Published: October 21, 2013

Join Us at the Otolaryngology Historical Society Meeting

On behalf of Marc R. Eisen, MD, PhD, this is a cordial invitation to Academy members to attend the Otolaryngology Historical Society (OHS) meeting, Monday, September 10, from 6:30 pm to 8:30 pm at the Cosmos Club, Crentz Room, 2121 Massachusetts Avenue Northwest, Washington, DC. Transportation will be provided at 6:00 pm from the Walter E. Washington Convention Center. The program features the highly regarded appraiser of historical artifacts, Allan J. Stypeck, Jr., whose clients include the White House, the U.S. National Archives and Records Administration, the U.S. Department of State, and other famous Washington, DC, institutions. His talk is entitled “Collecting Books and Manuscripts in the 21st Century—Is There a Future?” Other presenters: Eduardo C. Corales, MD, Stanford University: “How Cranial Nerve Numbering Led to Widespread Inaccuracies in Modern Anatomical Illustrations.” Robert K. Jackler, MD, Stanford University: “Revisiting Max Brödel’s 1939 Classic Coronal Illustration of the Ear.” Andrew G. Shuman, MD, Memorial Sloan Kettering Cancer Center: “From Cancer to Cookbooks: The Story of Clementine Paddleford.” To celebrate the legacy of pioneering specialists, OHS members are encouraged to attend and bring guests to this delightful and elegant occasion. Robert J. Ruben, MD, a member of the Cosmos Club, notes that the club was the site for discussions that led to the formation of the National Institute on Deafness and other Communications Disorders (NIDCD) 25 years ago. To make a reservation for the OHS meeting, email ohs@entnet.org. To join the OHS as a member, email memberservices@entnet.org.

The Cosmos Club

On behalf of Marc R. Eisen, MD, PhD, this is a cordial invitation to Academy members to attend the Otolaryngology Historical Society (OHS) meeting, Monday, September 10, from 6:30 pm to 8:30 pm at the Cosmos Club, Crentz Room, 2121 Massachusetts Avenue Northwest, Washington, DC. Transportation will be provided at 6:00 pm from the Walter E. Washington Convention Center.

The program features the highly regarded appraiser of historical artifacts, Allan J. Stypeck, Jr., whose clients include the White House, the U.S. National Archives and Records Administration, the U.S. Department of State, and other famous Washington, DC, institutions. His talk is entitled “Collecting Books and Manuscripts in the 21st Century—Is There a Future?”

Other presenters:

Eduardo C. Corales, MD, Stanford University: “How Cranial Nerve Numbering Led to Widespread Inaccuracies in Modern Anatomical Illustrations.”

Robert K. Jackler, MD, Stanford University: “Revisiting Max Brödel’s 1939 Classic Coronal Illustration of the Ear.”

Andrew G. Shuman, MD, Memorial Sloan Kettering Cancer Center: “From Cancer to Cookbooks: The Story of Clementine Paddleford.”

To celebrate the legacy of pioneering specialists, OHS members are encouraged to attend and bring guests to this delightful and elegant occasion. Robert J. Ruben, MD, a member of the Cosmos Club, notes that the club was the site for discussions that led to the formation of the National Institute on Deafness and other Communications Disorders (NIDCD) 25 years ago.

To make a reservation for the OHS meeting, email ohs@entnet.org. To join the OHS as a member, email memberservices@entnet.org.

More from August 2012 - Vol. 31 No. 08

Medical Students, Residents Benefit from Foundation Education Opportunities

Sonya M. Malekzadeh, MD AAO-HNSF Coordinator, Education and Stacey L. Ishman, MD, MPH, AAO-HNS BOG Leg. Rep. Co-Chair The AAO-HNS Foundation’s Professional Education program is designed to improve healthcare provider competence through lifelong learning. Primary audiences for our education initiatives are physicians and physicians-in-training who specialize in otolaryngology–head and neck surgery. The Foundation recognizes that these groups have diverse areas of interest and therefore strives to develop resources that recognize these differences. In this article we share the Foundation’s education opportunities that have been developed specifically for medical students and residents to assist with their training and improve their competence in the specialty. As medical students gather knowledge about the medical specialties, the Foundation aims to offer resources that introduce them to the exciting field of otolaryngology–head and neck surgery. For residents who have chosen otolaryngology as their primary specialty, the Foundation provides education materials to support the successful completion of their training program and advancement to practicing otolaryngologists. Medical Students The third edition of Primary Care Otolaryngology was published as an e-book in summer 2011. This longstanding Foundation resource continues to be a useful tool for medical students who wish to learn more about common ENT conditions they may face in practice. It is an excellent overview of the otolaryngology field. The Foundation has three additional e-books covering geriatric otolaryngology, antimicrobial therapy, and TNM staging of the head and neck. Clinical Otolaryngology Online (COOL) courses offer online interactive patient case scenarios designed to help medical students and residents evaluate otolaryngology-related conditions and apply knowledge to real world situations. They are designed to identify common treatment errors and how to avoid making a clinical mistake or to teach new methods of treatment to improve patient care. Residents Comprehensive Otolaryngologic Curriculum Learning through Interactive Approach (COCLIA) has been updated and re-released. This teaching tool provides discussion questions for more than 100 major otolaryngology topics. COCLIA is designed as a teaching conference, and residents are encouraged to review the questions and learn from each other. This version has been enhanced with images and photos. The perennial Home Study Course (HSC) is a highly valued resource for residents. Each year more than 100 residency programs subscribe to HSC. Most programs require participation in the course and utilize the test scores in the assessment of residents. With multiple subspecialty topics covered each year, a resident gains a comprehensive understanding of the prominent literature in the subspecialties within otolaryngology. The Academic Bowl is an entertaining session during the AAO-HNSF Annual Meeting & OTO EXPO. Four teams of otolaryngology residents compete to answer clinical questions. Its purpose is to test the clinical prowess of top otolaryngology residents in the country. The audience participates and responds through an audience response system. AcademyU® provides courses on multiple ENT topics that are of great value to residents. It is composed of courses designed by content experts through the Foundation education committees. In addition, an online lectures series, containing the highlights from the annual meeting, has now been added. Otolaryngology–Head and Neck Surgery is the official journal of the Foundation and presents peer-reviewed articles on recent developments in treatment of the ear, nose, throat, and related structures of the head and neck. It is available online and in print and features a monthly podcast. Patient Management Perspectives in Otolaryngology (PMP), formerly known as Patient of the Month, is an interactive electronic or print series that simulates real-life clinical decision-making. Each issue includes a clinical case study, visual materials, detailed patient management summary, references for future study, and a self-assessment. Education Resources in the Works While we are pleased with the quality education resources currently available for medical students and residents, we are not resting on our laurels. We are now developing new products and services for these special audiences. The Foundation is currently working on a medical student curriculum. The first phase of this is geared toward integrating otolaryngology education into nonotolaryngology rotations and creating a set of evidence-based topics that every medical student should know prior to graduation. The second phase will focus on the education of medical students participating in otolaryngology rotations both at the elective and sub-internship levels. The new Resident Manual of Trauma to the Face, Head, and Neck is being developed by the Trauma Committee. Scheduled to be published this year, it will offer a simple, concise, and easily accessible source of diagnostic and therapeutic guidelines. The manual is intended to be a quick-reference tool in the evaluation of trauma patients. In addition, the Foundation education committees are developing a question bank to be used for test preparation and knowledge self-assessment. The bank will make available 400 questions to residents and practicing physicians and is expected to be available as a mobile application this year. An update to the longstanding Maintenance Manual for Lifelong Learning is underway. The primary goal of the manual is to address issues that are of practical importance for otolaryngologists in improving patient care. Intended for residents and practicing physicians, the study guide also includes a self-assessment section. The Foundation is currently developing an online digital video demonstrating a thorough ENT exam. The target audience for the video is medical students, residents, and allied health professionals. The video includes many images of normal anatomy, normal variances, and common abnormalities. The video covers four areas: the ear, the oral cavity and neck, the face and nose, and the nasopharynx and larynx. Resident and Medical Student Opportunities at the Annual Meeting Discounted registration fees First-time attendees orientation Section for Residents and Fellows-in-Training General Assembly Residents Day Monday, September 10 Free Admission to Instruction Courses for Academy members only Tuesday Miniseminars for Residents and Fellows For complete annual meeting information, visit www.entnet.org/annual_meeting Medical Student, Resident Resources Education Opportunities for Members www.entnet.org/educationandresearchPrimary Care Otolaryngology www.entnet.org/primarycare Comprehensive Otolaryngologic Curriculum Learning through Interactive Approach (COCLIA) www.entnet.org/coclia Home Study Course (HSC) www.entnet.org/hsc Clinical Otolaryngology Online Courses (COOL) www.entnet.org/cool AcademyU® www.entnet.org/academyu Patient Management Perspectives in Otolaryngology (PMP) www.entnet.org/pmp Otolaryngology–Head and Neck Surgery Journal http://otojournal.org

United Healthcare Private Payer Advocacy Update

On April 25, 2012, AAO-HNS representatives, including physician and audiology volunteers and staff, conducted a conference call with UnitedHealthcare (UHC) and hi HealthInnovations (HHI) executives as a follow-up to our January in-person meeting and February 21 letter regarding the direct-to-consumer hearing aid program (see the Private Payer website for more: www.entnet.org/Practice/News-and-Updates-from-Private-Payers.cfm. A day earlier, the Academy’s government affairs team spoke with HHI’s legal counsel regarding potential regulatory and statutory issues with the program. The AAO-HNS and numerous other hearing health organizations have expressed serious concerns regarding the company’s online hearing test. During the call, HHI confirmed it had removed the self-rendered online hearing test from the company’s website. However, HHI continues to distribute air conduction tests to providers. HHI has not made any changes to its program based on our feedback, so the Academy believes it is unlikely anything will change quickly. As a result, we made our position clear in our discussion with UHC and HHI that while we are supportive of providing patients access to affordable hearing aids, we do not believe the program represents safe and high quality care for patients. AAO-HNS staff also had a conference call on April 26 with counterparts at the American Academy of Audiology (AAA), the American Speech-Language Hearing Association (ASHA), the Academy of Doctors of Audiology (ADA), and the International Hearing Society (IHS) during which each organization discussed its recent interactions with UHC on this issue. On May 15, the Academy signed on to a letter urging state health departments to advise consumers experiencing hearing loss to seek a comprehensive hearing evaluation by a licensed hearing professional prior to purchasing hearing aids over-the-counter or through the Internet. The letter additionally urges each department of health to notify consumers of the importance of seeing a physician for hearing loss and that failure to do so skirts state and federal regulations and could potentially be harmful. The letter, which was signed by numerous other organizations, including the ADA, AAA, ASHA, and IHS, was sent to the departments of health in all 50 states and six unincorporated U.S. territories. The goal of the effort was for all states to issue a statement similar to the Minnesota Department of Health’s as part of May’s Better Hearing and Speech month. The statements were to stress the importance of seeing a hearing healthcare professional for hearing loss. To view the Minnesota Department of Health’s news release, view its website at www.health.state.mn.us/news/pressrel/2011/hearing102611.html. In addition, on June 25, the Academy communicated our concerns in a letter to the U.S. Food and Drug Administration (FDA), in an attempt to warn consumers at the federal level of risks associated with direct-to-consumer hearing aid programs. Stay tuned to the Academy website for further updates. If you or any of your patients are experiencing issues with UHC’s hearing aids or air conduction hearing kits, email the Academy’s Health Policy team at healthpolicy@entnet.org. Advocacy-Effort TimelineOctober 3, 2011—Academy is alerted of hi HealthInnovations’ new hearing aid program. October 24, 2011—Academy comments about the program in American Medical News. November 2, 2011—Comment letter sent to UHC followed by an immediate response from UHC to arrange a conference call. November 28, 2011—Several members from the Academy’s physician payment policy group (3P), Board of Governors chair, and staff conduct a brief conference call with UHC. All parties agree a face-to-face meeting is necessary. December 5, 2011—Academy follows up with UHC, sending a summary of the conference call and suggesting potential dates for a meeting. January 30, 2012—Academy leadership, physician and audiologist volunteers, and staff meet with UHC. February 9, 2012—Academy signs on to a joint statement emphasizing patient safety with four other associations. February 21, 2012—Academy follows up with a letter to UHC reaffirming Academy requests made during the January 30 meeting. April 24, 2012—Government Affairs staff speak with UHC counsel to discuss regulatory and statutory issues. April 25, 2012—Academy leadership, physician and audiologist volunteers, and staff participate in a conference call with UHC as a follow-up to the February 21 letter. April 26, 2012—Academy staff participates in conference call with four other organizations concerned with UHC’s hearing aid program. May 15, 2012—Academy signs on to letter urging state health departments in all 50 states and six unincorporated U.S. territories to warn consumers about potential health risks of UHC hearing aid [36.1] programs. June 25, 2012—Academy sends a letter to the FDA communicating concerns about consumer safety of DTC hearing aid programs.

Academy Piloting Patient Safety Portal

Rahul K. Shah, MD Co-chair, AAO-HNSF PSQI Committee George Washington University School of Medicine For the past two years, the Academy, under the direction of Jean Brereton, senior director of Research, Quality, and Health Policy, and with Peter Robertson, senior manager of Research and Quality Improvement, has been exploring the feasibility of having our membership anonymously report patient safety-related issues, such as errors, adverse events, and near misses. The concept behind this is similar to what the Federal Aviation Administration (FAA) does to keep track of near misses and similar events. The nonpunitive reporting system the FAA has is so robust that many consider it one of the reasons for that agency’s exemplary safety record. The federal designation as a patient safety organization as authorized by the Patient Safety and Quality Act of 2005 denotes certain protections to organizations in collecting such data and using this information in a nonpunitive manner. Our hope was that becoming a patient safety organization would be in the best interest of our members and their patients. However, after many months and extensive research into a number of options, including potentially partnering with an existing Patient Safety Organization, we have decided this is not the route to pursue. We need information on patient safety events to be able to take a macro-level view of the zones of risk in our practices and help aggregate our one-off occurrences into meaningful actionable data. The difficulty is that a problem experienced by one otolaryngologist in a specific region of the country may not even be known to another practitioner in a different practice region. The need to have information on these rare, but significant, events reach the broadest possible targeted audience is imperative. As such, the Academy, in conjunction with the Patient Safety Quality Improvement Committee, is piloting a patient safety portal where Academy members can securely, confidentially, and anonymously report an event. The reported error does not necessarily have to have resulted in an adverse event; reports can essentially reflect any safety concern that the Academy member has noted, including a near miss or other such error. Academy staff has gone to great lengths to ensure and corroborate the two most important aspects of a nonpunitive report system: confidentiality and anonymity. The initial step is to ensure users of the portal are Academy members. Once your membership is confirmed and you access the patient safety portal, your report immediately becomes anonymous. Indeed, we have run checks to ensure that no data are recorded, not even the IP address of the computer from which the report is submitted. As a final security check, as reports come in, they will be reviewed by a nonphysician Academy staff member to ensure that any report containing any type of identifying information is purged. Our hope is to create a place where Academy members can and should be able to report near misses, adverse events, and errors. The hope is that as our membership starts using this reporting tool, we will be able to rapidly identify macro trends that are becoming an issue. For example, if there are infrequent, but significant, issues associated with a particular device, the reporting system may be able to catch this. To be clear, the patient safety portal is not to be duplicative of existing reporting systems such as the U.S. Food & Drug Administration’s mandatory reporting system for device issues. Rather, it is to be complementary and immediately available and accessible for our Academy membership, with the ability to improve our practices and the safety for our patients and our specialty. We are currently piloting this with the Patient Safety and Quality Improvement Committee to discern if the portal asks the right questions that can lead to collection of actionable data. We hope to refine this portal soon and then begin opening this up to all members, so that we can identify opportunities for improvement of our systems of practice based on the aggregate data. We encourage members to write us with any topic of interest and we will try to research and discuss the issue. Members’ names are published only after they have been contacted directly by Academy staff and have given consent to the use of their names. Please email the Academy at qualityimprovement@entnet.org to engage us in a patient safety and quality discussion that is pertinent to your practice. Evidence-Based Guidelines Affecting Policy, Practice, and Stakeholders (E-GAPPS) Conference The 2012 E-GAPPS Conference is a two-day meeting co-sponsored by the Guidelines International Network North America (G-I-N NA) and the Section on Evidence-Based Health Care (SEBHC) of the New York Academy of Medicine. It will take place Monday, December 10, through Tuesday, December 11, in New York, NY. The E-GAPPS mission focuses on constructive dialogue and collaboration; best practices in guideline development, dissemination, and implementation; and perspectives, processes, values, and principles that influence healthcare policy. To register to attend, or to learn more about the confirmed plenary speakers, conference themes, or breakout sessions, visit http://www.nyam.org/events/2012/evidence-based-guidelines-conference.html.

Medicare Reimbursement: How the AMA Relative Value Update Committee (RUC) Works and Who Is Involved

By Jane T. Dillion, MD, with Jenna W. Minton, Esq., AAO-HNS Staff, Health Policy As an Academy member, you’ve probably seen frequent requests distributed in the e-News asking for volunteers for upcoming AMA Relative Value Update Committee (RUC) surveys of physician services. Many of you may have asked yourself what the RUC is and why the surveys are important. By providing the membership with some general background on this important process, we hope to encourage you to become an active participant in the annual RUC survey process. The AMA RUC was developed in response to the transition to a physician payment system based on the Resource-Based Relative Value Scale (RBRVS). The RUC is a multispecialty committee that provides clinical expertise and input on the resources required to provide physician services. The RUC submits recommendations to the Centers for Medicare and Medicaid Services (CMS) on an annual basis, which are used by CMS to develop relative values for physician services provided to Medicare beneficiaries. The RUC, in conjunction with the Current Procedural Terminology (CPT) Editorial Panel, has created a process where specialty societies can develop relative value recommendations for new and revised codes, and the RUC carefully reviews survey data presented by specialty societies to develop recommendations for consideration by CMS. CMS then issues final payment policies and values in the final Medicare Physician Fee Schedule rule, which is typically released in early November each year. The RUC is intended to represent the entire medical profession. Of its 31 members, 21 are appointed by major national medical specialty societies, including those recognized by the American Board of Medical Specialties; those with a large percentage of physicians in patient care; and those that account for high percentages of Medicare expenditures. Four seats rotate on a two-year basis, with two reserved for an internal medicine subspecialty, one for a primary care representative, and one for any other specialty. The RUC chair, the co-chair of the RUC Health Care Professionals Advisory Committee Review Board, and representatives of the AMA, American Osteopathic Association, the chair of the Practice Expense Review Committee, and chair CPT Editorial Panel hold the remaining six seats. The AMA Board of Trustees selects the RUC chair and the AMA representative to the RUC. The individual RUC members are nominated by the specialty societies and are approved by the AMA. The RUC currently includes the seats mentioned above and a representative and alternates for the following medical specialties: anesthesiology, cardiology, dermatology, emergency medicine, family medicine, general surgery, geriatrics, internal medicine, neurology, neurosurgery, obstetrics/gynecology, ophthalmology, orthopaedic surgery, otolaryngology, pathology, pediatrics, plastic surgery, primary care (rotating seat), pulmonary medicine (rotating seat), psychiatry, radiology, rheumatology (rotating seat), thoracic surgery, urology, and vascular surgery (rotating seat). The Academy actively participates in the RUC process and surveys codes for nearly every RUC meeting. Meetings take place three times a year during the winter, spring, and fall. The Academy’s current RUC representatives include RUC panel member Charles F. Koopmann, MD, and panel member alternate, Jane T. Dillon, MD. It is important to recognize that the RUC representatives for each specialty are not advocates for their specialty; rather they participate in an individual capacity and represent their own views and independent judgment while serving on the panel. The Academy also has RUC Advisors who are responsible for working with the Physician Payment Policy Workgroup (3P) and Academy staff to develop relative value recommendations and practice expense direct inputs for otolaryngology services that are presented to the RUC. The Academy RUC advisors are Wayne M. Koch, MD, and advisor alternate John T. Lanza, MD. As part of the Academy’s participation in the RUC, we often ask members to participate in surveys to help value CPT codes. The RUC team, outlined above, uses those survey responses to develop the recommendations for values and practice expenses that are presented to the RUC. The RUC hears presentations from all specialties interested in the service being reviewed and determines whether they agree with the proposed values, or whether the code needs further review. In the event the RUC does not agree with the value presented by the society, the code is sent to a facilitation committee to try to reach agreement on the most appropriate value for the service. Familiarity with the survey instrument and methodology is essential for accurate completion of a survey, which has important implications for Medicare reimbursement. Survey instruments are standardized across all specialties and random member samples are used to derive data for presentation to the RUC. In order to participate, respondents must be American physicians who are familiar with the service under review. Respondents must have supervised or performed the code being surveyed at least once during the past 12 months to complete a survey. For more background on the RUC Survey Process, members can access the following PowerPoint presentation on the AcademyU® website, located under Practice Management: www.entnet.org/educationandresearch/academyu.cfm. Members can also email any questions to healthpolicy@entnet.org. We hope this background is useful to members in better understanding the composition of the RUC as well as the importance of the survey process and its role in the valuation of medical services.

3P Update: Quality and Resource Use Reports and the Value-Based Payment Modifier Program

The Physician Payment Policy Workgroup (3P), co-chaired by Richard W. Waguespack, MD, and Michael Setzen, MD, is the senior advisory body to Academy leadership and staff on issues related to socioeconomic advocacy, regulatory activity, coding or reimbursement, and practice services or management. The Health Policy staff and 3P have been busy during the first half of 2012 with a continued high level of activity, constant emails and monthly calls, working diligently and tirelessly on behalf of all members. 3P has focused on the development of future payment mechanisms and two programs the Centers for Medicare and Medicaid Services (CMS) are working on, the distribution of Quality Resource Use Reports (QRURs), and the installation of the value-based payment modifier program. By way of background, the Medicare Improvements for Patients and Providers Act of 2008 created the Physician Resource Use Measurement and Reporting Program. In 2010, the Affordable Care Act extended and enhanced the program and named it the Physician Feedback Program. The program authorizes CMS to produce annual physician QRURs. The Affordable Care Act also authorized the creation of the value-based payment modifier program, which requires the use of differential payments to physicians or groups based upon the quality of care furnished compared with cost. QRURs In early March 2012, CMS sent the first QRURs to nearly 24,000 physicians in Iowa, Kansas, Missouri, and Nebraska. Data contained in QRURs compared the cost and clinical care provided to Medicare beneficiaries in 2010 by a physician to the average costs and clinical care of other physicians in these four states. These reports contained the number of Medicare beneficiaries a physician saw during the reporting period, compared the quality of care for Medicare beneficiaries seen by a physician to other physicians based upon 28 quality measures (27 of which are National Quality Forum endorsed), and showed cost data for patients whose care the physician directed, influenced, or contributed to. This was measured by outpatient evaluation and management (E&M) office visits or total professional costs. Wisconsin Physician Services (WPS), the Medicare contractor that processes claims in the four states, emailed QRURs to one physician or employee who has been designated as the primary contact for communications from WPS. The reports were available until the first week of June. These reports, according to CMS, are intended to be informational and allow physicians to compare the quality and cost of Medicare patients’ care to physicians in their specialty and by all physicians within those states. Although they are currently informational in nature only, the reports also provided quality of care and cost information that will be used by CMS in the development of the value-based payment modifier program, which will begin to be phased in starting in 2015. Value-Based Payment Modifier Program The Affordable Care Act created the value-based payment modifier program and required the use of differential payments to physicians or groups based upon the quality of care furnished compared with cost and will apply to services physicians’ bill under the Medicare Physician Fee Schedule. Through the program, CMS will make adjustments in cost for difference in geographic rates (payment standardization) and the underlying health status of individual beneficiaries seen by a provider (risk adjustment). Although the Value-Based Modifier will not take effect until 2015, the 2015 modifier will be based upon services provided during 2013. For 2015 and 2016, the U.S. Secretary of Health and Human Services has discretion to apply the modifier to specific physicians and/ or groups of physicians they deem appropriate. In 2017, the modifier will apply to most or all physicians who submit claims through the Medicare Physician Fee Schedule. Few specifics are currently known about the program, but CMS plans on proposing methodology for the value-based modifier program during the 2013 Physician Fee Schedule rulemaking process. CMS is soliciting input from associations, including the Academy, in the development of the methodology for the modifier, and the Academy will provide input to CMS through comments and coalitions as necessary. The Academy is asking members who received and downloaded QRURs to notify the health policy unit and provide input so we can forward concerns from members to CMS officials. For example, are the performance highlights important or are there others that may be more useful? Please email feedback to healthpolicy@entnet.org. At this year’s annual meeting in Washington, DC, 3P will conduct a miniseminar on Academy Advocacy for Physician Payment: 2012 on Sunday, September 9, 2012, from 10:30 am to 11:50 am. One of the future payment strategies that will be discussed during the miniseminar is the value-based payment modifier program that will likely incorporate aspects from the initial QRURs. In the meantime, please monitor our Medicare Updates page, which can be accessed at http://www.entnet.org/Practice/Medicareupdates.cfm, for updates on these programs.

Stay Informed with the AAO-HNS Legislative and Political Affairs Webpage

Do you want to be one of the first to know the status of healthcare bills moving through Congress or your state? Bookmark the Legislative and Political Affairs webpage today! By visiting the webpage, you can learn more about the issues affecting the specialty, including the flawed Sustainable Growth Rate (SGR) formula, medical liability reform, scope-of-practice battles, Graduate Medical Education (GME) funding, truth-in-advertising initiatives, and efforts to repeal the Independent Payment Advisory Board (IPAB). Visit www.entnet.org/advocacy.

In the Political Hub of Our Nation, Advocacy Activities Await!

Advocacy Opportunities during the Meeting It is a legislative and political affairs homecoming during the AAO-HNSF 2012 Annual Meeting & OTO EXPO! With this year’s meeting in Washington, DC, AAO-HNS members are provided the perfect opportunity to become more involved in advocacy-related events scheduled during the meeting. As in past years, the ENT PAC Booth will serve as the Government Affairs “hub” for the meeting. AAO-HNS members are encouraged to stop by the booth to learn more about easy ways to support the Academy’s various legislative, political, and grassroots advocacy programs. The booth will be located in the convention center on the L Street Bridge. Visit the booth to: Obtain information on becoming a 2012 ENT PAC Investor; Sign our petition to Congress on a key AAO-HNS legislative issue; View the renowned ENT PAC 2012 “Wall of Investors;” Receive copies of the latest edition of the ENT PAC “Investors Report;” Join the ENT Advocacy Network to receive timely updates on political and legislative issues affecting the specialty and a free subscription to a biweekly e-Newsletter, The ENT Advocate; Receive the latest updates on federal and state legislation affecting your practices and your patients; Learn ways to effectively advocate on behalf of the specialty when you return home. Exclusive Events for ENT PAC Investors during Annual Meeting ENT PAC, the political action committee of the AAO-HNS, financially supports incumbent Members of Congress and viable candidates regardless of their party affiliation who champion the specialty’s legislative priorities. To that end, it is important to achieve diverse and widespread support from AAO-HNS members across the country. In order to better educate ENT PAC Investors and eligible supporters about the importance of the PAC, the ENT PAC Board of Advisors and staff have scheduled various events during the annual meeting to share critical information with PAC Investors. The events scheduled for 2012 include: The annual ENT PAC Investors “thank-you” reception. This popular event will take place on Monday, September 10. U.S. AAO-HNS members who make donations to ENT PAC prior to or during the annual meeting are invited to the event. An inaugural “Residents Briefing,” on Tuesday, September 11. As the future of the specialty, now is the time for residents to learn about the Academy’s various political and legislative programs. Residents will receive an “insider’s” update on current federal legislative activities, upcoming elections, and new PAC programs. Residents can expect an exciting, yet casual, discussion outlining the politics and policy fueling efforts on Capitol Hill. A special “thank-you” luncheon for members of the ENT PAC Chairman’s Club ($1,000+ donors). The luncheon, hosted by members of the ENT PAC Board of Advisors, is a unique opportunity to learn about the Academy’s political strategy and decision-making process. The luncheon will take place on Tuesday, September 11. Mark your calendars today to attend these special events! For more information on becoming an ENT PAC Investor, visit www.entnet.org/entpac (U.S. AAO-HNS member log-in required) or email ENT PAC staff at entpac@entnet.org. *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.

Online Exclusive: Back to School ENT Health

By Dale Tylor, MD, for the Media and Public Relations Committee As summer winds down, families complete preparations for the transition of returning to school. While it can be easy to focus on purchasing the necessary back-to-school supplies and clothing for the child, families should be educated about a number of otolaryngologic health considerations that can help ensure a successful and safe year ahead. Hearing Loss and Hearing Screening Fortunately, most newborns undergo hearing screening evaluations, but this does not guarantee that hearing will remain within normal limits as they age.1 Hearing loss in children may be associated with issues of speech, even if the loss is unilateral.2 Clues to hearing impairment include complaints from the family or teacher that they have to repeat themselves to be understood by the child, or the child preferring to watch television at volumes that are excessively loud. Parents should ask their pediatrician or otolaryngologist about hearing testing if they have any concerns about the child’s hearing, language development, or ability to concentrate at school or home. These children may require a formal audiogram with an audiologist. Ultimately, issues of conductive or sensorineural hearing loss or central auditory processing disorder and a variety of medical and surgical managements can help to address the spectrum of diagnosed hearing disorders. Speech Delay The ability to communicate effectively is vital to scholastic and occupational success.3 Children with delayed speech development are at a severe disadvantage in school. If parents are concerned about the child’s language development or articulation, they should ask their doctor if the child might benefit from a formal evaluation with a speech-language pathologist and subsequent speech therapy. An otolaryngologist can also help assess medical causes of speech impairment, including ankyloglossia, palatal anomalies, or tonsil hypertrophy. Sleep Disordered Breathing Children who snore or have witnessed apneic pauses, gasping, or choking can be paradoxically hyperactive during the day with impaired behavioral and neurocognitive function.4 The poor quality sleep experienced by children with obstructive sleep-disordered breathing can lead to short-term consequences, such as diminished attention spans, headaches, hypersomnolence or hyperactivity, and enuresis, and longer-term health effects on the heart, lungs, brain, and other body systems. Parents who notice their child snoring or not getting restful sleep should discuss this with their physician, as the child may require a sleep study or other evaluation. Children with suspected attention deficit hyperactivity disorder and concomitant symptoms of sleep-disordered breathing might be evaluated by an otolaryngologist to rule out sleep apnea before commencing prescription medication for the ADHD. Often medical or surgical management of sleep apnea can significantly improve the child’s quality of life. Facial Trauma/Sports Facial fractures are fairly common in active children, and care should be taken during higher risk activities to minimize the risk of trauma to the craniofacial skeleton. Protective sports gear (helmets, facial visors, mouth guards) should be worn when appropriate. Children with suspected nasal or facial fractures, auricular hematomas, or concussions should be evaluated expeditiously after an injury, as some of these conditions are best addressed in an immediate fashion. Recurrent Upper Respiratory Infections During the cooler months at school, children are more likely to be indoors and in fairly close quarters. This leads to increased risk of acquiring upper respiratory infections like the common cold, and other subsequent infections of the upper aerodigestive tract, including otitis media, sinusitis, and tonsillitis. Parents should be reminded that the average child suffers with 20 viral upper respiratory infections by the age of 12,5 the vast majority of which do not benefit from the administration of antibiotics or treatment other than conservative care. Children should be taught to wash their hands frequently, to cough into their sleeve, and how to use nasal saline irrigations. If the child has repeated episodes of acute otitis media, tonsillitis, or sinusitis that are affecting quality of life, or has chronic symptoms of these infections, it is reasonable for the parents to request evaluation with an otolaryngologist–head and neck surgeon. References: Lü J, Huang Z, Yang T, Li Y, et al. Screening for delayed-onset hearing loss in preschool children who previously passed the newborn hearing screening. Int J Pediatr Otorhinolaryngol 2011; 75(8):1045-9. Lieu JE, Tye-Murray N, Karzon RK, Piccirillo JF. Unilateral hearing loss is associated with worse speech-language scores in children. Pediatrics 2010; 125(6):e1348-55. Muir C, O’Callaghan MJ, Bor W, Najman JM et al. Speech concerns at 5 years and adult educational and mental health outcomes. J Paediatr Child Health 2011; 47(7):423-8. Landau YE, Bar-Yishay O, Greenberg-Dotan S, Goldbart AD, et al. Impaired behavioral and neurocognitive function in preschool children with obstructive sleep apnea. Pediatr Pulmonol 2012; 47(2):180-8. Grüber C, Keil T, Kulig M, Rolls S, et al. History of respiratory infections in the first 12 years among children from a birth cohort. Pediatr Allergy Immunol 2008; 19(6):505-12.

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Empty Nest: Crisis, Challenge, or Relief?

By Kathleen Yaremchuk, MD, for the Women in Otolaryngology Section The term “empty nest syndrome” refers to a sense of sadness and loneliness that may occur after a grown child leaves home. Although women and men may parent equally, the primary caregiver is most likely to experience that feeling. The transition affects many tasks considered a major focus of the nurturing parent role, such as organizing or overseeing the typical school activities of athletics, social commitments, and parent-teacher conferences. As a physician and a parent, one makes compromises and decisions on whether to attend soccer games, after-school activities, and parent-teacher conferences or to pursue professional advancement by engaging in research, journal club, specialty medical societies, and departmental meetings. With limited hours in the day, the opportunity to serve on institutional committees or attend meetings that require travel and time away from home often means missing out on a family dinner or children’s activities. The decision to favor parenting activities instead of professional pursuits isn’t meant to be intentionally detrimental to a career, but is based on priorities at the time. Children aren’t always going to be young and want their parents at a special event. Nevertheless, these commitments can be problematic when the operating room is running late or the on-call emergency beckons. Usually, there are times in every parent’s experience that induce a feeling of guilt because of missed opportunities. Much of family life revolves around the children’s schedule. When the last child heads off to college or work, parents and the rest of the family often experience a void in social activities. For some, this leads to depression and a loss of purpose. There is often an underlying concern that the child is unprepared for life on his/her own. How will the child survive without the parents? The challenge is to be emotionally prepared for the change in relationship with the children and to learn to maintain communication without the daily face-to-face at home. Texting, email, and cell phone chats allow frequent contact and communication. Online chats can provide the visual contact that many have come to depend on. The newfound free time can be problematic for some parents while others breathe a sigh of relief. It is a time to reconnect with a spouse and share mutual interests. Travel, hobbies, and professional growth are areas that can be cultivated in a way that was not possible previously. Without the pressure of rushing home to make dinner and sit with the family, there is time to meet with friends and reconnect anew. Similarly, professional contacts that have been made during the years can be leveraged to do research and advance professionally. The AAO-HNSF Annual Meeting & OTO EXPO, Combined Section Meeting, and Combined Otolaryngology Spring Meetings (COSM) are all opportunities to travel, learn, and spend time with colleagues. The many committees of the AAO-HNS and specialty societies are always looking for members to volunteer time and knowledge to further the aims of otolaryngology. A common misconception is that to become an active participant in our specialty it is necessary to do so right after residency. In fact, the “right time” is whenever you are ready to raise your hand and volunteer for an assignment. There is no dearth of work for the willing participant. All AAO-HNS committees welcome members to attend meetings, even if they are not formal members of the committee. The multitude of committees are listed on the Academy’s website, so make plans to attend a committee meeting that interests you this September in Washington, DC. Many individuals in academics may have been limited in their activities because of constraints from home. With the freedom of the “empty nest” and newfound time, an interest in research or leadership can become a reality. Develop a game plan that includes sharing your goals with the chair of the department, dean, or chief medical officer. Sign up for courses offered internally or through affiliated institutions that will help you grow. Similarly, mentors within the department or in other departments can give advice and help in reinventing yourself. Professional volunteerism will help in many ways, too. It is never too late to learn and challenge yourself personally or professionally. While much of this discussion has centered on professional development, the spirit of volunteerism can be given to the community or spiritual institutions. It’s important to recognize what gives you happiness and fulfillment at the end of the day. Keep in mind, just when you are recovering from the empty nest and bursting with energy, the kids may come home. This new phenomenon has been described by social psychologists as the “boomerang kids.” They are adult children between the ages of 25 and 34 who live with their parents after college because they “want the limited responsibility of childhood and the privileges of adults.” So take advantage of your empty nest freedom and look over your shoulder for the “boomerang” effect.

A member of the Millennium Society uses his computer in the 2011 Millennium Society Donor Appreciation Lounge. To join the Society, visit www.entnet.org/donate

A Thousand Reasons to Join the Millennium Society

September is a special time of year for all of you. For some, this may be your first AAO-HNSF Annual Meeting & OTO EXPO. For others, attending the annual meeting has become a fall custom. From the Opening Ceremony to the last instruction courses on Wednesday afternoon, your days are filled with learning the latest advances in patient care and practice management and networking with your colleagues from around the world. As you continue to empower yourselves and the specialty through this world-class educational event, we would like you to consider supporting the AAO-HNSF through the Millennium Society. The Millennium Society, established by the Board of Directors, is a group of Academy members who, like you, believe in our mission and generously support achievement of the AAO-HNSF initiatives. The Millennium Society is our philanthropic annual fund program that provides a vital means of financial support for the AAO-HNSF mission and is essential to expanding the significant accomplishments of the AAO-HNSF in improving patient care. The 2012 Millennium Society program year runs January 1 through December 31, 2012. Donors are recognized in many special ways (see sidebar). Amelia F. Drake, MD, and Samuel B. Welch, MD, PhD, shared their thoughtful and inspirational quotes while visiting the 2011 Millennium Society Donor Appreciation Lounge. Dr. Drake highlighted many of the important reasons why giving back and joining the Millennium Society is important to her and many others like her. “Each of us cares…the Millennium Society allows us to translate our care in a meaningful direction whether it be diversity, women in OTO, education, research, international, or residents and young physicians,” Dr. Drake said. Dr. Welch shared his thoughts on the influence of the AAO-HNS/F and the Millennium Society. “By ourselves, each of us cannot ensure that our specialty is secured for future generations of otolaryngologists,” Dr. Welch said. “Giving any amount supports the efforts of our Academy to do just that. Giving helps protect our future and that of our patients.” Membership in the Society is achieved by making an annual gift of at least $1,000 ($250 for residents and young physicians). If you are not already a member, please consider a charitable gift in support of your specialty and join the Millennium Society today by visiting www.entnet.org/donate. See you in September! Special Millennium Society Donor Recognition Offerings Access to a special recognition lounge offering complimentary concierge-like experience, including business center services, breakfast, lunch, and snacks throughout the day. Enjoy donor amenity services while relaxing and networking with colleagues. Recognition on the highly visible Donor Wall of Honor, in AAO-HNS/F publications, on our website, and reserved seating during lunch in the exhibit hall. Millennium Society lapel pin, prestigious annual meeting donor ribbon, and special thank you gift. Naming opportunities.

Dates to Remember

August 1 Monthly mini-PR and media outreach tools available for members at www.entnet.org/aboutus/PressRoom.cfm. August 3 AAO-HNSF 2012 Annual Meeting & OTO EXPO advanced registration deadline, visit www.entnet.org/annual_meeting August 11 -12 Cheer Coordinator’s Conference, email: kschulz@entnet.org. Aug 17-18 Coding Workshop, Hilton Nashville Downtown http://karenzupko.com/workshops/otolarngology/index.html. August 21 AAO-HNS/F Election voting closes. For voting questions email ELaguna@entnet.org. September 1 Bulletin feature: The Value of Membership. September 1 Monthly mini-PR and media outreach tools available for members at www.entnet.org/aboutus/PressRoom.cfm. September 9 – 12 AAO-HNSF 2012 Annual Meeting & OTO EXPO in Washington, DC. September 21-22 Coding Workshop, Wyndham Baltimore Peabody Court http://karenzupko.com/workshops/otolarngology/index.html. October 1 Bulletin feature: AAO-HNS/F Annual Report. October 1 Monthly mini-PR and media outreach tools available for members at www.entnet.org/aboutus/PressRoom.cfm. October 26-27 Coding Workshop Costa Mesa, CA, Westin South Coast Plaza http://karenzupko.com/workshops/otolarngology/index.html.

Member Component Events at the Annual Meeting & OTO EXPO

Board of Governors (BOG) Saturday, September 8 BOG Leaders Training Luncheon, noon-12:55 pm BOG Socioeconomic & Grassroots Committee Meeting, 1:00 pm-2:45 pm BOG Legislative Representatives Committee Meeting, 3:00 pm-4:45 pm Monday, September 10 BOG General Assembly meeting, 5:00 pm-7:00 pm Tuesday, September 11 BOG Executive Committee Miniseminar “Hot Topics in Otolaryngology: 2012,” 10:30 am-11:50 am Diversity Committee Tuesday, September 11 Diversity Committee meeting, 1:00 pm-2:00 pm Humanitarian Efforts Visit the Humanitarian Efforts Booth Sunday, September 9 Humanitarian Efforts Committee meeting, 2:00 pm-3:00 pm Humanitarian Efforts Committee open forum, 3:30 pm-5:30 pm Section for Residents and Fellows-in-Training (SRF) Once again, Monday, September 10, is officially “Residents Day” at the annual meeting. See the schedule below for the special resident-focused events. Sunday, September 9 AAO-HNSF Academic Bowl, supported by the AAO-HNSF Education Steering Committee, 10:30 am-11:50 am Monday, September 10— Residents Day SRF Miniseminar “Section for Residents and Fellows-in-Training Survey Results,” 9:30 am-10:20 am Section for Residents and Fellows-in-Training (SRF) General Assembly, 2:30 pm-4:30 pm (Note: all Resident Leadership Grant recipients must attend the session in its entirety.) Tuesday, September 11 SRF Miniseminar “Interviewing: What to Ask and How,” 8:00 am-9:20 am SRF & YPC Miniseminar “Finding Balance in a Surgical Career,” 10:30 am-11:50 am Other Highlighted Resident Events (every day) Free Instruction Courses for residents who are Academy members Poster Presentations ENT Careers Live AcademyU® Learning Lab Women in Otolaryngology (WIO) Section Monday, September 10 WIO Section committee meetings, 7:00 am-8:00 am (concurrent sessions) WIO Section miniseminar “Professional Advancement: Why Gender Differences Matter,” 10:30 am-11:50 am WIO Luncheon, Kevin Pho, MD, KevinMD.com, social media’s leading physician voice, noon-1:00 pm (Note: seating is limited—attendees must have a ticket for entry.) WIO General Assembly meeting, 1:00 pm-2:00 pm Young Physicians Committee (YPC) Tuesday, September 11 YPC Committee meeting, 10:30 am-noon

CTModSociety

Connecticut Ear, Nose & Throat Society Receives BOG Model Society Award

The Connecticut Ear, Nose & Throat Society is the recipient of the Board of Governors (BOG) 2012 Model Society Award. The society is represented on the BOG by Ken Yanagisawa, MD, as governor, David S. Boisoneau, MD, as legislative representative, and Steven B. Levine, MD, as immediate past governor and current public relations representative. Denis C. Lafreniere, MD, serves as the chair-elect for the BOG. The Connecticut ENT Society, representing 90 percent of the otolaryngologists practicing in the state, has participated in several public awareness activities already this year, including Doctor’s Day at the capital, Hartford, in February; the organization of 10 statewide, free head and neck cancer screenings during Oral and Head and Neck Cancer Awareness Week in April; and more than 15 health fairs sponsored by both Democratic and Republican senators. The Society worked effectively with other Connecticut medical societies, under the guidance of Debbie Osborn (executive director for ENT and three other medical specialty organizations), to defeat an effort by trial lawyers to weaken the current Certificate of Merit laws. In addition to participating in this major defeat, the Society also supported coverage for hearing aids in the pediatric population with testimony given in February 2012, to the Insurance Committee and it used its lobbying team to push for truth in advertising legislation, which led to the passage of HB 5045 (2011), an act requiring healthcare providers to display photographic identification badges during working hours. In addition to legislative advocacy, the Society continues to promote effective practice management awareness and has retained a healthcare attorney to advocate for fair and transparent business and insurance company interactions on behalf of its members. The Society hosts two educational meetings a year with robust medical education lectures given by distinguished guest lecturers from around the country and state, as well as informative lectures updating the membership on socioeconomic, legal, and practice management trends and issues. The Connecticut Ear, Nose & Throat Society will be recognized for its exemplary efforts at the Board of Governors General Assembly meeting on Monday afternoon, September 10, in Washington, DC, in salons ABC of the convention center.

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Candidate Statements (BOG Member-at-Large)

Stacey L. Ishman, MD Candidate, BOG Member-at-Large What are your qualifications and what is your experience? I have had the opportunity to serve the Academy and the Board of Governors in a number of roles during the past 10 years: as a member of numerous committees, guideline reviewer, author of CME educational products, legislative representative to the BOG, and most recently as vice-chair of the BOG Legislative Representative Committee and ex-officio member of the BOG Executive Committee. In addition, I have been an attendee of our advocacy day and BOG meetings for the last 10 years and have been proud to serve in advocacy roles in the past as an AMA delegate for the SRF and as a member of the ENT PAC Board. These experiences have given me an understanding of the role of the BOG in the Academy and allowed me to see how the Academy’s strategic plan can be best reflected in the actions of our BOG. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. Recently, Peter Abramson, MD, and the Socioeconomic and Grassroots Committee proposed a system of regional representation designed to encourage participation at a local/regional level and allow for a greater interchange of ideas and issues. If chosen to serve as the member-at-large, I would like to assist in the integration of this regional network into the BOG, allowing information to be more freely exchanged between the constituent societies and within the BOG. In addition, I would suggest we engage the public relations representatives to serve as regional representatives and as primary facilitators for information sharing. Lastly, I feel that we need to target residents, fellows, and young physicians for inclusion in the BOG and would like to work with the leadership to help facilitate continued engagement with these groups. b Sanjay R. Parikh, MD Candidate, BOG Member-at-Large What are your qualifications and what is your experience? Since completing residency 13 years ago, I have been a dedicated member, participant, supporter, and leader in the Academy’s mission. As the past chair of the Academy’s Young Physicians Committee, I served the Academy’s Board of Directors and Board of Governors. I was fortunate to work with past-presidents Richard T. Miyamoto, MD; James C. Denneny, III, MD; David W. Kennedy, MD; Ronald B. Kuppersmith, MD; and J. Regan Thomas, MD, during their terms. I have been a participant in many BOG Legislative, Big On Goals, public relations, and executive committee meetings. I have been a presenter, instructor, journal reviewer, Millennium Society member, and Honor Award recipient for the Academy. I have lobbied for healthcare and liability reform on Capitol Hill for five of the last six years on behalf of otolaryngologists. I have also held executive or leadership positions in the American College of Surgeons, AMA, Northwest Academy of Otolaryngology, American Rhinologic Society, and American Society of Pediatric Otolaryngology. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. My goal on the Board of Governors is to ensure that the Academy recognizes the challenges that private practice and academic otolaryngologists face every day. Specifically, with the ever-increasing frustrations otolaryngologists face with reimbursement, liability threats, and uncertain healthcare reform, our strategic plan must prioritize our members’ needs. As a member of your Board of Governors, I will use my communication and leadership skills to augment advocacy, practice management, and education. I will make sure that we engage our members in advocacy, liability reform, and protection of our scope of practice through our Political Action Committee. I will ensure that our Academy understands the current practice climate by developing programs in EMR and safety, adopting mid-level providers, and optimizing reimbursement. The Board of Governors was established to provide a voice for its members in private practice and academics. I will do my best to make sure the Academy hears that voice.

Abramson

Candidate Statements (BOG Chair-Elect)

Vote during the 2012 BOG General Assembly, Monday, September 10, 2012 Ballots are distributed and voting takes place during the BOG General Assembly meeting on Monday, September, 10, between 5:00-7:00 pm, Walter E. Washington Convention Center, Salon ABC. The positions of chair-elect and member-at-large will be elected by the BOG members present, no proxy votes are allowed. Only Governors or the designated alternate governor (i.e., Leg. Rep. or PR Rep.) attending the meeting in lieu of the governor shall have the power to vote on any matter before the Board of Governors. Peter M. Abramson, MD Candidate, BOG Chair-Elect What are your qualifications and what is your experience? Served as secretary, treasurer, president-elect, and president of the Metro Atlanta Educational Society for Otolaryngology, member BOG. Served as secretary, treasurer, president-elect, and president of the Georgia Society of Otolaryngology, member BOG. Current governor, Georgia Society of Otolaryngology. Immediate-past secretary, Board of Governors. Current chair, Socioeconomic and Grassroots Committee, Board of Governors. Member, Media and Public Relations Committee, AAO-HNS. Founding member of ENT of Georgia. Clinical assistant professor, department of otolaryngology, Emory University School of Medicine. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. The most important goal for the Board of Governors is to be connected to every member of the Academy. As current chair of the Socioeconomic and Grassroots Committee of the BOG and as chair of the BOG, I will remain committed to implementation of a regional representation plan. This additional layer of communication will get our committee members closer to the practicing ENT and thus more responsive to local/regional issues and better able to disseminate vital and timely information to the local practitioner from the Board of Governors. As the national healthcare landscape changes, the BOG needs to be responsive to our needs as a specialty. ICD-10 transition, accountable care organizations (in whatever form they ultimately assume), insurance reimbursement, and scope of practice matters are just a few of the many issues that will need a strong BOG leadership to remain a proactive advocate for all otolaryngologists. Jay S. Youngerman, MD Candidate, BOG Chair-Elect What are your qualifications and what is your experience? My experience and qualifications for chair of the Board of Governors extend over a 20-year time frame. As legislative representative from the Long Island Society of Otolaryngology (past president), then governor for 16 years, I was a member of the BOG Legislative Representatives (nine years), and Carrier Relations Committees (three years). I was the first elected member-at-large and on the BOG Executive Committee working and learning from past chairs for eight years, winning a chair award, and in 2007 the Academy’s Honor Award. I was chair of the BOG’s Big On Goals initiative and the BOG Development/Fundraising Task Force. I formed Long Island ENT Associates (1983), creating a premier, independent eight-physician otolaryngology and allergy practice. I was a founding member of the AAO-HNS Partners for Progress. I helped form a multispecialty ambulatory surgical center. I am chair of the division of otolaryngology, North Shore Plainview, and the physician in charge at North Shore Syosset. Given the Academy’s strategic plan, outline and prioritize your goals for the Board of Governors. The function of the BOG is to support the Academy’s strategic plan physically with time and effort (committees, research, participating in guideline development and surveys, meeting and emailing politicians, and informing patients, colleagues, and those who control reimbursement of our specialty’s value), and, financially, joining with others in the Millennium Society, Hal Foster Endowment, and ENT PAC. Developing future leaders and new strategies, and steering both toward strengthening our Academy is paramount. Membership education, understanding what the Academy does for us and the public, becoming more energized and active, speaking up, making suggestions, bringing new ideas to the Academy both academically, (course suggestions, research opportunities) and financially, is vital. Many of our physicians have extensive business experience that can help steer the Academy in its goals to become financially independent by introducing products and ideas that will profit the Academy and members in general as only a grassroots organization can do.

20120806_Cordes

Responding to Changes in Healthcare: BOG Annual Meeting Events

While our nation prepares for what is sure to be another historic election, otolaryngologists from around the world will meet in September in Washington, DC, for the AAO-HNSF 2012 Annual Meeting & OTO EXPO. The 116th annual meeting promises to be more valuable and exciting than ever, covering a broad range of topics and issues germane to otolaryngologists. Experts in our field will present scientific research, instruction courses, miniseminars, and honorary guest lectures. In addition, the meeting provides unparalleled collaborative and networking opportunities. Though it seems the dust is settling after the U.S. Supreme Court’s decision to uphold the healthcare reform act, once again the flawed Sustainable Growth Rate (SGR) formula threatens deep (27 percent) cuts in Medicare reimbursement. In addition, the fate of the Independent Payment Advisory Board (IPAB) is being debated, and Graduate Medical Education funding is under scrutiny. While these and other issues are being settled, we are fortunate to have the Academy and Board of Governors (BOG) working diligently to protect the interests of otolaryngologists and our patients. As such, the BOG will host a slate of events at the annual meeting designed to engage otolaryngologists from all types of practices. More than ever, otolaryngologists cannot afford to be uninformed or misinformed, and the annual meeting is the opportune time and place to get up-to-date information. Saturday Leadership skills are critical in the current healthcare environment, and there are countless talented physician leaders among our otolaryngology ranks. Learn how to be an effective physician leader at the BOG Leaders Training Session from noon to 1:00 pm on Saturday, September 8. The training session will be followed by the BOG Socioeconomics & Grassroots Committee Meeting from 1:00 pm to 2:45 pm, and the BOG Legislative Representatives Committee Meeting from 3:00 pm to 4:45 pm. All are welcome at these committee meetings. Come see what these important committees are doing on your behalf. Monday Monday’s program includes the BOG General Assembly Meeting from 5:00 pm to 7:00 pm. As always, all are welcome at the assembly, which features the election of the BOG chair and Member-at-large, committee reports, and awards presentations. If you’ve never attended the BOG General Assembly, let this be your year to check it out. Tuesday Following the positive response to last year’s miniseminar, “Hot Topics in Otolaryngology: 2011,” the BOG Executive Committee is pleased to present “Hot Topics: 2012,” from 10:30 am to 11:50 am on Tuesday, September 11. BOG Secretary Wendy B. Stern, MD, will moderate the panel. Returning speaker Raymund C. King, MD, an otolaryngologist and attorney, will discuss hospital-physician joint ventures from a legal perspective. Darlene Burgess, vice president of corporate government affairs for Henry Ford Health System, will review such ventures from an institutional and financial perspective. And the Academy’s Joy L. Trimmer, JD, Senior Director of Government Affairs, will provide a legislative update of issues affecting medicine and otolaryngology, particularly in light of the upcoming elections. There is no question the landscape of healthcare is changing. Where will physicians fit into that landscape? Will we be the grass that gets walked on, or the brush that fades into the background and everyone looks past? Or will we be the trees that stand tall and strong, yet flexible enough to endure the unpredictable winds of change? We are physicians and therefore a vital component of the healthcare system, but we will have to learn to survive in this new landscape. The Academy and BOG serve as vital resources to help us survive and thrive in the shadow of the Patient Protection and Affordable Care Act, but can do so only with the dedication, support, and engagement of our ranks. It is never too late (or too early) to get informed and get involved, and the annual meeting is an excellent place to start, as Academy activities for the upcoming year get underway. While the practice of medicine is undergoing drastic changes, the one thing that will not change is the ongoing scrutiny of the delivery and cost of healthcare. In order to advocate for our patients and preserve our ability to provide the best possible care, we will need to stand strong, but also work with our hospitals, legislators, and other interested parties to realistically make changes that will create a healthcare system that allows all of us to thrive.

David R. Nielsen, MD, AAO-HNS/F EVP/CEO

Change and Transition

David R. Nielsen, MD, AAO-HNS/F EVP/CEO This summer I enjoyed celebrating several graduations. Whether it was for a member of my own family, friends, or graduating residents joining us as otolaryngology colleagues, some of the feelings expressed on each occasion were the same. There is always a great sense of accomplishment, joy in the realization of goals, and even some relief that the “race” has been completed. While celebrations are clearly in order and important to mark, there is another theme that pervades each graduation. It is universally felt that graduation is a time of starting a new phase in life, a realization that after a short rest, new effort in the next step in our education or employment awaits us. In fact, our lives are marked by new beginnings on a regular basis: assessments of progress are made, accomplishment of goals is celebrated, and measures of success are reported. This can be as prosaic as filing an annual tax return, or as meaningful as starting a new job, buying a new home, approaching a marriage, a birth, or a loved-one’s death. We reflect on change at each new calendar year and how we can “transition” to better our lives. In his book, Managing Transitions, William Bridges describes the difference between change and transition. Change is the shift that takes place in the external situation, while transition is our reaction to that change, or the reorientation that must take place if we are to adapt successfully to that change. Transitions often occur in three stages: endings, neutral zone, and beginnings. Transitioning to change, especially if that change is unexpected or unwelcome, can remind us of the stages of grief. Bridges writes that we go through phases of transitioning, beginning with denial. We reflect on the way things used to be, our comfort with the familiar, and we refuse to hear new information that we find unpleasant. This is followed by resistance, characterized by anger, stubbornness, complaining, and doubting one’s ability. These two characteristics—denial and resistance—are a part of the first stage, accepting the ending of what was. The second stage, or neutral zone, is characterized at first by uncertainty, questioning, disorientation, and sometimes even disorganization. As time progresses, this uncertainty and questioning leads to exploration, seeing possibilities, creating alternatives, potential solutions and adjustments, and learning new skills. The actions or implementation of these new ideas leads to the third stage, that of beginnings. This is a time of commitment, focus, cooperation, and vision. Those who recognize change too late, or refuse to transition, suffer the most. Those who learn early in the neutral zone to consider options, see alternatives, and learn new skills fare better in the changed environment and can even exploit the change to advance their goals. Renowned business management consultant Geoffrey Moore reinforces these ideas using a different model handed down from decades of experience with the acceptance of new technology: The Technology Adoption Life Cycle. Social science from the 1950s and 1960s formed the foundation of these labels that we all recognize. In his book, Escape Velocity, Moore shows a bell-shaped curve with the labels “innovators and early adopters” on the left tail of the curve and “laggards” on the right tail. Sound familiar? Moore’s work focuses on what he calls the “chasm” or gap that occurs between the early adopters and the much larger group, the early majority. Closing that gap, shortening the time it takes to get new ideas from the innovators to be accepted and used by the pragmatists, is the focus of his work on marketing new technology. Can you see the connection between Moore’s work on “marketing” change and Bridges’ work on transitioning to change? Both teach us much about the importance of understanding how to approach and adapt to our constantly changing world. As we observe every day, clinical medicine, related technology, and how we pay for and manage care are changing faster than at any other time in history. We must increase our skills in understanding this change, driving that change that is necessary, and adapting successfully to the unavoidable change that characterizes much of our world. Next month, many annual vacation times may be finished. Medical practices tend to be busier through the fall and winter months. Before this occurs, assess the change you observe in your world. Come to the AAO-HNSF 2012 Annual Meeting & OTO EXPO in Washington, DC. Contribute your voice, your time, and your skills to ensuring that otolaryngologists lead positive change clinically, organizationally, and fiscally, and create a more satisfying experience for our members, better healthcare for our patients, and a more optimistic future for our children.

Rodney P. Lusk, MD, AAO-HNS/F President

AAO-HNS, AAO-HNSF, BOG, SSAC, ABOto: Who Does What?

Rodney P. Lusk, MD, AAO-HNS/F President As we come closer to our yearly Foundation Annual Meeting & OTO EXPO it seemed appropriate to review our corporate structure. What are the relationships between the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS, internally called the Academy); the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF, internally called the Foundation); the Board of Governors (BOG); the Specialty Society Advisory Council (SSAC); and the American Board of Otolaryngology (ABOto)? Why are these structures so complex? Our roots start with Hal Foster, MD, who took it on himself to organize a meeting of practicing ophthalmologists and otolaryngologists in Kansas City, MO, in 1896. This two-day session resulted in the formation of the Ophthalmological, Otological, Laryngological, and Rhinological Association. This organization was instrumental in creating the first specialty boards in the United States: the American Board of Ophthalmology in 1917 and the American Board of Otolaryngology in 1924. Contrary to some misconceptions, there is no relationship between the Academy or the Foundation and ABOto. The missions of the organizations are different. The mission of ABOto is to ensure that certified diplomates have met the professional standards of training and knowledge that define otolaryngology–head and neck surgery. In other words, ABOto’s mission is to test your knowledge of otolaryngology and provide you with an accepted document of your expertise. As expertise and interests of ophthalmologists and otolaryngologists diverged, our original association inevitably underwent an orderly separation in 1978 into the American Academy of Ophthalmology and the American Academy of Otolaryngology. Two years later we added “Head and Neck Surgery” to our name (AAO-HNS) to better reflect the expanded scope of diseases we treat. The function of this state of the association was solely to educate its membership regarding the diagnosis and treatment of head and neck diseases. Earlier, in 1965, with the passage of Medicare and the federal government’s participation in healthcare, it became clear that otolaryngology–head and neck surgery needed an advocate, and the American Council of Otolaryngology was formed in 1968 as a separate entity. To speak with a unified voice, it merged in 1982 with our current organizations of the Academy and Foundation (AAO-HNS/F). The Board of Governors was also incorporated in the same year as a grassroots organization of the Academy to advise the Board of Directors. In 2009, the SSAC was formed to ensure that the AAO-HNS/F Boards would have the advice and perspectives of our diverse member interests. Both AAO-HNS and the AAO-HNSF (AAO-HNS/F) have the vision of empowering otolaryngologist-head and neck surgeons to deliver the best patient care and the mission of helping our members to achieve excellence and provide the best ear, nose, and throat care through professional and public education, research, and health policy advocacy. Both organizations are recognized as nonprofit entities, but there are significant differences in their activities as a consequence of their IRS designations. The Academy is designated as a 501(c)(6) organization, which is permitted to advocate and lobby with fewer restrictions and functions as a “trade association” with its own political action committee (ENT PAC) that has its own funding for political contributions. Think of it as “the Academy advocates” for its membership and patients. The Academy is involved with advocating in legislative affairs, socioeconomic and regulatory affairs, practice management, public relations, and member relations, via the Bulletin. The BOG is the “grassroots” arm of the Academy. The BOG chair, chair-elect, and past chair are members of the AAO-HNS/F Boards of Directors and are eligible to vote on both boards. The chair and chair-elect are also members of the AAO-HNS/F Executive Committee, but only the chair is eligible to vote. The chair is also a voting member of the Academy’s Nominating Committee. The SSAC, like the BOG, is a part of the Academy. Like the BOG, the SSAC has its own bylaws. The chair and chair-elect of the SSAC are eligible to vote on the Academy’s Board of Directors. The Foundation, however, is a 501 (c)(3) organization, which is a “public trust” organization with significant limitations regarding its ability to advocate and has no involvement with ENT PAC. Think of the Foundation as education and research. The Foundation sponsors research, provides education, publishes the Otolaryngology–Head and Neck Surgery journal, and coordinates our humanitarian efforts. Donations to the Foundation are tax deductible. I would like to emphasize once more that the Academy and Foundation are two separate organizations. When your Executive Committee and Board meet on a regular basis there are separate agendas for each. I hope this has given you an overview of the Academy and Foundation’s organizational structure. You can see that as with all sustaining entities, we change and adapt to better serve our goals. – See more at: http://aaobulletin.365.staging2.ascendmedia.com/Highlight.aspx?id=5077&p=416#sthash.jB2iWUV3.dpuf

ENT Careers Live! Coming to the AAO-HNSF 2012 Annual Meeting & OTO EXPO

Looking to hire? In search of a job? ENT Careers Live! will be at the 2012 Annual Meeting & OTO EXPO in Washington, DC, in booth 2543 at Hall B in the Convention Center. Staff will be available to help attendees and answer questions about the services provided by the online job board, ENT Careers. This is a valuable networking opportunity for job seekers and employers who will be together in the same city at the world’s largest gathering of otolaryngologists. Event Connection is the key to making the most of ENT Careers Live! at the annual meeting. It allows employers to flag their job postings to indicate that they will be attending the annual meeting with details of how and where job seekers can contact them for an interview during the event. ENT Careers Live! staff can walk you through the Event Connection process at booth 2543 or you can get started now by visitingwww.healthecareers.com/aaohns/healthcare-events/. As always, job seekers pay no fee to use ENT Careers, including uploading a resume and applying for jobs online. Register your job seeker profile on the career center at www.healthecareers.com/aaohns to gain access to the entire collection of online career resources provided to you by ENT Careers. Once you have registered, you can apply for jobs, manage your job search history, upload up to six different versions of your resume, and sign up for Job Alerts. For hiring organizations, the staff at the ENT Careers booth can post your jobs onsite, or you can call us at 1-888-884-8242 to get your jobs posted at any time of the year. Job postings are competitively priced, giving you direct access to qualified otolaryngology candidates including AAO-HNS members and other otolaryngology physician job seekers. The ENT Careers Live! booth will be equipped with computers and a printer during the annual meeting for your convenience. Interview areas will be available on a first-come, first-served basis. The booth will be open throughout the OTO EXPO so guests may take as much time as needed. ENT Careers is brought to you by HEALTHeCAREERS Network, an Academy Advantage Premier Partner.

Online Exclusive: A Giant with a Small Footprint: The Walter E. Washington Convention Center

Home to the AAO-HNSF 2012 Annual Meeting & OTO EXPO, the convention center is at the forefront of implementing environmentally friendly initiatives to make our world a greener place. The convention center’s management is proud that the steps it has taken will have a great influence on the health and well being of our environment for years to come. As one of the largest buildings in the District of Columbia, the convention center has an extensive recycling program and its employees are committed to reducing its carbon footprint. It uses products that marry high quality with environmental responsibility in their quest to reduce human exposure to potentially harmful contaminants. The convention center was designed to be environmentally friendly. Its modern, steel and glass exterior hints at the level of energy efficient practices used both inside and outside of the three-building facility. The exterior walls are made of clear, low-emission glass that reflects natural light and minimizes indoor temperature fluctuations. Meeting rooms with exterior windows are equipped with system-controlled shades for solar heat management. High-efficiency lighting and sensor systems are used throughout the building. A sophisticated lighting automation system operates at light levels of 10 percent when halls and public areas are unoccupied, 50 percent during move-in and move out, and 100 percent during an event. Because water is one of the planet’s most precious resources, convention center management works to maximize the building’s efficiency and minimize its influence on the local environment. Like most modern facilities, the bathroom fixtures are highly efficient to reduce the burden placed on the water supply and wastewater systems. The convention center’s storm water management system was designed to support the District of Columbia’s storm system. Rainwater is fed into nine large underground collection tanks, which filter and slowly release the water into the District’s storm system. This reduces peak demand on the city’s storm system and improves the operation of its treatment plant. No green initiative would be complete without an extensive recycling program. The “Know the Code” recycle compliance program uses a color-coded approach to separating waste at the source. The convention center was the first to offer color-coded recycling stations, which can be found in all exhibit halls and meeting rooms. As you walk through the halls during the annual meeting, you’ll notice that the convention center strives to recycle just about everything. The most common materials are glass, aluminum, plastic, cardboard, and mixed paper. All leftover food is donated to the DC Central Kitchen, a nationally recognized nonprofit organization that not only runs the largest soup kitchen in the city, but also offers food service training to disadvantaged adults. The City of Washington, DC, has Adopted Green Initiatives, Too. The National Park Service controls 70 percent of land in Washington, DC. There are 250,000 acres of parkland in the Greater Washington Metropolitan area. In 2007, DC was named the most walkable city in the United States in a study by the Brookings Institute. In late 2006, the city council passed an initiative making the nation’s capital the first major city to require developers to adhere to guidelines established by the U.S. Green Building Council. The Washington Nationals Ballpark is striving to be the country’s first green-certified ballpark. DC’s hotels have implemented green initiatives, including wind power, renewable energy credits, recycling, and adopt-a-park programs with neighborhood green spaces. See you in Washington, DC! – See more at: http://aaobulletin.365.staging2.ascendmedia.com/Highlight.aspx?id=5093&p=416#sthash.NBUKyFhN.dpuf

Thomas Jefferson Memorial

Washington, DC: Fun Facts

The Walter E. Washington Convention Center Houses the Largest Public Art Collection in the City Home to more than 120 works of art, including sculpture, painting, photography, mixed media, and graphics, the Washington Convention Center Authority is the proud owner of the largest public art collection in Washington, DC. With help from the National Gallery of Art, Smithsonian American Art Museum, Corcoran Gallery of Art, Federal Commission of Fine Arts, and DC Commission on the Arts and Humanities, the Convention Center developed a lavish collection valued at more than $4 million. The collection, which primarily focuses on works from local artists, is a unique feature not found in most convention centers. (www.dcconvention.com) Visitors Flock to the Nation’s Capital Annually DC welcomes about 17 million visitors each year, generating an estimated $5.7 billion in visitor spending for the city alone. In 2011, DC hosted 808 conventions, meetings, and tradeshows, including 48 at the Walter E. Washington Convention Center. These meetings attracted more than 1 million attendees. About 1.7 million international visitors come to DC annually. Top countries of origin: United Kingdom, Germany, Australia, China, Italy, Brazil, Japan, South Korea, and the Netherlands. Top Attractions National Air & Space Museum (7 million visitors) National Museum of Natural History (6.6 million visitors) Lincoln Memorial (5.4 million visitors) National Museum of American History (4.6 million visitors) World War II Memorial (4 million visitors) Vietnam Veterans Memorial (3.8 million visitors) Korean War Veterans Memorial (2.9 million visitors) FDR Memorial (2.3 million visitors) Rock Creek Park (2 million visitors) Thomas Jefferson Memorial (1.9 million visitors) National Zoological Park (1.9 million visitors) Restaurants There are more than 100 restaurants located in downtown Washington, DC, not including fast food, delis, and take out. Forty restaurants in the metropolitan region received Zagat scores of 25 or higher (out of 30). Called “one of the most exciting restaurant cities on the East Coast” by Travel + Leisure, DC’s culinary distinctions include James Beard award-winning chefs, AAA Five Diamond ratings, and restaurants included on Esquire’s list of the “Best New Restaurants in America.” More than 90 DC restaurants offer private dining space, including 10 within a few blocks of the convention center. Another 26 restaurants with private dining space are located within 1.5 miles of the convention center.

Specialty & Exhibitor Meetings

The satellite functions that occur around the AAO-HNSF 2012 Annual Meeting & OTO EXPO provide attendees with numerous ways to enrich their time in our nation’s capital. For the most up-to-date roster of additional networking and educational opportunities, visit our itinerary planner at www.entnet.org/annual_meeting and select “view the program.” 47th Annual ANS Fall Meeting-ANS Scientific Program; Facial Nerve Study Group; William House Cochlear Implant Study Group; Stereotactic Radiosurgery Study Group Saturday, September 8, 6:45 am Walter E. Washington Convention Center, Room 146A ABEA Council Meeting Saturday, September 8, 4:00 pm, Washington Renaissance, Meeting Room 5 AHNS Annual Meeting 115th World Congress IFHNOS-2014 Saturday, September 8, 9:00 am Washington Renaissance, Meeting Room 11 American Broncho-Esophagological Association Task Force Meeting Monday, September 10, 9:00 am Washington Renaissance, Meeting Room 5 American Journal of Rhinology & Allergy Editorial Board Meeting Monday, September 10, 6:30 am Washington Renaissance, Meeting Room 11 Annual CSO Board Meeting and Membership Banquet Saturday, September 8, 5:00 pm Henley Park, Eton Room ANS Executive Council Meeting-Luncheon, followed by ANS Education Committee Meeting Friday, September 7, noon Washington Renaissance, Meeting Room 15 AOS Council Meeting Sunday, September 9, 7:30 am Walter E. Washington Convention Center, Meeting Room 159A ASPO Board and Committee Meetings Saturday, September 8, 7:00 am Washington Renaissance, Meeting Room 12 ASPO Committee Meetings Saturday, September 8, 7:00 am Washington Renaissance, Meeting Room 13 COSM SLC Meeting Monday, September 10, 7:00 am Washington Renaissance, Meeting Room 4 CSO Fellowship Breakfast Meeting Sunday, September 9, 6:00 am Henley Park, Front Parlor da Vinci Transoral Surgery-Optimal Therapy Selection in the era of HPV + Oropharyngeal Cancer Monday, September 10, 5:30 am Washington Renaissance, Renaissance Ballroom Ear, Nose & Throat Journal Editorial Board Meeting Sunday, September 9, 6:00 am Washington Renaissance, Meeting Room 16 Eustachian Tube Study Group Sunday, September 9, 7:00 am Washington Renaissance, Meeting Room 4 Innovations in the Treatment of Allergic Rhinitis Monday, September 10, 6:30 pm Washington Renaissance, Grand Ballroom Laryngoscope-Contemporary Review Committee Tuesday, September 11, 11:30 am Washington Renaissance Meeting Room 3 Laryngoscope-How I Did It Committee Tuesday, September 11, 11:30 am Washington Renaissance, Meeting Room 4 Laryngoscope-TRIO BP Committee Tuesday, September 11, 11:30 am Washington Renaissance, Meeting Room 5 Laryngoscope Editors Meeting Sunday, September 9, 11:30 am Washington Renaissance, Meeting Room 7 Neurolaryngology Study Group (American Laryngological Association) Tuesday, September 11, 7:30 am Walter E. Washington Convention Center, Room 150A Otology & Neurotology Board of Directors Meeting/Luncheon Monday, September 10, noon Walter E. Washington Convention Center, Meeting Room 159A SPAO-HNS CME Membership Meeting Sunday, September 9, 8:00 am Washington Renaissance, Meeting Room 5 The 35th Annual Meeting of the Association of Otolaryngologists of Indian Heritage Monday, September 10, 7:00 pm Rasoi Indian Kitchen; 1810 K Street Northwest Washington, DC 20006 The Laryngoscope Editorial Board Meeting Monday, September 10, 7:00 am Washington Renaissance, Congressional A Treatment of Advanced Laryngeal Cancer (TALC) Study Investigators Meeting Sunday, September 9, 7:00 am Walter E. Washington Convention Center, Room 140A

Companies Exhibiting at the AAO-HNSF 2012 Annual Meeting & OTO EXPO

(as of July 25, 2012) 20th IFOS World Congress Seoul-2013 1748 www.ifosseoul2013.com Acclarent 1107 www.acclarent.com IRT Leader Acumed Instruments Corporation 2619 www.e-acumed.com Advanced Bionics/Phonak 1937 www.advancedbionics.com Advanced Endoscopy Devices 520 www.aed.md Alcon Laboratories, Inc. 1607 www.alcon.com IRT Member ALK-Abello Inc 522 www.prepen.com AllMeds 837 www.allmeds.com Amer Acad of Facial Plastic & Reconst Surgery 2507 www.aafprs.org American Board of Otolaryngology 2331 www.aboto.org American Hearing Aid Associates 2043 www.ahaanet.com American Journal of Rhinology & Allergy 1816 www.AJRA.com American Medical Endoscopy 2509 www.endoscopia.com American Medical Systems 623 www.americanmedicalsystems.com Amplivox 421 www.amplivox.us Annals Publishing Company 2019 www.annals.com Anthony Products/Gio Pelle 1027 www.anthonyproducts.com Antigen Laboratories, Inc. 1254 www.antigenlab.com Apdyne Medical Co 2024 www.apdyne.com Arches Tinnitus Formulas 1012 www.tinnitusformula.com ArthroCare 1506 www.arthrocare.com ATMOS Inc 1353 www.atmosmed.us Atos Medical Inc. 1749 www.atosmedical.com Audiology Management Group, Inc. 2240 www.audiologymanagementgroup.com balanceback 847 www.balanceback.com Bausch + Lomb 2142 www.bausch.com Beaver-Visitec International 2324 www.beaver-visitec.com Beijing Fanxing Guangdian Med Treatment Equip 1149 www.bjfxgd.com.cn Beutlich LP Pharmaceuticals 1717 www.beutlich.com Beyondtinnitus.com 2047 www.beyondtinnitus.com BFW Inc 2618 www.bfwinc.com Bien Air Surgery 2017 www.bienair.com Biomet Microfixation 1913 www.biometmicrofixation.com Blue Tree Publishing Inc 1313 www.bluetreepublishing.com Boston Medical Products Inc 614 www.bosmed.com Brainlab 737 www.brainlab.com Brazilian Association of ENT 851 www.aborlccf.org.br Bryan Medical Inc 2141 www.bryanmedical.net Carestream Health Inc 2429 www.carestream.com/ent-allergy Carl Zeiss Meditec 1629 www.meditec.zeiss.com Carnegie Surgical LLC 2323 www.carnegiesurgical.com CEREDAS 1144 www.ceredas.com ChartLogic Inc 443 www.chartlogic.com Checkpoint Surgical, LLC 523 www.checkpointsurgical.com CHEER Practice-Based Research Network 439 www.cheerresearch.org Chef’s Special and Indian Food Carts 325 Cincinnati Children’s Hosp Med Ctr Division of Human Genetics 757 www.cincinnatichildrens.org/genetics ClientTell 1842 www.clienttell.net Clinicon Corporation 426 www.clinicon.com Cobalt Medical Supply Inc 2343 www.cobaltmed.com Cochlear Americas 1007 www.cochlear.com Compulink Business Systems, Inc. 1742 www.compulinkadvantage.com ConeScan 2519 www.conescan.com Cook Medical 1917 www.cookmedical.com Covidien 2529 www.covidien.com/rms/pages.aspx DEKA Medical Inc 423 www.dekamedinc.com Dental Sleep Med Systems & The Snoring Is Boring Team 1844 www.getdentalsleep.com Department of Defense Hearing Center of Excellence 440 www.hearing.health.mil Designs for Vision Inc 1346 www.dvimail.com Doc’s Duds 1446 www.docsduds.com Doc’s Proplugs Inc8 31 www.proplugs.com DocumENT 1848 www.documENT-emr.com Doximity 1736 www.doximity.com Dr. Kim Co. 422 www.dr-kim.net Eagle Surgical Products LLC 414 www.electrolubesurgical.com Ear Nose & Throat Journal 748 www.entjournal.com Ecleris 1707 www.ecleris.com Ellman International 2237 www.ellman.com Elmed Incorporated 620 www.elmed.com Elsevier 724 www.us.elsevierhealthcom Endoscopy Support Services Inc 2415 www.endoscopy.com Entellus Medical 1541 www.entellusmedical.com IRT Associate ENTrigue Surgical, Inc 1615 www.entriguesurgical.com Envoy Medical 2023 www.envoymedical.com EPIC Hearing Healthcare 2037 www.epichearing.com Ethicon Endo-Surgery 1006 www.ethiconendo.com Euroclinic Division of Nicos Group Inc 2123 www.nicosgroup.com Everyday Health Inc 2223 www.EverydayHealth.com/practice-marketing Eyemaginations 1315 www.eyemaginations.com Academy Advantage Partner Fahl Medizintechnik Vertrieb GmbH 1045 www.fahl.de Feather Safety Razor Co Ltd 1449 www.feather.co.jp Firefly Global 2322 www.fireflyglobal.com FMD LLC 1049 www.duroscope.com GE Healthcare 1523 www.gehealthcare.com General Surgical Company (India) PVT., LTD 2013 www.gescoindia.com Genzyme 2537 www.genzyme.com Global Life Technologies Corp.2143 www.nozin.com Global Medical Endoscopy 1820 www.globalmedicalendoscopy.com Global Surgical Corp 1021 , 1022 www.globalsurgical.com GN Otometrics 1908 www.otometrics.com Grace Medical Inc 823 www.gracemedical.com Grason-Stadler 1307 www.grason-stadler.com Greenway Medical Technologies 543 www.greenwaymedical.com Greer Laboratories Medical Affairs 2313 www.greerlabs.com Health eCareers/ENT Careers Live! 2543 www.entnet.org/Community/public/careers.cfm Health Management Associates 2046 www.hma.com Healthworld International, Inc. 2607 www.healthworldintl.com Hemostatix Medical Technologies LLC 2318 www.hemostatix.com Hood Laboratories Inc 923 www.hoodlabs.com HRA Healthcare Research & Analytics 408 www.hraresearch.com ImThera Medical Inc 952 www.imtheramedical.com InHealth Technologies 1948 www.inhealth.com Insightra Medical 1152 www.insightra.com Inspire Medical Systems 1455 www.inspiresleep.com Insta-Mold Products Inc 1925 www.instamold.com Instrumentarium 1719 www.instrumentarium-online.com Intelligent Hearing Systems 431 www.ihsys.com Interacoustics 723 www.interacoustics-us.com Interamerican Assoc of Ped Otorhinolaryngology 1040 www.iapo.org.br Intersect ENT 2229 www.intersectENT.com Intersocietal Accreditation Commission 856 www.intersocietal.org/intersocietal.htm Intuitive Surgical 413 www.intuitivesurgical.com IRT Associate Invotec International Inc 1809 www.invotec.net IRIDEX 1944 www.iridex.com J. Morita Mfg. Corp. 2219 www.morita.com/global/cms/website.php?id=/en/index.htm JAMA & Archives Journals 2615 www.pubs.ama-assn.org Jaypee Highlights Medical Publishers Inc 2239 www.jphmedical.com JEDMED Instrument Company 1823 , 1923 www.jedmed.com Jullundur Surgical Works 943 www.jullsurgindia.com Kaiser Permanente 1814 www.physiciancareers.kp.org/ncal KARL STORZ Endoscopy-America Inc. 1037 www.ksea.com KARL STORZ Endoscopy-Latin America 949 www.ksea.com KayPENTAX 1127 www.kaypentax.com Kirwan Surgical Products Inc 2118 www.ksp.com KLS Martin Group 407 www.klsmartinusa.com Kurz Medical Inc 2213 www.kurzmed.com Labo America, Inc (LABOMED) 1247 www.laboamerica.com Laser Engineering 1153 www.laserengineering.com Leica Microsystems 529 www.leica-microsystems.com LifeCell Corporation 740 www.lifecell.com Lifestyle Lift 2337 www.lifestylelift.com IRT Leader Lippincott Williams & Wilkins/Wolters Kluwer Hlth 1715 www.lww.com Liquid Smile 1550 www.liquidsmile.com Lisa Laser USA 410 www.lisalaserusa.com LMA North America 1851 www.lmana.com LocumTenens.com 1252 www.LocumTenens.com Longtek Scientific Co. Ltd. 950 www.cenefom.com Lumenis 507 www.lumenis.com Maico Diagnostics 907 www.maico-diagnosctics.com Marina Medical Instruments 1849 www.marinamedical.com Massaging Insoles by Superior Health Inc 1248 www.massaginginsoles.com McKeon Products Inc 528 www.macksearplugs.com MD Logic EMR 537 www.mdlogic.com Meda Pharmaceuticals 647 www.meda.us Medafor Inc 944 www.medafor.com MedCo Data LLC 1743 www.medcodata.com MED-EL 1815 www.medel.com Medical Digital Developers (MDDev) 1340 www.mddev.com Medical Modeling Inc 515 www.medicalmodeling.com MediCapture Inc. 1416 www.medicapture.com Medifix Inc 1053 www.medifixinc.com MedInvent, LLC 2613 www.nasoneb.com Mediplast AB 1548 www.mediplast.com MedNet Locator Inc 1044 www.mednetlocator.com MedNet Technologies 913 www.mednet-tech.com Medtronic Surgical Technologies 609 , 707 www.medtronic.com IRT Associate Merz Global VOICE Business 1623 www.radiesse-voice.com Microline Surgical 2423 www.microlinesurgical.com Micromedical Technologies Inc 1929 www.micromedical.com Microsurgery Instruments Inc 521 www.microsurgeryusa.com Miltex an Integra Company 2112 www.integralife.com/integra-miltex Ministry Health Care 2315 www.ministryhealth.org/recruitment Möller-Wedel GmbH 745 www.moeller-wedel.com MTI1527 www.mti.net National Spasmodic Dysphonia Association 2145 www.dysphonia.org Natus Medical Incorporated 2514 www.natus.com NeilMed Pharmaceuticals Inc 1015 www.neilmed.com Neurosign 722 www.neurosignsurgical.com Neurovision Medical Products 1554 www.neurovisionmedical.com New York Head and Neck Institute 1350 www.nyhni.org NexTech 1737 www.nextech.com NextGen Healthcare 1738 www.nextgen.com NIDCD 548 www.nidcd.nih.gov NIDCD National Temporal Bone Registry 650 www.tbregisty.org NSI 1246 www.nsi-healthsystems.com Officite 930 www.officite.com Academy Advantage Partner Olympus America, Inc. 1322 www.olympusamerica.com IRT Associate OmniGuide 2609 www.omni-guide.com On the Avenue Marketing 946 www.ontheavenuemarketing.com Optim LLC 746 www.optimnet.com Optum 1645 www.optumcoding.com Oticon Medical LLC 2306 www.oticonmedical.com Otodynamics Ltd 941 www.otodynamics.com Otomed, Inc 1412 www.otomed.com OtoSim, Inc 1349 www.otosim.com OTOTRONIX 629 , 729 www.ototronix.com Panamerican Congress of Otolaryngology, HNS 517 www.panamorl.com.ar PeriOptix, Inc. 845 www.perioptix.com Physician Assistants in ORL/HNS 1756 www.entpa.org Piezosurgery Incorporated 1651 www.piezosurgery.us Plural Publishing Inc 1516 www.pluralpublishing.com Polyganics 1750 www.polyganics.com Prescott’s Inc 1841 www.surgicalmicroscopes.com Prime Clinical Systems Inc 643 www.primeclinical.com Pulmodyne 2147 www.pulmodyne.com QED Medical 641 www.qed-medical.com Quality Medical Publishing Inc 850 www.qmp.com Quest Medical Inc 1347 www.questmedical.com Reliance Medical Products Inc 1725 www.reliance-medical.com RG Medical 1055 www.rgmedical.com RGP, Inc. 1649 www.rgpergo.com Richard Wolf Medical Instruments Corporation 429 , 911 www.richardwolfusa.com Riverside Health System 1451 www.riversideonline.com Rose Micro Solutions 524 , 2329 www.rosemicrosolutions.com SAGE 2225 www.sagepub.com Samanghen Corporation 2116 www.entsafety.com Sandhill Scientific Inc 1244 www.sandhillsci.com SANOSTEC Corp 624 www.maxairnosecones.com SEC Medical Speech Pathology Consulting & Training 1251 www.secmedicalspeech.com Seiler Precision Microscopes 1940 www.seilerinst.com Shippert Medical Technologies Incorporated 625 www.shippertmedical.com Simplicity EMR 2029 www.emr-simplicity.com Sinocclusive LLC 1453 www.sinocclusive.com SinuScience Network 929 www.sinuscience.com Sinusys 1818 www.sinusys.com Sleep Group Solutions 2319 www.sleepgs.com SNAP Diagnostics LLC 2022 www.snapdiagnostics.com Sonitus Medical, Inc. 2115 www.sonitusmedical.com Sontec Instruments Inc 2006 www.sontecinstruments.com Sophono, Inc. 1146 www.sophono.com SOPRO-COMEG 2246 www.sopro-comeg.com Soredex 430 www.soredex.com/usa Springer 406 www.springer.com Squip, Inc. 525 www.squipusa.com Starkey 1119 www.StarkeyPro.com Stryker 1337 www.stryker.com Summit Medical 1241 www.summitmedicalusa.com Surgical Innovations LLC 1256 www.thyroidretractor.com SurgiTel/General Scientific Corp 536 www.surgitel.com Synthes 2109 www.synthes.com TeleVox 1637 www.televox.com Teva Respiratory 2631 www.tevarespiratory.com The Alkalol Company 1145 www.alkalolcompany.com The Doctors Company 1947 www.thedoctors.com Academy Advantage Premier Partner Thermo Fisher Scientific 1147 www.thermoscientific.com/phadia Thieme Medical Publishers 1907 www.thieme.com TriCord Pharmaceuticals1 655 www.LAVImed.com Ultimate Creations Inc 549 www.infinitealoe.com United Endoscopy 1448 www.endoscope.com United Regional Healthcare System 1856 www.unitedregional.org University Medical Center Hamburg-Eppendorf 437 www.voxel-man.de Ventus Medical 2045 www.proventtherapy.com ViroPharma Incorporated 2606 www.viropharma.com Vision Sciences, Inc. 2007 www.visionsciences.com Vivosonic Inc 424 www.vivosonic.com Widex USA 2129 www.widexusa.com Wiley Blackwell 1249 www.wileyblackwell.com Xoran Technologies Inc 2409 www.xorantech.com Yodle 2317 www.yodle.com

AAO-HNSF 2012 Annual Meeting & OTO EXPO Checklist

The annual meeting is fast approaching, and the Academy wants to make sure you’re prepared. Before leaving for Washington, DC, be sure to: Book your hotel room through the official annual meeting housing block. Go to the Annual Meeting website and create your conference schedule there through the education dropdown option, “view the program.” Purchase instruction course tickets. Review the OTO EXPO map, and choose which exhibitors are of most interest to you. Download the Final Program from the annual meeting bookshelf, available at www.entnet.org/annual_meeting. Make dinner reservations, plan trips to visit monuments, museums, and any other adventures and excursions you hope to include while visiting Washington, DC. Use social media to connect with colleagues and get the latest news prior to and during the meeting. Visit www.entnet.org/annual_meeting to read the latest news before, during, and after the meeting. We look forward to welcoming you to the AAO-HNSF 2012 Annual Meeting & OTO EXPO September 9-12! Use your smartphone to read this Annual Meeting website quick code.

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Destination OTO EXPO!

One of the most exciting components of the AAO-HNSF annual meeting is the OTO EXPO. Here you’ll find an extensive showcase of products and services for otolaryngologist–head and neck surgeons. The OTO EXPO annually brings in an average of 300 companies that cater to every aspect of your practice—device manufacturers, pharmaceutical companies, collections, EMR systems, waiting room solutions, financial management firms, and more. The OTO EXPO resembles an ENT Market Square where you, the buyer, can easily compare prices and discuss purchasing options with qualified sales representatives. It’s one-stop shopping for every need of the ENT physician, surgeon, nurse, or hospital administrator. This setting is also ideal for networking with colleagues from other societies, publication firms, pharmaceutical companies, and device manufacturers who have come from around the world to participate in the specialty’s premier event. Following a virtual ribbon-cutting taking place from the stage of the annual meeting’s Opening Ceremony, the OTO EXPO will open its doors. Guests will then be led into the OTO EXPO located in Halls A-C of the Walter E. Washington Convention Center. We encourage you to refer to the exhibitor directory in your registration bag and the annual meeting mobile app (available soon) for a complete list of exhibiting companies, maps, contact information, and booth numbers to properly prepare yourself to make the most of your time on the show floor. For first-time attendees, the OTO EXPO will soon become a can’t-miss experience and an invaluable resource. Returning attendees will find that touring the OTO EXPO can be a time to observe the advances companies have made throughout the years, and ways products and services have improved. All attendees will be able to view any and all of the newest products being made available to otolaryngologists. ENT Careers Live! Employers and job seekers will have an opportunity to participate in ENT Careers Live!, the Academy’s employment event, during the annual meeting. It will be located on the show floor in Hall B, Booth 2543. Don’t miss out on this valuable networking opportunity. Learn more at www.healthecareers.com/aaohns. New: Practice Management Pavilion A Practice Management Pavilion has been designed to highlight the latest in advanced technologies for healthcare professionals, such as EHR, database management software, business services, and other products and services related to the practice of otolaryngology. This designated area is your one-stop shop for practice management solutions for your hospital facility or personal practice. It provides an opportunity for quick comparison of company products/services, and will help you maximize your time on the show floor. Choose How to Feed Your Hunger The choice is now yours—box lunch or voucher lunch. Full conference attendees now have two options for lunch in the OTO EXPO. During the registration process, you may select the traditional box lunch option or opt for a $15 daily meal voucher to be redeemed at any convention center food stand. The concession stands, specializing in Caribbean, Indian, and American cuisine, will be stationed in convenient locations throughout the OTO EXPO. This is shaping up to be another banner year for the OTO EXPO, and your presence is highly encouraged. Be sure to view the latest list of exhibitors and watch the OTO EXPO floor plan expand on our website. We are looking forward to sharing this exciting experience with you. See you there, September 9-12!