegial and cooperative work is taking place between the American Academy of Asthma, Allergy, and Immunology and our members who also belong to and lead the American Academy of Otolaryngic Allergy. We see evidence of cooperation among plastic surgeons of different training programs working together to strengthen standards for cosmetic and reconstructive surgery and hope for similar success in collegiality in the future. One of the likely long-term results of healthcare delivery reform tied to global health outcomes will be the elimination of irrelevant turf battles. Increased team-based care will be brought about by the actual evidence of quality care documentation being required of all physicians. We stand for the highest standard of healthcare and a patient-centered focus. We congratulate our members for their leadership skills and collegiality and consensus building that strengthens team-based collaborative care and is recognized by others outside of our specialty. We hope this trend will continue.