Published: November 6, 2013

The Human Cost of Healthcare

Stephanie Ashmore Senior Research Officer British Medical Association, London, UK Mahmood F. Bhutta, FRCS, DPhil ENT Surgery Registrar, John Radcliffe Hospital, Oxford, UK Founder, Medical Fair and Ethical Trade Group, British Medical Association Editor’s Note: During the 2012 Cochrane Colloquium in New Zealand, several Academy members and staff had the good fortune to be introduced to Mahmood Bhutta, FRCS, DPhil, research fellow, Oxford University, and founder of the British Medical Association’s Medical Fair and Ethical Trade Group. Upon hearing of this compelling global health-related concern, they invited Dr. Bhutta and his senior research officer, Stephanie Ashmore, to submit an article for the Bulletin. While the Academy has not conducted research itself on the issue of unethical working conditions in the manufacture of some medical products, we are pleased to share this information with you for your consideration. Introduction Every year, trillions of dollars are spent on medical supplies. In many cases, little consideration is given to the conditions in which they are made and their impact on the people who make them. Research carried out by the British Medical Association (BMA) Medical Fair and Ethical Trade Group has revealed unethical working conditions in the manufacture of a number of medical products, especially those bound for the operating room. 1,2,3,4 The operating room is the largest user of medical supplies within the hospital, typically accounting for a third of all hospital supply costs.5 When making purchasing decisions for healthcare, consideration is given to value for money and quality, but consideration is rarely given to the conditions in which these supplies are made. Abuses of labor standards have been uncovered in the manufacture of many of the high-throughput supplies used routinely in the operating room, including latex gloves from Malaysia,1 surgical masks from Mexico,2 cotton scrubs from South Asia,3 and surgical instruments from Pakistan.4 Awareness of campaigns for fair and ethical trade of consumer products such as coffee, chocolate, and clothing is high, but the same scrutiny is not applied to commodities used every day in medicine. Surgical Instruments A well-documented example is the surgical instrument industry, which is a major focus of the BMA’s ethical trade campaign. The vast majority of surgical instruments are made either in Tuttlingen in Germany or Sialkot in Pakistan. Exports of surgical instruments from Pakistan alone are worth $300 million per year and up to 30 percent are exported to the United States,6 usually supplied through local suppliers as Pakistani companies have difficulty accessing healthcare markets directly. Outsourcing the manufacture of surgical instruments to developing countries can help boost income in local economies and support development, but outsourcing often involves seeking the lowest price, risking exploitation of workers and abuse of labor rights. There are an estimated 50,000 manual laborers working in the surgical instrument industry in Sialkot. A typical laborer will work 12 hours a day, seven days a week and earn about $2 per day, less than the living wage set by the Pakistan government.7 Conditions in the major factories tend to be good, but due to competition and consumer demand for low-cost products, much of the work is outsourced to backstreet garages, undermining labor standards. A finished surgical instrument might be bought by a healthcare provider for about $80; the Pakistani manufacturer would receive about $1.50. Manufacture of surgical instruments is an intensive multistage process involving forging, annealing, filing, grinding, drilling, riveting, de-scaling, and polishing. Workers face risks to their health including injury from heavy machinery, repetitive strain injuries, exposure to poor electrical wiring, metal dust, and noise, as well as toxic chemicals, including sulfuric acid, nitric acid, and trichloroethylene.3,4,8,9 An estimated 5,800 children work full time, six days a week, in the surgical instrument industry, some as young as seven. Children are often employed in high-risk, labor-intensive tasks such as grinding and polishing.8,10 Other Manufacturing Regions Mexico is also a major manufacturer of medical products, exporting $9 billion of low-tech medical products such as surgical masks and bandages to the U.S. every year. The global financial crisis has led to cuts in wages and labor standards as companies try to lower costs and remain competitive. Many workers have been moved from factories to home-based working, where they are not paid regular wages or entitled to benefits. Neither working conditions nor the identity of workers is checked, which risks the use of child labor.2 Problems have also been found in Malaysia, the world’s largest manufacturer of medical gloves. A large Malaysian glove factory employed workers for excessive hours and workers were subject to physical and sexual harassment. Healthcare clothing made in India also has been found to have been made under conditions of excessive working hours. U.S. Purchasing and Policy Supply chains for medical products are often complex. Most of the supplies used in the operating room are probably purchased by the hospital though a Group Purchasing Organization (GPO), which negotiates contracts with suppliers. In the U.S., the healthcare industry spends more than $200 billion annually on medical and non-medical products, with more than 70 percent spent via a GPO.11 At present, the U.S. has no universal policy for ensuring basic labor standards in the manufacture of medical products. The problem with surgical instrument manufacturing has nonetheless been recognized in the U.S. for nearly three decades. Surgical instrument manufacture is listed in the U.S. Department of Labor’s List of Goods Produced by Child Labor or Forced Labor12 and U.S. government policy states that “companies and industry groups should implement social compliance systems to ensure they are not directly or indirectly causing or contributing to labor abuses in their supply chains.” More recently, the U.S. Department of Labor Bureau of International Labor Affairs has created “a standard set of practices” and an online “toolkit” to support the establishment of strong social compliance systems for businesses at http://www.dol.gov/ilab/child-forced-labor/index.htm.13  The policy suggests auditing and monitoring of suppliers, and preventing suppliers using child labor from entering U.S. markets. Although these ideas appear laudable, experience has shown that policies involving audit and boycotting are ineffective and may even be harmful. A culture of audit leads to an antagonistic relationship between manufacturer and purchaser. The majority of factories subject to audit will keep double books and will coach workers ahead of audits.14 Elimination of child labor cannot be achieved without understanding why it exists, identifying alternative education or employment opportunities for children, and realizing the potential economic impact of removing a working member of a family. A simple boycott can make working conditions for children worse. In surgical instrument manufacture in Pakistan, many U.S. and international suppliers have stipulated conditions including a ban on child labor, and the International Labor Organization (ILO) ran a program that aimed to eliminate child labor in the industry.15,16 However, despite decades of work, such policies and programs have failed to significantly affect child labor in surgical instrument manufacture. Ethical Trade and Fair Trade Modern approaches to addressing labor rights abuses focus on models of “ethical trade” or “fair trade.” Both models aim to make international trade work better for poor and otherwise disadvantaged people, through different but complementary approaches. Fair trade is a bottom-up approach that aims to certify products (especially agricultural products) that are made with assured labor standards and includes a premium paid to workers for social causes. The approach relies on labeling of products and so is consumer led, with huge growth in the U.S. in recent years.17 The approach could be used in some parts of the medical sector by certifying the raw cotton used to make healthcare bandages, gauze, or uniforms, or for latex for manufacturing gloves or catheters. Ethical trade is a top-down approach, and refers to the steps that purchasing organizations, such as hospitals or GPOs, take to improve the pay and conditions of people involved in the supply of goods and services. It asks purchasers to systematically assess the risk of labor rights abuses in the goods and services they procure, and to push for improvement where necessary. This includes working with companies throughout the supply chain to help workers realize fundamental rights, such as the right to safe and decent working conditions, to be paid at least the legal minimum wage, to join and form unions so they can bargain collectively for their rights, and to eliminate child labor. Ethical trade relies on transparency, open dialogue, and continual improvement. As such, there is no “ethical trade” label. Evidence suggests that this approach also makes business and financial sense: improving labor standards leads to improved productivity, better quality, and better worker retention through improved morale.18,19 Consequently, ethically manufactured products do not need to cost more and, in many cases, actually cost less to manufacture. Campaign for Ethical Trade in the Healthcare Sector The BMA has been campaigning for ethical purchasing in healthcare since 2007. This has led to UK government support for ethical procurement in the public sector20 and the publication of guidance and training resources for procurement staff.21,22 Procurement professionals in the UK now have the tools to develop an ethical purchasing strategy, map and risk assess their supply chains, seek commitment to continuous improvement from suppliers, and to specify ethical criteria when making purchasing decisions. Similar policies are in place in other European countries, including Sweden, Norway, and Denmark. These resources are relevant to all healthcare procurement systems and accessible anywhere in the world. Doctors in the UK have shown strong support for the campaign, with research showing that 88 percent support the BMA campaign for National Health Service organizations to adopt ethical procurement policies.23 What can clinicians do to influence procurement in the health sector in the U.S.? As end-users of medical commodities, healthcare professionals can be powerful advocates by campaigning for change in the way healthcare providers purchase supplies. A number of advocacy tools have been developed, including a short film “The Human Cost of Healthcare.”24 Healthcare professionals can support the campaign by raising awareness among colleagues or setting up a multi-stakeholder team with representatives from across healthcare organizations. Involving individuals from across the organization is important—for example, the corporate social responsibility lead, chief executive, public relations manager, and procurement manager, as well as clinicians. Most healthcare providers in the U.S. make purchasing decisions in a committee. Find out who is on this committee and tell them about ethical procurement. Once senior-level support is secured, the committee could raise these issues with their GPO. The healthcare sector, with its huge purchasing power, can improve conditions for workers around the world. The more individuals and organizations raise these issues with suppliers, the more companies will change procurement practices and drive ethical improvements in supply chains. By supporting this campaign, healthcare professionals can improve not just patients’ lives but those of workers risking their health to make products for the health sector—whether children making surgical instruments in Pakistan, women sewing nurses’ uniforms in India, or home workers producing surgical masks in Mexico. Find out how you can get involved; visit www.fairmedtrade.org.uk.   References Bjurling K. Papyrus Sweden AB’s purchase of Nitrile gloves from Malaysia. Stockholm: Swedwatch, 2010 www.vgregion.se/upload/Regionservice/Ink%C3%B6p/Milj%C3%B6h%C3%A4nsyn/Rapport%20om%20handskar.pdf Roberts O, Garcia A, Bhutta MF. Medical Fair and Ethical Trade Group: Visit to Medical Manufacturing Companies Mexico. London: BMA, 2010. Swedwatch. The Dark Side of Healthcare. Stockholm: Swedwatch, 2007 www.swedwatch.org/en/reports/dark-side-healthcare-0 Bhutta MF. Fair trade for surgical instruments. BMJ. 2006;333(7562):297-9 www.bmj.com/content/333/7562/297 The Business Case for Greening the Operating Room – Practice Greenhealth www.c4spgh.org/HCW1_Presentations/GOR_FullSet_Guidance%20Docs_Web_042711.pdf Surgical Instrument Manufacturers Association of Pakistan www.simap.org.pk/facts.php (accessed December 2012) Pakistan Institute of Labour Education and Research. Denial and Discrimination: Labour rights in Pakistan. Karachi: PILER, 2007 www.piler.org.pk/labourestatusreport.pdf Ethical Trade in Surgical Instruments: Bringing Change to the Supply Chain: BMA, 2008. Adverse Health Effects of Child Labor: High Exposure to Chromium and Oxidative DNA Damage in Children Manufacturing Surgical Instruments, Muhammad Sughis et al (June 2012) Environ Health Perspect. 120:1469–1474 (2012). http://ehp.niehs.nih.gov/1104678/ Akida Management Consultants. Baseline survey report on child labour in surgical instruments manufacturing industry in Sialkot. Lahore, 2004. HealthTrust Purchasing Group www.healthtrustcorp.com/Content/BecomeAMember/WhyChooseHT.htm U.S. Department of Labor’s List of Goods Produced by Child Labor or Forced Labor www.dol.gov/ilab/programs/ocft/2012TVPRA.pdf 22 U.S.C. § 7112: US Code – Section 7112: Additional activities to monitor and combat forced labor and child labor 22 U.S.C. 7112(b)(2)(D) http://codes.lp.findlaw.com/uscode/22/78/7112 Progress not Perfection – Impact’s 10th Anniversary Report (2007) www.impacttlimited.com/resources/resources-part-8-2 ILO-IPEC, Nasir Dogar, Workplace Monitoring Project in the Surgical Instrument Industry, Working Papers on Child Labour in Asia – Vol -2, Bangkok, ILO, 2001 www.ilo.org/wcmsp5/groups/public/—ed_mas/—eval/documents/publication/wcms_126892.pdf Combating hazardous and exploitative child labour in surgical instruments manufacturing through prevention, withdrawal and rehabilitation – Phase II (2009) www.ilo.org/wcmsp5/groups/public/—ed_mas/—eval/documents/publication/wcms_126892.pdf Fair Trade USA 2011 Fair Trade Almanac http://fairtradeusa.org/sites/default/files/Almanac%202011.pdf Oxfam International. Better jobs in better supply chains. Oxford, 2010 http://www.oxfam.org/en/policy/better-jobs-better-supply-chains Ethical Trading Initiative, June 2009. www.ethicaltrade.org/in-action/member-performance/productivity-and-wage-rises-go-hand-in-hand Department of Health. Health is global: a UK Government strategy 2008-13. London, 2008 www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_088702 Ethical Procurement for Health: Workbook www.ethicaltrade.org/resources/key-eti-resources/ethical-procurement-for-health-workbook www.fairmedtrade.org.uk BMA Omnibus Survey – August 2012 The Human Cost of Healthcare: www.youtube.com/watch?v=iJ_vvac2tyE


02_Cost-healthcare_image1

Teenagers welding laryngoscope blades in Sialkot, Pakistan.

Stephanie Ashmore
Senior Research Officer
British Medical Association, London, UK

Mahmood F. Bhutta, FRCS, DPhil
ENT Surgery Registrar, John Radcliffe Hospital, Oxford, UK
Founder, Medical Fair and Ethical Trade Group, British Medical Association

Editor’s Note: During the 2012 Cochrane Colloquium in New Zealand, several Academy members and staff had the good fortune to be introduced to Mahmood Bhutta, FRCS, DPhil, research fellow, Oxford University, and founder of the British Medical Association’s Medical Fair and Ethical Trade Group. Upon hearing of this compelling global health-related concern, they invited Dr. Bhutta and his senior research officer, Stephanie Ashmore, to submit an article for the Bulletin. While the Academy has not conducted research itself on the issue of unethical working conditions in the manufacture of some medical products, we are pleased to share this information with you for your consideration.

Introduction

Every year, trillions of dollars are spent on medical supplies. In many cases, little consideration is given to the conditions in which they are made and their impact on the people who make them. Research carried out by the British Medical Association (BMA) Medical Fair and Ethical Trade Group has revealed unethical working conditions in the manufacture of a number of medical products, especially those bound for the operating room. 1,2,3,4 The operating room is the largest user of medical supplies within the hospital, typically accounting for a third of all hospital supply costs.5

When making purchasing decisions for healthcare, consideration is given to value for money and quality, but consideration is rarely given to the conditions in which these supplies are made. Abuses of labor standards have been uncovered in the manufacture of many of the high-throughput supplies used routinely in the operating room, including latex gloves from Malaysia,1 surgical masks from Mexico,2 cotton scrubs from South Asia,3 and surgical instruments from Pakistan.4 Awareness of campaigns for fair and ethical trade of consumer products such as coffee, chocolate, and clothing is high, but the same scrutiny is not applied to commodities used every day in medicine.

Surgical Instruments

A well-documented example is the surgical instrument industry, which is a major focus of the BMA’s ethical trade campaign. The vast majority of surgical instruments are made either in Tuttlingen in Germany or Sialkot in Pakistan. Exports of surgical instruments from Pakistan alone are worth $300 million per year and up to 30 percent are exported to the United States,6 usually supplied through local suppliers as Pakistani companies have difficulty accessing healthcare markets directly.

Outsourcing the manufacture of surgical instruments to developing countries can help boost income in local economies and support development, but outsourcing often involves seeking the lowest price, risking exploitation of workers and abuse of labor rights.

There are an estimated 50,000 manual laborers working in the surgical instrument industry in Sialkot. A typical laborer will work 12 hours a day, seven days a week and earn about $2 per day, less than the living wage set by the Pakistan government.7 Conditions in the major factories tend to be good, but due to competition and consumer demand for low-cost products, much of the work is outsourced to backstreet garages, undermining labor standards. A finished surgical instrument might be bought by a healthcare provider for about $80; the Pakistani manufacturer would receive about $1.50.

Manufacture of surgical instruments is an intensive multistage process involving forging, annealing, filing, grinding, drilling, riveting, de-scaling, and polishing. Workers face risks to their health including injury from heavy machinery, repetitive strain injuries, exposure to poor electrical wiring, metal dust, and noise, as well as toxic chemicals, including sulfuric acid, nitric acid, and trichloroethylene.3,4,8,9 An estimated 5,800 children work full time, six days a week, in the surgical instrument industry, some as young as seven. Children are often employed in high-risk, labor-intensive tasks such as grinding and polishing.8,10

Other Manufacturing Regions

Mexico is also a major manufacturer of medical products, exporting $9 billion of low-tech medical products such as surgical masks and bandages to the U.S. every year. The global financial crisis has led to cuts in wages and labor standards as companies try to lower costs and remain competitive. Many workers have been moved from factories to home-based working, where they are not paid regular wages or entitled to benefits. Neither working conditions nor the identity of workers is checked, which risks the use of child labor.2

Problems have also been found in Malaysia, the world’s largest manufacturer of medical gloves. A large Malaysian glove factory employed workers for excessive hours and workers were subject to physical and sexual harassment. Healthcare clothing made in India also has been found to have been made under conditions of excessive working hours.

U.S. Purchasing and Policy

Supply chains for medical products are often complex. Most of the supplies used in the operating room are probably purchased by the hospital though a Group Purchasing Organization (GPO), which negotiates contracts with suppliers. In the U.S., the healthcare industry spends more than $200 billion annually on medical and non-medical products, with more than 70 percent spent via a GPO.11 At present, the U.S. has no universal policy for ensuring basic labor standards in the manufacture of medical products.

The problem with surgical instrument manufacturing has nonetheless been recognized in the U.S. for nearly three decades. Surgical instrument manufacture is listed in the U.S. Department of Labor’s List of Goods Produced by Child Labor or Forced Labor12 and U.S. government policy states that “companies and industry groups should implement social compliance systems to ensure they are not directly or indirectly causing or contributing to labor abuses in their supply chains.” More recently, the U.S. Department of Labor Bureau of International Labor Affairs has created “a standard set of practices” and an online “toolkit” to support the establishment of strong social compliance systems for businesses at http://www.dol.gov/ilab/child-forced-labor/index.htm.13  The policy suggests auditing and monitoring of suppliers, and preventing suppliers using child labor from entering U.S. markets.

Although these ideas appear laudable, experience has shown that policies involving audit and boycotting are ineffective and may even be harmful. A culture of audit leads to an antagonistic relationship between manufacturer and purchaser. The majority of factories subject to audit will keep double books and will coach workers ahead of audits.14

Elimination of child labor cannot be achieved without understanding why it exists, identifying alternative education or employment opportunities for children, and realizing the potential economic impact of removing a working member of a family. A simple boycott can make working conditions for children worse. In surgical instrument manufacture in Pakistan, many U.S. and international suppliers have stipulated conditions including a ban on child labor, and the International Labor Organization (ILO) ran a program that aimed to eliminate child labor in the industry.15,16 However, despite decades of work, such policies and programs have failed to significantly affect child labor in surgical instrument manufacture.

Ethical Trade and Fair Trade

Modern approaches to addressing labor rights abuses focus on models of “ethical trade” or “fair trade.” Both models aim to make international trade work better for poor and otherwise disadvantaged people, through different but complementary approaches.

Fair trade is a bottom-up approach that aims to certify products (especially agricultural products) that are made with assured labor standards and includes a premium paid to workers for social causes. The approach relies on labeling of products and so is consumer led, with huge growth in the U.S. in recent years.17 The approach could be used in some parts of the medical sector by certifying the raw cotton used to make healthcare bandages, gauze, or uniforms, or for latex for manufacturing gloves or catheters.

Ethical trade is a top-down approach, and refers to the steps that purchasing organizations, such as hospitals or GPOs, take to improve the pay and conditions of people involved in the supply of goods and services. It asks purchasers to systematically assess the risk of labor rights abuses in the goods and services they procure, and to push for improvement where necessary. This includes working with companies throughout the supply chain to help workers realize fundamental rights, such as the right to safe and decent working conditions, to be paid at least the legal minimum wage, to join and form unions so they can bargain collectively for their rights, and to eliminate child labor. Ethical trade relies on transparency, open dialogue, and continual improvement. As such, there is no “ethical trade” label. Evidence suggests that this approach also makes business and financial sense: improving labor standards leads to improved productivity, better quality, and better worker retention through improved morale.18,19 Consequently, ethically manufactured products do not need to cost more and, in many cases, actually cost less to manufacture.

Campaign for Ethical Trade in the Healthcare Sector

The BMA has been campaigning for ethical purchasing in healthcare since 2007. This has led to UK government support for ethical procurement in the public sector20 and the publication of guidance and training resources for procurement staff.21,22

Procurement professionals in the UK now have the tools to develop an ethical purchasing strategy, map and risk assess their supply chains, seek commitment to continuous improvement from suppliers, and to specify ethical criteria when making purchasing decisions. Similar policies are in place in other European countries, including Sweden, Norway, and Denmark. These resources are relevant to all healthcare procurement systems and accessible anywhere in the world.

Doctors in the UK have shown strong support for the campaign, with research showing that 88 percent support the BMA campaign for National Health Service organizations to adopt ethical procurement policies.23

What can clinicians do to influence procurement in the health sector in the U.S.?

As end-users of medical commodities, healthcare professionals can be powerful advocates by campaigning for change in the way healthcare providers purchase supplies. A number of advocacy tools have been developed, including a short film “The Human Cost of Healthcare.”24

Healthcare professionals can support the campaign by raising awareness among colleagues or setting up a multi-stakeholder team with representatives from across healthcare organizations. Involving individuals from across the organization is important—for example, the corporate social responsibility lead, chief executive, public relations manager, and procurement manager, as well as clinicians. Most healthcare providers in the U.S. make purchasing decisions in a committee. Find out who is on this committee and tell them about ethical procurement. Once senior-level support is secured, the committee could raise these issues with their GPO.

The healthcare sector, with its huge purchasing power, can improve conditions for workers around the world. The more individuals and organizations raise these issues with suppliers, the more companies will change procurement practices and drive ethical improvements in supply chains. By supporting this campaign, healthcare professionals can improve not just patients’ lives but those of workers risking their health to make products for the health sector—whether children making surgical instruments in Pakistan, women sewing nurses’ uniforms in India, or home workers producing surgical masks in Mexico.

Find out how you can get involved; visit www.fairmedtrade.org.uk.

 

References

  1. Bjurling K. Papyrus Sweden AB’s purchase of Nitrile gloves from Malaysia. Stockholm: Swedwatch, 2010 www.vgregion.se/upload/Regionservice/Ink%C3%B6p/Milj%C3%B6h%C3%A4nsyn/Rapport%20om%20handskar.pdf
  2. Roberts O, Garcia A, Bhutta MF. Medical Fair and Ethical Trade Group: Visit to Medical Manufacturing Companies Mexico. London: BMA, 2010.
  3. Swedwatch. The Dark Side of Healthcare. Stockholm: Swedwatch, 2007 www.swedwatch.org/en/reports/dark-side-healthcare-0
  4. Bhutta MF. Fair trade for surgical instruments. BMJ. 2006;333(7562):297-9 www.bmj.com/content/333/7562/297
  5. The Business Case for Greening the Operating Room – Practice Greenhealth www.c4spgh.org/HCW1_Presentations/GOR_FullSet_Guidance%20Docs_Web_042711.pdf
  6. Surgical Instrument Manufacturers Association of Pakistan www.simap.org.pk/facts.php (accessed December 2012)
  7. Pakistan Institute of Labour Education and Research. Denial and Discrimination: Labour rights in Pakistan. Karachi: PILER, 2007 www.piler.org.pk/labourestatusreport.pdf
  8. Ethical Trade in Surgical Instruments: Bringing Change to the Supply Chain: BMA, 2008.
  9. Adverse Health Effects of Child Labor: High Exposure to Chromium and Oxidative DNA Damage in Children Manufacturing Surgical Instruments, Muhammad Sughis et al (June 2012) Environ Health Perspect. 120:1469–1474 (2012). http://ehp.niehs.nih.gov/1104678/
  10. Akida Management Consultants. Baseline survey report on child labour in surgical instruments manufacturing industry in Sialkot. Lahore, 2004.
  11. HealthTrust Purchasing Group www.healthtrustcorp.com/Content/BecomeAMember/WhyChooseHT.htm
  12. U.S. Department of Labor’s List of Goods Produced by Child Labor or Forced Labor www.dol.gov/ilab/programs/ocft/2012TVPRA.pdf
  13. 22 U.S.C. § 7112: US Code – Section 7112: Additional activities to monitor and combat forced labor and child labor 22 U.S.C. 7112(b)(2)(D) http://codes.lp.findlaw.com/uscode/22/78/7112
  14. Progress not Perfection – Impact’s 10th Anniversary Report (2007) www.impacttlimited.com/resources/resources-part-8-2
  15. ILO-IPEC, Nasir Dogar, Workplace Monitoring Project in the Surgical Instrument Industry, Working Papers on Child Labour in Asia – Vol -2, Bangkok, ILO, 2001 www.ilo.org/wcmsp5/groups/public/—ed_mas/—eval/documents/publication/wcms_126892.pdf
  16. Combating hazardous and exploitative child labour in surgical instruments manufacturing through prevention, withdrawal and rehabilitation – Phase II (2009) www.ilo.org/wcmsp5/groups/public/—ed_mas/—eval/documents/publication/wcms_126892.pdf
  17. Fair Trade USA 2011 Fair Trade Almanac http://fairtradeusa.org/sites/default/files/Almanac%202011.pdf
  18. Oxfam International. Better jobs in better supply chains. Oxford, 2010 http://www.oxfam.org/en/policy/better-jobs-better-supply-chains Ethical Trading Initiative, June 2009.
  19. www.ethicaltrade.org/in-action/member-performance/productivity-and-wage-rises-go-hand-in-hand
  20. Department of Health. Health is global: a UK Government strategy 2008-13. London, 2008 www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_088702
  21. Ethical Procurement for Health: Workbook www.ethicaltrade.org/resources/key-eti-resources/ethical-procurement-for-health-workbook
  22. www.fairmedtrade.org.uk
  23. BMA Omnibus Survey – August 2012
  24. The Human Cost of Healthcare: www.youtube.com/watch?v=iJ_vvac2tyE

More from November 2013 - Vol. 32 No. 11

07_OR-Team_1
Lessons Learned in Honduras
Stephen Nogan, MD Ohio State University On September 7, 2013, I returned from a one-week surgical mission trip to Guaimaca, Honduras, thanks in no small part to the support I received from the American Academy of Otolaryngology—Head and Neck Surgery Foundation. It was a highly successful trip with many patients treated, and the experience laid the groundwork for future international missions in my own career. My first glimpse into international surgical missions came at the age of 20 during my undergraduate studies. I traveled into a Mexican village with 100 strangers and no clear career path, and I left at the end of the trip with many new friends and mentors and a determination to pursue a career in surgery. One of those new friends was David S. Parsons, MD, a pediatric otolaryngologist from Charlotte, NC,  whom I joined on several subsequent trips to Mexico and who was the team captain for my recent trip to Honduras. Guaimaca is a municipality in the department (state) of Francisco Morazán in the central part of the country. Honduras has more than 8 million people, more than 50 percent of whom are living under the poverty line and more than 25 percent of whom are unemployed. Guaimaca is no exception to these national statistics. Within Guaimaca exists a hospital, Hospital Bautista, on a mission compound built with private donations and equipped with four brand new operating rooms that Dr. Parsons, Harvey M. Tucker, MD, Robert A. Willis, MD, Christopher L. Tebbit, MD, Tabitha L. Galloway, MD, and I were the first to use. We performed approximately 65 surgeries over the course of four days and distributed hundreds of medications. The operating rooms were fully staffed by U.S. volunteers, and we received additional, incredible support from Honduran physicians, nurses, translators, and security guards throughout the week. Operations included tonsillectomies, adenoidectomies, septoplasties, endoscopic sinus surgery, endoscopic laryngeal surgery, Sistrunk procedures, tympanoplasties, a thyroidectomy, a parotidectomy, and various soft tissue excisions. Having done some limited mission work in the past, the biggest surprise to me on this trip was the quality of the facility. In an area where the local residents had no clean water and inadequate plumbing and electricity, we were able to operate in a facility that met U.S. standards in these capacities. This was truly extraordinary. Because of the high quality of the hospital and, more important, the high character of the Honduran and American volunteers involved, I know we were able to impact the patients in a big way and will continue to do so on future trips. Our friendships with the missionaries and permanent volunteers at the hospital and nearby orphanages will allow us to accurately gauge our impact throughout the coming year and improve the effectiveness of the care we will provide in Honduras going forward. In the big picture of international surgical mission work, there will never be two experiences that are the same, neither in the impact on the volunteer nor the impact on the patients. In many instances, the long-term effectiveness of a short-term experience is difficult to measure, making evaluation and validation of our work challenging. Furthermore, it is impossible to account for all variables in this type of setting. Things like safety, natural resources, medical equipment, and surgical complications can change or arise in an unpredictable fashion, all of which can have an impact on patient care. However, I do believe there are aspects of this type of mission work that you can control. Strong leadership, high character, and loyalty to the cause and the patients are the most important of these and can overcome the inevitable challenges of short-term mission work. Much thanks to Baptist Medical & Dental Mission International (BMDMI), our sponsoring organization, for hosting us during our week in Honduras and the AAO-HNSF Humanitarian Efforts Committee for graciously helping with funding.
CPT for ENT: How to Use Unlisted Codes
Q: When should I use an unlisted code? A: An unlisted code should be used to report a procedure when no Category I or III CPT code exists to describe the procedure. Q: When shouldn’t I use an unlisted code? A: When a valid CPT code exists to describe the procedure. Unlisted codes should not be utilized as an attempt to obtain increased reimbursement in cases where a CPT code exists, but the reimbursement for the existing CPT code is low. Q: Are there steps I should take to increase the likelihood that my unlisted code will be paid? A: Yes, best practices for using unlisted codes include, but are not limited to, the following: Obtain prior authorization or certification for elective cases. Learn what the carrier needs to process the unlisted code; many request the following: Submit your claim on a CMS 1500 claim form with an operative note and cover letter outlining how you are using the unlisted code and how you’ve selected your “base code.” Access the Academy’s sample unlisted code cover letter here: http://www.entnet.org/Practice/Appeal-Template-letters.cfm Select a base code that is SIMILAR to the procedure you performed. The code should represent surgery on the same area of the body and utilize a similar approach and exposure to the procedure you performed. In your cover letter, list two to three things that make the unlisted procedure more or less difficult than the comparator CPT code. List the RVUs of the similar code to be sure it reflects a fair value for the work you have performed. If it does not, select a different base code. Use your normal fee for the comparison code. Note that the payer will then adjust this up or down from their fee schedule, not your charge. Q: Are there any other areas to be cautious about, or to avoid? A: Yes, keep the following in mind when using unlisted codes: As is the case with all claims, do not unbundle procedures that are included in a global surgery. Do not use modifier 22 on unlisted procedure codes. Do not report more than one unlisted procedure code per operative session. Payment delays are likely, as the payer may perform a more detailed review of your claim when an unlisted code is submitted. Make certain your documentation is fully supportive of the service and clearly describes the work performed, especially if it “deserves” a significantly higher reimbursement than the base code. For additional coding guidance and resources, visit the Academy’s coding corner at:  http://bit.ly/ENTcoding
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CPT for ENT: Coding 31000 with Balloon Dilation Procedures
Q: I’ve noticed that there are not any coding edits in place for CPT 31000 Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium) when billed with 31295 (endoscopic balloon dilation of the maxillary sinus). Does this mean I can code separately for the work of lavage when performing this service? A: No. The lavage is a lower-valued procedure performed at the same operative session on the same structure (maxillary sinus) and, therefore, would be included in the primary procedure code of 31295. Some additional things to consider are: The vignette associated with 31295 includes a statement that a catheter for irrigation may be placed at the same time. This unequivocally means that irrigation of the dilated sinus INCLUDES irrigation if performed at the same session. The only time 31000 should be reported with 31295 is if the primary procedure is performed on one side and ONLY an irrigation is performed on the opposite, contralateral side. In this case, the procedures would be reported using RT and LT modifiers. A -59 modifier would not be used, as there is not currently a CCI edit in place for this code combination. 31000 is an open code [i.e., anterior rhinoscopic guided service] and 31295 is an endoscopic code. 31000 represents a separate procedure in which the nose is anesthetized, decongested and a needle or cannula inserted into the antrum for irrigation. It is not intended for flushing through a patent or newly created surgical opening into the antrum. The same logic would apply to 31002 with relevant sphenoid codes. Q: In addition, there is a CCI edit in place of “1” for the code combinations of 31000 with 31256 (endoscopic maxillary antrostomy) and 31267 (endoscopic maxillary antrostomy with tissue removal from within the sinus), but I am able to bypass the edit using modifier 59 (distinct procedural service). Is it appropriate to append modifier 59 to 31000 in these instances? A: No, it is not appropriate to append modifier 59 to 31000 just to get the procedure paid. You must meet the criteria for use of modifier 59 in order to use the modifier appropriately and bypass the CCI edits. The lavage is a lower-valued procedure performed at the same operative session on the same structure (maxillary sinus) and, therefore, would be included in the primary procedure codes of 31256, 31267. Some additional things to consider are: The only time 31000 should be reported with 31256, 31267 with a 59 modifier is if the primary procedure is performed on one side and ONLY an irrigation is performed on the opposite, contralateral side. 31000 is an open code [i.e., anterior rhinoscopic guided service] and 31256, 31267 are all endoscopic codes. 31000 represents a separate procedure in which the nose is anesthetized, decongested and a needle or cannula inserted into the antrum for irrigation. It is not intended for flushing through a patent or newly created surgical opening into the antrum. Overuse of the -59 modifier with certain code combinations can trigger a CMS review of the code combination that could alter our ability to bill separately for these codes in the future. The same logic would apply to 31002 with relevant sphenoid codes.
AAO-HNS Members Make I-GO Summer Kickoff a Success
U.S. Representative Paul Tonko visiting Albany ENT & Allergy Services.
Government Affairs Highlights from the Annual Meeting
During the AAO-HNSF 2013 Annual Meeting & OTO EXPOSM in Vancouver, BC, Academy members visited the ENT PAC and Grassroots Booth—the Government Affairs “hub” during the meeting—to learn more regarding the Academy’s federal legislative priorities, grassroots initiatives, and new/ongoing political programs. Here is a brief overview of what took place in Vancouver. #FixtheSGR This year, the U.S. House Energy and Commerce (E & C) and Ways and Means (W & M) committees have been diligently working on the development of legislation to repeal the flawed Sustainable Growth Rate (SGR) formula used to determined payments to physicians in the Medicare program, and replace it with a new payment system that rewards the delivery of high-quality and efficient healthcare. In late July, legislation was unanimously passed by the E & C Committee, setting the stage for possible passage of legislation by the end of the year. AAO-HNS members are encouraged to contact their lawmakers via an AAO-HNS “Legislative Action Alert” to urge swift passage of SGR repeal legislation. In Vancouver, the Grassroots Table provided attendees with easy access to the Action Alert and additional information about other AAO-HNS federal legislative priorities. Calling All Residents! In Vancouver, the ENT PAC Board of Advisors and staff were excited to launch a new Resident and Fellows-in-Training PAC and Advocacy Involvement Campaign. The program, which relies on a simple point system, provides participants the opportunity to accrue points for themselves and their training program based on involvement in various AAO-HNS advocacy and political activities. For more information, email govtaffairs@entnet.org. ENT PAC Goes “Rogue” On Monday, September 30, all 2013, ENT PAC Investors were invited to attend the annual PAC “thank you” reception. This year’s event took place at the Rogue Kitchen & Wetbar in Vancouver. The ENT PAC Board of Advisors and staff thank all 2013 PAC Investors! For more information, contact entpac@entnet.org.* Lunch among Leaders On Tuesday, October 1, former Member of Parliament and Leader of the Liberal Party in Canada, the Honourable Bob Rae, spoke at the ENT PAC Chairman’s Club ($1,000+ annual contribution) Luncheon. The lunch featured a roundtable discussion about healthcare delivery in the U.S. and Canada. For more information about ENT PAC Leadership Clubs, visit www.entpac.org. What Is I-GO? The newest AAO-HNS advocacy program, the In-district Grassroots Outreach or “I-GO” program, was launched earlier this year and extensively discussed during this year’s annual meeting. The program, which encourages AAO-HNS members to engage in in-district advocacy opportunities (e.g., meeting with a lawmaker, attending a fundraiser, participating in a townhall, etc.), was a main tenet of the Government Affairs programming in Vancouver. The AAO-HNS Government Affairs staff and physician advocacy leaders hope the I-GO program will strengthen our advocacy “footprint” and provide AAO-HNS members with increased opportunities to develop relationships with lawmakers locally and, when applicable, participate in the political process. For more information, contact govtaffairs@entnet.org. Until the AAO-HNSF 2014 Annual Meeting & OTO EXPOSM in Orlando, ensure you receive the latest legislative and political news by joining our social media networks. “Follow” us on Twitter  @AAOHNSGovtAffrs, “Like” us on Facebook,  and “Connect” to us  on LinkedIn! *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. ENT PAC is a program of the AAO-HNS, which is exempt from federal income tax under section 501 (c) (6) of the Internal Revenue Code.
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Where Do We Go From Here? Attacking the Larger Problems in Safety and Quality
Rahul K. Shah, MD, George Washington University School of Medicine, Children’s National Medical Center, Washington, DC. A few years back, there was real concern whether the patient safety and quality improvement renaissance following the Institute of Medicine’s report in 1999 was real. In other words, were we moving the needle in actually reducing adverse events, near misses, and medical errors? This is a very basic, albeit profound question. Some experts had questioned if focusing tremendous attention on patient safety and quality improvement was taking limited resources away from other competing priorities. Within the last few years there have been myriad studies actually demonstrating an improvement in outcomes and other concomitant patient safety/quality improvement metrics in varying practice settings. It is of course exciting to see the needle move and the tremendous efforts of providers, such as our Academy members, working to improve the quality of care for our patients. How did the needle move? A trite answer is that there were so many opportunities that focusing on the low-hanging fruit was productive. Indeed, our Academy employed similar strategies when creating a prioritization matrix for patient safety and quality improvement work. The bigger question is: What do we do now? How can we attack the larger problems and move the needle a similar magnitude? There are several large databases and quality improvement platforms, which I will refrain from naming, that are perhaps the wrong strategy (and I do not want to implicate any platform per se). Instead of macro-level snapshots of data, many of us believe that targeted, specialty-specific initiatives will be necessary to make an impact and go after the more elusive specialty-specific issues. For example, Atul Gawande, MD, and his research team made incredible contributions to the understanding of the role of checklists, especially for surgery. The next iterations may be specialty-specific or case-specific checklists. Indeed, I know of many specialty practices, surgery centers, and hospitals that have such specialty/procedure-specific checklists to customize a standardized process. The next generation of patient safety and quality improvement will undoubtedly require a tremendous amount of resources, as it will be geared toward specific groups of providers (emergency department physicians, hospitalists, psychiatrists, etc.). Furthermore, it will require a much broader group of leaders, as there will be hundreds of competing initiatives. An example is the Hospital Engagement Networks (HEN) that many of our hospitals participate in. These networks are essentially huge collaboratives in which hospitals get together to look at aggregate macro-level data, as well as best practices, to collectively improve the care in their own hospitals and for the HEN itself. To my knowledge, there are no specific HEN metrics that are pertinent specifically to otolaryngology-head and neck surgery. I am aware of quality improvement collaboratives that are beginning in our specialty that are slowly gaining traction and will most certainly be highlighted in this column as they mature. Nevertheless, the future of patient safety and quality improvement could not be more exciting. The prior decade has shown that the needle has moved and the future looks promising that the needle will continue to move. As expected, there will be different strategies and techniques that will be required to move the needle in this decade, but we are on the right track and there will certainly be more involvement among our specialty and our members. 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.
Clinical Practice Guideline Summary: Bell’s Palsy
Reginald Baugh, MD; Gregory Basura, MD, PhD; Lisa Ishii, MD, MHS; Seth R. Schwartz, MD, MPH; Caitlin Murray Drumheller; Rebecca Burkholder, JD; Nathan A. Deckard, MD; Cindy Dawson, MSN, RN, CORLN; Colin Driscoll, MD; M. Boyd Gillespie, MD, MSc; Richard K. Gurgel, MD; John Halperin, MD, FAAN; Ayesha N. Khalid, MD; Kaparaboyna Ashok Kumar, MD, FRCS, FAAFP; Alan Micco, MD; Debra Munsell, DHSc, PA-C, DFAAPA; Steven Rosenbaum, MD, FAAEM; William Vaughan This month, the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) published its latest clinical practice guideline, Bell’s Palsy, as a supplement to Otolaryngology–Head and Neck Surgery. Recommendations developed encourage accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae, or evaluation of new or worsening symptoms not indicative of Bell’s palsy. The guideline was developed using the a priori protocol outlined in the AAO-HNS Clinical Practice Guideline Development Manual.1 The complete guideline is available at http://oto.sagepub.com. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. Recommendations in a guideline can be implemented only if they are clear and identifiable. This goal is best achieved by structuring the guideline around a series of key action statements, which are supported by amplifying text and action statement profiles. For ease of reference only the statements and profiles are included in this brief summary. Please refer to the complete guideline for the important information in the amplifying text that further explains the supporting evidence and details of implementation for each key action statement. For more information about the AAO-HNSF’s other quality knowledge products (clinical practice guidelines and clinical consensus statements), our guideline development methodology, or to submit a topic for future guideline development, please visit http://www.entnet.org/guidelines. Introduction Bell’s palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mononeuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis.1 Bell’s palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. The myriad treatment options for Bell’s palsy include medical therapy (steroids and antivirals, alone and in combination),2-4 surgical decompression,5-8 and complementary and alternative therapies such as acupuncture. Some controversy exists regarding the effectiveness of several of these options and there are consequent variations in care. Additionally, there are numerous diagnostic tests available that are used in the evaluation of Bell’s palsy patients. Many of these tests are of questionable benefit in Bell’s palsy, including laboratory testing,9,10 diagnostic imaging studies, and electrodiagnostic tests.10-12 Furthermore, while Bell’s palsy patients enter the healthcare system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell’s palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell’s palsy. When evaluating a patient with facial weakness/paralysis for Bell’s palsy, the following should be considered: Bell’s palsy is rapid in onset (
Farewell and Thanks to Gregory W. Randolph, MD, AAO-HNSF Coordinator for International Affairs, 2009-2013
After serving a four-year term as International Coordinator, Gregory W. Randolph, MD, is stepping down to be succeeded by James E. Saunders, MD, former chair, Humanitarian Efforts Committee and 2013 awardee of the Humanitarian Award. Our thanks go to Dr. Randolph for his tireless efforts to build up and promote the Academy’s international program among Academy members with international contacts. Dr. Randolph transformed the International Steering Committee into a high-performing operational committee by appointing outstanding Academy leaders as Regional Advisors, who act as liaisons to the International Corresponding Societies in their regions. Several past presidents are among the Regional Advisors: G. Richard Holt, MD, D-BE, MSE, MPH (Middle East), David W. Kennedy, MD (Europe), K.J. Lee, MD (Pacific Rim), Eugene N. Myers, MD, FRCSEd (Hon.) (the Balkans, Greece, and Turkey), and James L. Netterville, MD (Africa). On Dr. Randolph’s watch, International Fellows and Members of the Academy are now number 1,200 from 93 countries and the International Corresponding Societies (ICS) network has grown to 54 societies on six continents. New corresponding societies include those of El Salvador, Honduras, Kenya, Nicaragua, Paraguay, South Africa, and the College of Surgeons of East, Central and Southern Africa (COSECSA.) Dr. Randolph is among those who generously supported the International Visiting Scholars. Since 2008, 37 scholars from 18 countries have attended our annual meetings and take part in observerships. To show the extent of the Academy’s involvement in advancing the specialty around the globe, Dr. Randolph launched the first Global Health 2010: Your Academy around the World at the Annual Meeting & OTO EXPO in Boston, MA, with eight “Goodwill Ambassadors” from Australia, Germany, Haiti, New Zealand, Serbia, UAE, Venezuela, and Zimbabwe, introduced by their Regional Advisors. Since then the Global Health event has taken place annually with speakers from 30 countries. Dr. Randolph will continue to be active in international organizations. He worked closely with Professor Chong-Sun Kim and his organizing committee on the recent World Congress of the International Federation of Oto-Rhino-Laryngology Societies (IFOS) in Seoul, Korea, June 2013, and is now on the IFOS Executive Board and the Otolaryngology Education Committee, planning for the 2017 World Congress in Paris.
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Academy Advantage Partner: Search Engine Optimization (SEO) at a Glance
By Glenn Lombardi If you want to bring new patients to your practice, you need to be where they look. The Yellow Pages are long dead, and while direct mail and other old methods can sometimes work, Google is far and away the most proactive way to make your practice visible online. The facts speak for themselves. And so the bottom line is obvious: to keep your practice growing, you need to understand how search engine optimization (SEO) works, and how to use it effectively as part of your web presence. Otherwise, you might not appear on search engines at all. The Most Common Search Categories: Examples and Advice Location-Based Search: “ENT, Chicago, IL.” The front page of results is the holy grail of Internet visibility—75 percent of search users never look further. And unless you’re the only ENT in Chicago, you won’t show up there. So if you practice in a metropolitan area, it’s best to use SEO to improve your search ranking for specific neighborhoods. Try optimizing for searches such as “ENT, Wicker Park” instead of going for the whole metropolitan area. General Search: “Hearing Aid Evaluations, Boston” One of the best ways to get your practice to stand out is to optimize your website for specific services rather than the catchall of “ENT.” If you specialize in a certain procedure or want to drive more attention to your less popular services, optimizing for general, service-based queries is a good way to differentiate your practice from the competition. Search After Referral: “Mark Rosewater, ENT, Seattle” Patients who have already received a referral to you often search this way. So if your name is part of what drives patients to your practice, then optimizing accordingly is always a good idea. It’s also crucial to pay attention to your reviews on sites such as Yelp and Healthgrades®, because those reviews will appear alongside your website. SEO is an ever-changing field, so give yourself a quick checkup today. If you don’t know how, call an expert like the ones at Officite, and put your practice in the spotlight. About the Author: Glenn Lombardi is president of Officite, the national leader in websites and online marketing strategies for healthcare professionals. Officite is a partner of the AAO-HNS’ Academy Advantage program and has built more than 20,000 websites and generated more than 600,000 new patient appointments. They specialize in helping practices graduate from a simple website to a full web presence platform, offering solutions such as turnkey social media strategies, expert search marketing, top-tier patient education, continual reputation monitoring, and premium mobile websites. For more information, visit www.officite.com or call 877-889-4042. SearchEngineJournal and Google “Keyword Planner” reports: Search is one of the top two activities performed on the Internet, second only to email. It’s also the No. 1 driver of traffic to content sites, beating social media by more than 300 percent. 90 percent of online experiences start with a search engine. 16.6 million people search for “ENT” online every month.
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Academy and Foundation Cluster and Committee Rosters
The following are the committee rosters of the Academy and Foundation, grouped by clusters. These are all members, unless otherwise noted, who were appointed to terms October 1, 2013, as well as continuing their service. The number following each name indicates end of their term. If you’d like to serve on a committee, applications are now being accepted through February 3, 2014. Please submit your application at www.entnet.org/committees/ Review the committee rosters online for the most up-to-date listing at  www.entnet.org/Community/committeeRoster.cfm Images depict members at committee activities from this year’s annual meeting by julesclifford.com. Standing and Board Steering CommitteesArticles of Incorporation and Bylaws Committee Kathleen L. Yaremchuk, MD, MSA, Committee Chair, 16 Bradley F. Marple, MD, Member, 14 Karen T. Pitman, MD, Member, 16 Estella Laguna, Staff Liaison David R. Nielsen, MD, Ex-Officio Audit Committee Kenneth W. Altman, MD, PhD, Committee Chair, 14 Steven W. Cheung, MD, Member, 15 Paul T. Fass, MD, Member, 14 Duane J. Taylor, MD, Member, 15 Jerome W. Thompson, MD, MBA, Member, 16 Michael D. Seidman, MD, Member, 16 Carrie Hanlon, CPA, Staff Liaison Brenda Hargett, CPA, CAE, Staff Liaison David R. Nielsen, MD, Ex-Officio Ethics Committee Lauren S. Zaretsky, MD, Committee Chair, 14 Susan D. McCammon, MD, Committee Chair-Elect, 18 Daniel C. Chelius Jr., MD, Member, 14 Roger D. Cole, MD, Member, 15 Susan R. Cordes, MD, Member, 15 Ilaaf Darrat, MD, Member, 14 Christopher Discolo, MD, Member, 15 Beth R. Duncan, MD, MBA, Member, 14 Paul E. Hammerschlag, MD, Member, 14 Jonathan B. Ida, MD, Member, 14 John W. Jones, MD, Member, 14 Paul Konowitz, MD, Member, 15 Travis J. Pfannenstiel, MD, Member, 15 Werner C. Roennecke, MD, Member, 14 Joshua D. Rosenberg, MD, Member, 14 Andrew G. Shuman, MD, Member, 15 Timothy J. Siglock, MD, Member, 14 Mark J. Syms, MD, Member, 14 Ira D. Uretzky, MD, Member, 14 Steven J. Wang, MD, Member, 14 Barry L. Wenig, MD, MPH, Member, 14 Sarah K. Wise, MD, Member, 14 Lauren Bohm, MD, Consultant, 14 Daniel H. Coelho, MD, Consultant, 15 Kevin Christopher McMains, MD, Consultant, 14 Brenda Hargett, CPA, CAE, Staff Liaison Executive Committee Richard W. Waguespack, MD, President, 14 James L. Netterville, MD, Immediate Past President, 14 Gayle E. Woodson, MD, President-Elect, 14 Gavin Setzen, MD, Secretary/Treasurer, 15 Peter J. Abramson, MD, Chair/BOG, 14 Wendy B. Stern, MD, Guest/BOG, 14 Bradley F. Marple, MD, Director-at-Large, 14 Jerry M. Schreibstein, MD, Director- at-Large, 14 David R. Nielsen, MD, Executive Vice President & CEO Estella Laguna, Staff Liaison Finance and Investment Subcommittee Gavin Setzen, MD, Committee Chair, 15 Jerry M. Schreibstein, MD, Member, 16 J. Pablo Stolovitzky, MD, Member, 15 Jerry M. Schreibstein, MD, Member, 16 Michael G. Stewart, MD MPH, Member, 14 Pell Ann Wardrop, MD, Member, 14 Lynn Frischkorn, Staff Liaison Carrie Hanlon, CPA, Staff Liaison Brenda Hargett, CPA, CAE, Staff Liaison David R. Nielsen, MD, Ex-Officio Susan D. McCammon, MD, Ex-Officio Nominating Committee James L. Netterville, MD, Committee Chair, 14 Peter J. Abramson, MD, Member, 14 Ellen S. Deutsch, MD, Member, 15 Howard W. Francis, MD, Member, 14 Gady Har-El, MD, Member, 14 Brian Nussenbaum, MD, Member, 15 Shannon P. Pryor, MD, Member, 15 Cecelia E. Schmalbach, MD, Member, 14 P. Ashley Wackym, MD, Member, 14 Ken Yanagisawa, MD, Member, 15 Estella Laguna, Staff Liaison David R. Nielsen, MD, Ex-Officio Lauren S. Zaretsky, MD, Ex-Officio, 14 Physician Resources Committee David W. Kennedy, MD, Committee Chair, 15 Ramesh K. Agarwal, MD, Member, 14 Reginald F. Baugh, MD, Member, 14 Linda S. Brodsky, MD, Member, 14 Adam P. Campbell, MD, Member, 14 David W. Eisele, MD, Member, 14 Isaac D. Erbele, MD, Member, 14 Berrylin J. Ferguson, MD, Member, 14 Bruce J. Gantz, MD, Member, 14 Eric M. Gessler, MD, Member, 15 Marie T. Gilbert, PA-C, Member, 15 Ethan B. Handler, MD, Member, 14 Joseph E. Hart, MD, MS, Member, 14 Karl Hoermann, MD, Member, 14 Steven B. Levine, MD, Member, 14 Patrick G. McMenamin, MD, Member, 15 Vikas Mehta, MD, Member, 14 Robert H. Miller, MD, MBA, Member, 14 Sami Pierre Moubayed, MD, Member, 14 William P. Potsic, MD, Member, 14 Jonathon O. Russell, MD, Member, 14 John W. Seibert, MD, Member, 14 Gavin Setzen, MD, Member, 15 Pell Ann Wardrop, MD, Member, 14 Lauren S. Zaretsky, MD, Member, 14 Michael M.E. Johns II, MD, Consultant, 14 Harold C Pillsbury III, MD, Consultant, 15 Jean Brereton, MBA, Staff Liaison Science and Educational Committee Richard M. Rosenfeld, MD MPH, Committee Chair, 14 Sukgi S. Choi, MD, Member, 16 Sonya Malekzadeh, MD, Member, 15 John S. Rhee, MD MPH, Member, 14 Eben L. Rosenthal, MD, Member, 16 Mary Pat Cornett, CAE, CMP, Staff Liaison James E. Saunders, MD, Non-Voting Guest, 17 Gavin Setzen, MD, Non-Voting Guest, 15 Brenda Hargett, CPA, CAE, Ex-Officio David R. Nielsen, MD, Ex-Officio Board of Governors (BOG) Committees BOG Executive Committee Peter J. Abramson, MD, Chair/BOG, 14 Stacey L. Ishman, MD, MPH, Member-At- Large, 14 David R Edelstein, MD, Member, 14 Joseph E. Hart, MD, MS, Member, 14 Paul M. Imber, DO, Member, 14 Richard N. Carson Jr, Staff Liaison Bethany D. Clifton, Staff Liaison Sanford M. Archer, MD, Ex-Officio, 14 Susan R. Cordes, MD, Ex-Officio, 14 Sanjay R. Parikh, MD, Ex-Officio, 14 BOG Legislative Representatives Committee Paul M. Imber, DO, Committee Chair, 14 Susan R. Cordes, MD, BOG Vice Chair, 14 Art A. Ambrosio, MD, Member, 14 K. Paul Boyev, MD, Member, 14 Paul C. Bryson, MD, Member, 14 Hamad Chaudhary, MD, Member, 14 Nathan A. Deckard, MD, Member, 14 Soha N. Ghossaini, MD, Member, 15 Joseph E. Hart, MD, MS, Member, 15 Charles F Koopmann Jr, MD, MHSA, Member, 14 Phillip L. Massengill, MD, Member, 15 Zara M. Patel, MD, Member, 14 Brian K. Reilly, MD, Member, 14 Brianne B. Roby, MD, Member, 14 Michelle M. Roeser, MD, Member, 14 Javad A. Sajan, MD, Member, 15 Lawrence M. Simon, MD, Member, 14 Larry N. Smith, MD, Member, 14 Hayes H. Wanamaker, MD, Member, 15 Ashley E. Wenaas, MD, Member, 14 Christopher F. Baranano, MD, Consultant, 14 J. Scott Magnuson, MD, Consultant, 14 Richard Capparell, Staff Liaison Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison BOG Rules and Regulations Committee Joseph E. Hart, MD, MS, Committee Chair, 14 Sanford M. Archer, MD, BOG Vice Chair, 14 Boris Chernobilsky, MD, Member, 15 Robert A. Frankenthaler, MD, Member, 14 Satish Govindaraj, MD, Member, 15 Paul M. Imber, DO, Member, 15 Kanwar S. Kelley, MD, JD, Member, 15 John Y. Kim, MD, Member, 14 Steven T. Kmucha, MD, JD, Member, 14 H. Baltzer LeJeune, MD, Member, 15 Sami Pierre Moubayed, MD, Member, 14 Spencer C. Payne, MD, Member, 14 Jesse G. Wardlow Jr, MD, Member, 15 Jeffrey S. Wolf, MD, Member, 14 H. Russell Wright, Jr, MD, Member, 14 Andrew J. Heller, MD, Consultant, 14 Richard N. Carson Jr, Staff Liaison Bethany D. Clifton, Staff Liaison BOG Socioeconomic and Grassroots Committee David R. Edelstein, MD, Committee Chair, 14 Sanjay R. Parikh, MD, BOG Vice Chair, 14 Stephen W Bayles, MD, Member, 14 Phyllis B. Bouvier, MD, Member, 15 Soha N. Ghossaini, MD, Member, 15 Kevin T. Kavanagh, MD, Member, 14 Eric J. Kezirian, MD MPH, Member, 14 Ayesha N. Khalid, MD, Member, 15 Charles F. Koopmann, Jr., MD, MHSA, Member, 14 Brian J. McKinnon, MD MBA, Member, 14 Kevin K. Motamedi, MD, Member, 15 Mark E. Prince, MD, Member, 15 Brianne B. Roby, MD, Member, 15 Lawrence M. Simon, MD, Member, 15 Robert J. Stachler, MD, Member, 14 Mark J. Syms, MD, Member, 15 Ira D. Uretzky, MD, Member, 15 Daniel L. Wohl, MD, Member, 14 Joseph E. Hart, MD, MS, Consultant, 15 Douglas L Worden, MD, Consultant, 15 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison Women in Otolaryngology (WIO) Section Committees WIO Awards Committee Valerie A. Flanary, MD, Committee Chair, 14 Elizabeth A. Blair, MD, Member, 14 Megan L. Durr, MD, Member, 14 Soha N. Ghossaini, MD, Member, 14 Inna A. Husain, MD, Member, 14 Stacey L. Ishman, MD, MPH, Member, 14 Mimi S. Kokoska, MD, Member, 14 Tomoko Makishima, MD, PhD, Member, 15 Nikhila P. Raol, MD, Member, 15 Amanda L. Stapleton, MD, Member, 14 Tammara L. Watts, MD, PhD, Member, 15 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison WIO Communications Committee Erika A. Woodson, MD, Committee Chair, 14 Stephanie A. Austin, MD, Member, 14 Marcella R. Bothwell, MD, Member, 14 Susan R. Cordes, MD, Member, 14 Elizabeth A. Dunham, MD MPH, Member, 14 Valerie A. Flanary, MD, Member, 14 Sezelle Gereau, MD, Member, 14 A. Kristina E. Hart, MD, Member, 14 Melissa G. Kress, DO, Member, 14 Nila M. Novotny, MD, Member, 14 Pamela C. Roehm, MD, PhD, Member, 14 Jayde M. Steckowych, MD, Member, 14 Sarah K. Wise, MD, Member, 14 Kathleen L. Yaremchuk, MD, MSA, Member, 14 Richard N. Carson Jr, Staff Liaison Bethany D. Clifton, Staff Liaison WIO Council on Committees Linda S. Brodsky, MD, Committee Chair, 14 Valerie A. Flanary, MD, Member, 14 Pell Ann Wardrop, MD, Member, 14 Erika A. Woodson, MD, Member, 14 Lauren S. Zaretsky, MD, Member, 14 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison WIO Endowment Committee Pell Ann Wardrop, MD, Committee Chair, 14 Phyllis B. Bouvier, MD, Member, 14 Sujana S. Chandrasekhar, MD, Member, 14 Elizabeth Guardiani, MD, Member, 15 Anna Kristina E. Hart, MD, Member, 14 Beth N. McNulty, MD, Member, 14 Mary McMahon, Staff Liaison Ron Sallerson, Staff Liaison WIO Leadership Development and Mentorship Carol R. Bradford, MD, Committee Chair, 15 Meredith E. Adams, MD, Member, 14 Leslie Asbury, MD, Member, 14 Kathleen Billings, MD, Member, 14 Jennifer Decker, MD, Member, 14 Debra M. Don, MD, Member, 14 Soha N. Ghossaini, MD, Member, 14 Rebecca D. Golgert, MD, Member, 14 Mary E. Gorman, MD, Member, 14 Jamie R. Litvack, MD, Member, 14 Edith A. McFadden, MD, MA, Member, 14 Abby R. Nolder, MD, Member, 14 Lucia S. Olarte, MD, Member, 14 Sarah L. Rohde, MD, Member, 14 Jamie Stern, MD, Member, 14 Debra G. Weinberger, MD, Member, 14 Linda S. Brodsky, MD, Consultant, 14 Shannon P. Pryor, MD, Consultant, 14 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison WIO Program Committee Suman Golla, MD, Committee Chair, 15 Lauren S. Zaretsky, MD, Committee Chair, 14 Meredith E. Adams, MD, Member, 14 Stephanie A. Austin, MD, Member, 14 Lauren Bohm, MD, Member, 15 Phyllis B. Bouvier, MD, Member, 14 Holly Boyer, MD, Member, 14 Sydney C. Butts, MD, Member, 14 Cecelia Damask, DO, Member, 14 Ilaaf Darrat, MD, Member, 14 Rebecca D. Golgert, MD, Member, 14 Mary E. Gorman, MD, Member, 14 Stacey T. Gray, MD, Member, 14 Natasha Mirza, MD, Member, 14 Margaret A. Ogden, MD, Member, 14 Michelle M. Roeser, MD, Member, 14 Jayde M. Steckowych, MD, Member, 14 Marita S. Teng, MD, Member, 14 Debara L. Tucci, MD, Member, 14 Julie L. Wei, MD, Member, 14 Nina S Yoshpe, MD, Member, 14 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison WIO Research and Survey Committee Linda S Brodsky, MD, Committee Chair, 14 Carol A. Bauer, MD, Member, 14 Abby E. Gross, MD, Member, 14 Jamie R. Litvack, MD, Member, 14 Edith A. McFadden, MD, MA, Member, 14 Beth N. McNulty, MD, Member, 14 Lucia S. Olarte, MD, Member, 14 Colleen F. Perez, MD, Member, 14 Shannon P. Pryor, MD, Member, 14 Pamela C. Roehm, MD PhD, Member, 14 Kristina W Rosbe, MD, Member, 14 Maya G. Sardesai, MD, MEd, Member, 14 Amanda L. Stapleton, MD, Member, 14 Kathleen L. Yaremchuk, MD, MSA, Member, 14 Katherine C. Yung, MD, Member, 14 Richard N. Carson Jr, Staff Liaison Bethany D. Clifton, Staff Liaison Academy/Foundation Committees Head and Neck Steering Committee Bradley F. Marple, MD, Committee Chair, 14 Gregory J. Artz, MD, Member, 15 Joseph A. Brennan, MD, Member, 15 Douglas B. Chepeha, MD, MSPH, Member, 14 Christine G. Gourin, MD, Member, 15 Donna J. Millay, MD, Member, 15 Ralph P. Tufano, MD, Member, 15 Jeanne McIntyre, CAE, Staff Liaison Endocrine Surgery Committee Ralph P. Tufano, MD, Committee Chair, 15 Sarah E. Bailey, MD, Member, 14 Kevin T. Brumund, MD, Member, 15 Jeffrey M. Bumpous, MD, Member, 14 Salvatore M. Caruana, MD, Member, 15 Deepak Gurushanthaiah, MD, Member, 15 Chase Heaton, MD, Member, 14 Jeffrey J. Houlton, MD, Member, 15 Jason Patrick Hunt, MD, Member, 14 Miriam N. Lango, MD, Member, 15 Vikas Mehta, MD, Member, 14 Phillip K. Pellitteri, DO, Member, 14 Aaron K. Remenschneider, MD, Member, 14 David Rosen, MD, Member, 15 Joseph Scharpf, MD, Member, 15 Merry E. Sebelik, MD, Member, 14 Alfred A Simental Jr, MD, Member, 14 Michael C. Singer, MD, Member, 14 Venkat R Srinivasan, FRCS (ORL), Member, 15 Krishnamurthi Sundaram, MD, Member, 14 Mike Yao, MD, Member, 14 F. Christopher Holsinger, MD, Consultant, 15 Christopher Klem, MD, Consultant, 15 Lisa A. Orloff, MD, Consultant, 15 Russell B. Smith, MD, Consultant, 14 Brendan C. Stack, Jr, MD Consultant, 14 Robert L. Witt, MD, Consultant, 14 Catherine R. Lincoln, CAE, MA (Oxon), Staff Liaison Head and Neck Surgery and Oncology Committee Christine G. Gourin, MD, Committee Chair, 15 Sarah E. Bailey, MD, Member, 15 Carol M. Bier-Laning, MD, Member, 14 Elizabeth A. Blair, MD, Member, 14 Yu-Wai Jimmy Chan, MRCS, FCSHK, Member, 14 Neal D. Futran, MD, DMD, Member, 14 Marion B. Gillespie, MD, Member, 14 Douglas A. Girod, MD, Member, 14 Allen S. Ho, MD, Member, 15 Jason Patrick Hunt, MD, Member, 14 Samir Khariwala, MD, Member, 14 Alexander Langerman, MD, Member, 14 Derrick T. Lin, MD, Member, 14 Jeffrey C. Liu, MD, Member, 15 Michael G. Moore, MD, Member, 15 Kristen J. Otto, MD, Member, 14 Chan W. Park, MD, Member, 15 Karen T. Pitman, MD, Member, 14 Mark E. Prince, MD, Member, 15 Gregory J. Renner, MD, Member, 14 Jeremy D. Richmon, MD, Member, 15 Brendan C. Stack, Jr., MD, Member, 15 Ralph P Tufano, MD, Member, 15 Steven J. Wang, MD, Member, 14 Barry L, Wenig, MD, MPH, Member, 14 Daniel G. Deschler, MD, Consultant, 15 Urjeet Patel, MD, Consultant, 14 Cecelia E. Schmalbach, MD, Consultant, 14 Dain G. Oswald, Staff Liaison Microvascular Committee Douglas B Chepeha, MD, MSPH, Committee Chair, 14 Keith A. Casper, MD, Member, 14 John J. Chi, MD, Member, 14 David P. Goldstein, MD, FRCSC, Member, 14 Matthew M. Hanasono, MD, Member, 14 Christian Hasney, MD, Member, 14 Jeffrey J. Houlton, MD, Member, 15 Jeffrey B. Jorgensen, MD, Member, 15 Jason M. Leibowitz, MD, Member, 14 Oleg N. Militsakh, MD, Member, 14 Brian A. Moore, MD, Member, 14 Liana Puscas, MD, Member, 14 Jason Thomas Rich, MD, Member, 15 Marita S. Teng, MD, Member, 14 Paul G. Van der Sloot, MD, Member, 14 D. Gregory Farwell, MD, Consultant, 14 Thomas J. Gal, Jr, MD MPH, Consultant, 14 Urjeet Patel, MD, Consultant, 14 Yelizaveta Shnayder, MD, Consultant, 14 Eileen Cavanagh, Staff Liaison Plastic and Reconstructive Surgery Committee Donna J. Millay, MD, Committee Chair, 15 Marcelo B. Antunes, MD, Member, 14 Artemus J. Cox III, MD, Member, 15 William M. Guy, MD, Member, 15 Kate E. McCarn, MD, Member, 14 John M. Morehead, MD, Member, 14 Larry L. Myers, MD, Member, 15 Mohsen Naraghi, MD, Member, 15 Krishna G. Patel, MD, PhD, Member, 15 John S. Rhee, MD, MPH, Member, 15 Bryan N. Rolfes, MD, Member, 14 Chelsey J. Smith, MD, Member, 14 Duc A. Tien, MD, Member, 14 Preston D. Ward, MD, Member, 14 Heather McGhee, Staff Liaison Skull Base Surgery Committee Gregory J. Artz, MD, Committee Chair, 15 Abib A. Agbetoba, MD, Member, 14 Pete S. Batra, MD, Member, 14 Nathan A. Deckard, MD, Member, 14 Rodney Diaz, MD, Member, 15 Ivan H. El-Sayed, MD, Member, 15 Rick A. Friedman, MD PhD, Member, 14 John C. Goddard, MD, Member, 15 Stacey T. Gray, MD, Member, 15 David Kaylie, MD, Member, 14 Theodore McRackan, MD, Member, 14 Sami J. Melki, MD, Member, 14 Bradley P. Pickett, MD, Member, 14 Ryan G. Porter, MD, Member, 14 B. Todd Schaeffer, MD, Member, 15 John Caleb Simmons, MD, Member, 14 Eric W. Wang, MD, Member, 14 Marilene B. Wang, MD, Member, 14 Robert A. Williamson, MD, Member, 15 Erika A. Woodson, MD, Member, 15 Rhoda Wynn, MD, Member, 15 Eric H. Holbrook, MD, Consultant, 15 J Walter Kutz Jr, MD, Consultant, 15 Derrick T. Lin, MD, Consultant, 14 Dain G. Oswald, Staff Liaison Trauma Committee Joseph A. Brennan, MD, Committee Chair, 15 Ben J. Balough, MD, Member, 15 Jose E. Barrera, MD, Member, 15 Mark E. Boston, MD, Member, 15 Marion E. Couch, MD PhD, Member, 15 Paul J. Donald, MD, Member, 15 Robert L. Eller, MD, Member, 15 Jeffrey A. Faulkner, MD, Member, 14 Neal D. Futran, MD, DMD, Member, 14 David K. Hayes, MD, Member, 15 Michael R. Holtel, MD, Member, 15 Robert M Kellman, MD, Member, 14 Manuel A. Lopez, MD, Member, 14 Stephen C. Maturo, MD, Member, 15 Eric J. Moore, MD, Member, 15 Whitney A. Pafford, MD, Member, 14 Douglas S. Ruhl, MD, Member, 14 Cecelia E. Schmalbach, MD, Member, 14 Joseph C. Sniezek, MD, Member, 15 Christian L. Stallworth, MD, Member, 15 Courtney C. J. Voelker, MD, DPhil, Member, 14 Meghan N. Wilson, MD, Member, 14 G. Richard Holt, MD, D-BE, MSE, MPH, Consultant, 15 Michael G. Stewart, MD, MPH, Consultant, 14 David Buckner, Staff Liaison Hearing and Equilibrium Steering Committee Michael G. Stewart, MD, MPH, Committee Chair, 15 Douglas D. Backous, MD, Member, 14 Craig A. Buchman, MD, Member, 14 Joel A. Goebel, MD, Member, 15 Joy L. Trimmer, JD, Staff Liaison Equilibrium Committee Joel A. Goebel, MD, Committee Chair, 15 Meredith E. Adams, MD, Member, 14 Oliver F. Adunka, MD, Member, 14 Yuri Agrawal, MD, Member, 15 James S. Atkins Jr, MD, Member, 14 Sanjay Bhansali, MD, Member, 14 Sujana S. Chandrasekhar, MD, Member, 14 Hamid R. Djalilian, MD, Member, 14 Jeremy Hornibrook, FRACS, Member, 14 David Kaylie, MD, Member, 14 Jeffery J. Kuhn, MD, Member, 14 J. Walter Kutz Jr, MD, Member, 14 Tomoko Makishima, MD, PhD, Member, 15 Kianoush Sheykholeslami, MD, PhD, Member, 14 Eric E Smouha, MD, Member, 14 Judith A White, MD, PhD, Member, 14 Allan M. Rubin, MD, PhD, Consultant, 15 Hamed Sajjadi, MD, Consultant, 14 Lorraine Nnacheta, MPH, Staff Liaison Hearing Committee Douglas D. Backous, MD, Committee Chair, 15 Alexander Ashford, MD, Member, 15 Marc L. Bennett, MD, Member, 15 Alexander G. Bien, MD, Member, 15 Kay W. Chang, MD, Member, 15 Alan G. Cheng, MD, Member, 14 Roberto A. Cueva, MD, Member, 15 John L. Dornhoffer, MD, Member, 14 Jose N. Fayad, MD, Member, 14 Neil A Giddings, MD, Member, 15 Richard K. Gurgel, MD, Member, 14 Michael S. Harris, MD, Member, 14 Tina C. Huang, MD, Member, 15 Ana H. Kim, MD, Member, 14 Greg R. Licameli, MD, Member, 14 Frank R. Lin, MD, Member, 14 Cliff A. Megerian, MD, Member, 15 Sami J. Melki, MD, Member, 15 Ted A. Meyer, MD PhD, Member, 14 Alan G. Micco, MD, Member, 14 Elias M. Michaelides, MD, Member, 15 Kourosh Parham, MD PhD, Member, 14 Ryan G. Porter, MD, Member, 15 Jess C. Roberts, MD, Member, 15 Cameron C. Wick, MD, Member, 14 Sujana S. Chandrasekhar, MD, Consultant, 15 Robert A. Dobie, MD, Consultant, 15 Robert K. Jackler, MD, Consultant, 15 Paul R. Kileny, PhD, Consultant, 14 Brenda L. Lonsbury-Martin, PhD, Consultant, 14 Leslie Caspersen, MBA, Staff Liaison Implantable Hearing Devices Committee Craig A. Buchman, MD, Committee Chair, 14 Oliver F. Adunka, MD, Member, 15 Daniela S. Carvalho, MD, Member, 15 Douglas A. Chen, MD, Member, 15 Robert Cullen, MD, Member, 15 Adrien A. Eshraghi, MD, MSc, Member, 15 Jose N. Fayad, MD, Member, 14 John C. Goddard, MD, Member, 15 Matthew B. Hanson, MD, Member, 15 Douglas M. Hildrew, MD, Member, 14 Robert S. Hong, MD, Member, 14 Anita S. Jeyakumar, MD, MS, Member, 14 J. Walter Kutz, Jr, MD, Member, 15 Samuel C. Levine, MD, Member, 15 Christopher J. Linstrom, MD, Member, 15 Brian J. McKinnon, MD, MBA, Member, 14 Ted A. Meyer, MD, PhD, Member, 14 Ravi N. Samy, MD, Member, 14 Jack A. Shohet, MD, Member, 14 Elizabeth H. Toh, MD, Member, 14 Jack J. Wazen, MD, Member, 15 Cameron C. Wick, MD, Member, 14 Robert A. Williamson, MD, Member, 15 Soha N. Ghossaini, MD, Consultant, 15 Alan J. Johnson, MD, MPH, Consultant, 14 Jeffery J. Kuhn, MD, Consultant, 14 William H. Slattery III, MD, Consultant, 14 Nancy M. Young, MD, Consultant, 14 Maureen Corrigan, Staff Liaison Kenneth H. Lee, MD, PhD, Non-Voting Guest, 14 S. George Lesinski, MD, Non-Voting Guest, 14 International Steering Committee James E. Saunders, MD, Committee Chair, 17 Susan R. Cordes, MD, Member, 14 Terry A. Day, MD, Member, 14 Ramon A. Franco Jr, MD, Member, 14 Bernard Gil Fraysse, MD, Member, 14 Karl Hoermann, MD, Member, 14 G. Richard Holt, MD, D-BE, MSE, MPH, Member, 14 David W. Kennedy, MD, Member, 14 Chong-Sun Kim, MD, PhD, Member, 14 KJ Lee, MD, Member, 14 Eugene N. Myers, MD, FRCS Edin (Hon), Member, 14 James L. Netterville, MD, Member, 14 Milan Profant, MD, PhD, Member, 15 Anatoly F. Romanchishen, MD, PhD, DSc, Member, 15 Nancy L. Snyderman, MD, Member, 14 J. Pablo Stolovitzky, MD, Member, 14 Mark E. Zafereo, Jr, MD, Member, 14 Gregory W. Randolph, MD, FACE, Consultant, 15 Hector E. Ruiz, MD, Consultant, 14 Catherine R. Lincoln, CAE, MA (Oxon), Staff Liaison Nikhil J. Bhatt, MD, Ex-Officio, 15 Juan Manuel Garcia Gomez, MD, Ex-Officio, 14 Merry E. Sebelik, MD, Ex-Officio, 15 Humanitarian Efforts Committee Merry E. Sebelik, MD, Committee Chair, 15 Susan R. Cordes, MD, Member, 15 Anthony Del Signore, MD, Member, 15 Ronald W. Deskin, MD, Member, 15 Susan D. Emmett, MD, Member, 14 Nazaneen N. Grant, MD, Member, 15 Clifford R. Hume, MD, PhD, Member, 14 Wayne M. Koch, MD, Member, 14 Alexander Langerman, MD, Member, 14 Anya J. Li, MD, Member, 15 James P. Malone, MD, Member, 15 Peggyann Nowak, MD, Member, 14 Roger C. Nuss, MD, Member, 15 Harold S. Pine, MD, Member, 15 Liana Puscas, MD, Member, 14 Mitchell J Ramsey, MD, Member, 15 Carol G. Shores, MD PhD, Member, 14 Mark G. Shrime, MD, Member, 15 James D. Sidman, MD, Member, 15 Sandra M Skovlund, MD, Member, 15 Peter Volsky, MD, Member, 15 Brent Wilkerson, MD, Member, 15 Eric P. Wilkinson, MD, Member, 14 Mark E. Zafereo, Jr., MD, Member, 15 Selena E. Heman-Ackah, MD, MBA, Consultant, 14 Bethany D. Clifton, Staff LiaisonInternational Otolaryngology Committee Nikhil J. Bhatt, MD, Committee Chair, 15 Dunia Abdul-Aziz, MD, Member, 14 Sanjay Athavale, MD, Member, 14 Nicolas BuSaba, MD, Member, 14 Juan A. Chiossone Kerdel, MA, MD, Member, 15 W. J. Cornay III, MD, Member, 14 Soha N. Ghossaini, MD, Member, 14 Mohammed A. Gomaa, MD, Member, 15 Anthony F. Jahn, MD, Member, 15 Herman A. Jenkins, MD, Member, 14 Ashutosh Kacker, MD, Member, 14 Rajesh S. Kakani, MD, Member, 14 Dinesh C. Mehta, MD, Member, 15 Shri K. Nadig, MD, FRCS, DLO, Member, 14 Mohsen Naraghi, MD, Member, 14 Vaclav Pavelec, MD, PhD, Member, 14 Hassan H. Ramadan, MD MSc, Member, 14 Anais Rameau, MD, Member, 14 Nikhila P. Raol, MD, Member, 15 Michael J. Rutter, MD, FRACS, Member, 15 Samuel H. Selesnick, MD, Member, 14 Aristides Sismanis, MD, Member, 15 Carl H. Snyderman, MD, MBA, Member, 14 Jesse G. Wardlow, Jr, MD, Member, 15 K. John Yun, MD, Member, 14 David W. Clark, MD, Consultant, 15 Arun K. Gadre, MD, Consultant, 14 Lily Love, MD, Consultant, 14 Kevin Christopher McMains, MD, Consultant, 15 Catherine R. Lincoln, CAE, MA (Oxon), Staff LiaisonPanamerican Committee Juan Manuel Garcia Gomez, MD, Committee Chair, 14 Jacqueline Alvarado Medina, MD, Member, 14 Hemendra N. Bhatnagar, MD, Member, 15 Emiro E. Caicedo Granados, MD, Member, 15 Gabriel Calzada, MD, Member, 14 Alejandra Daza, MD, Member, 14 Hernan Goldsztein, MD, Member, 14 Adam M. Klein, MD, Member, 15 Luis A. Macias Fernandez, MD, Member, 14 Kevin D. Pereira, MD, MS(ORL), Member, 15 Steven Daniel Pletcher, MD, Member, 15 Edmund A. Pribitkin, MD, Member, 14 Antonio J. Reyes Solarte, MD, Member, 15 Jonathon O. Russell, MD, Member, 14 Hector M. Santini, MD, Member, 15 Giovana R. Thomas, MD, Member, 14 Tulio A. Valdez, MD, Member, 15 Richard L. Voegels, MD PhD, Member, 14 Catherine R. Lincoln, CAE, MA (Oxon), Staff Liaison Laryngology and Sleep Steering Committee Kathleen L. Yaremchuk, MD, MSA, Committee Chair, 15 Joel H. Blumin, MD, Member, 15 Clark A. Rosen, MD, Member, 15 Pell Ann Wardrop, MD, Member, 14 Thomas D. Killam, CAE, Staff Liaison Airway and Swallowing Committee Joel H. Blumin, MD, Committee Chair, 15 Jonathan M. Bock, MD, Member, 14 Paul C. Bryson, MD, Member, 15 Alessandro de Alarcon, MD, Member, 15 Alexander T. Hillel, MD, Member, 15 Jonathan B. Ida, MD, Member, 14 Chandra M. Ivey, MD, Member, 14 Sid Khosla, MD, Member, 15 Priya D. Krishna, MD, Member, 15 Catherine R. Lintzenich, MD, Member, 14 Donna Lundy, PhD, Member, 15 Richard K. McHugh, MD, PhD, Member, 15 Reza Nouraei, MA, MB, MRCS, Member, 15 Michael J. Pitman, MD, Member, 14 Scott M. Rickert, MD, Member, 14 Bradley Schiff, MD, Member, 14 Joshua B. Silverman, MD, PhD, Member, 15 Salvatore J. Taliercio, MD, Member, 14 Seckin Ulualp, MD, Member, 14 Philip A. Weissbrod, MD, Member, 15 Milan R. Amin, MD, Consultant, 15 Dinesh K. Chhetri, MD, Consultant, 14 Dale C. Ekbom, MD, Consultant, 14 Albert L. Merati, MD, Consultant, 15 Phillip C. Song, MD, Consultant, 14 Karen B. Zur, MD, Consultant, 14 Gregory N. Postma, MD, Society Representative, 15 Lynn Frischkorn, Staff Liaison Sleep Disorders Committee Kathleen L. Yaremchuk, MD, MSA, Committee Chair, 15 Abib A. Agbetoba, MD, Member, 14 Nancy H. Appelblatt, MD, Member, 14 Karuna Dewan, MD, Member, 15 Michael Friedman, MD, Member, 14 Norman R. Friedman, MD, DABSM, Member, 14 Oleg Froymovich, MD, Member, 14 John Harwick, MD, Member, 14 Jennifer C. Hsia, MD, Member, 15 Tod C. Huntley, MD, Member, 15 Ofer Jacobowitz, MD, PhD, Member, 14 Alan Kominsky, MD, Member, 14 Michael J. Kortbus, MD, Member, 15 Andrea Furr Lewis, MD, Member, 15 Ho-sheng Lin, MD, Member, 14 Kevin E. McLaughlin, MD, Member, 15 Vaclav Pavelec, MD, PhD, Member, 14 Caroline M. Schlocker, MD, Member, 15 Ryan J. Soose, MD, Member, 14 Gerald D. Suh, MD, Member, 15 Maria V. Suurna, MD, Member, 14 Stephen C. Maturo, MD, Consultant, 14 Pell Ann Wardrop, MD, Consultant, 15 Jenna Minton, Esq, Staff Liaison Voice Committee Clark A. Rosen, MD, Committee Chair, 15 Milan R. Amin, MD, Member, 15 Ryan C. Branski, PhD, Member, 14 Thomas L. Carroll, MD, Member, 14 Norman D. Hogikyan, MD, Member, 14 Michael M. Johns III, MD, Member, 14 Richard Kelley, MD, Member, 14 Robbi A. Kupfer, MD, Member, 14 Catherine R. Lintzenich, MD, Member, 14 I-fan Theodore Mau, MD, PhD, Member, 15 Julina Ongkasuwan, MD, Member, 15 Robert H. Ossoff, DMD, MD, Member, 14 Michael J. Pitman, MD, Member, 15 David E. Rosow, MD, Member, 15 C. Blake Simpson, MD, Member, 15 Libby J. Smith, DO, Member, 14 Salvatore J. Taliercio, MD, Member, 14 VyVy N. Young, MD, Member, 14 Katherine C. Yung, MD, Member, 14 Lee M. Akst, MD, Consultant, 15 Kenneth W. Altman, MD, PhD, Consultant, 14 Seth M. Cohen, MD, MPH, Consultant, 14 David O. Francis, MD, Consultant, 15 Adam M. Klein, MD, Consultant, 14 Jeanne McIntyre, CAE, Staff Liaison Member Relations Steering Committee Gayle E. Woodson, MD, Committee Chair-Elect, 14 Nikhil J. Bhatt, MD, Member, 15 David W. Kennedy, MD, Member, 15 Pierre Lavertu, MD, Member, 15 Lawrence R. Lustig, MD, Member, 15 Lisa Perry-Gilkes, MD, Member, 14 Wendy B. Stern, MD, Member, 15 Monica Tadros, MD, Member, 14 Ayesha N. Khalid, MD, Member, 14 Kanwar Kelley, MD, SRF Rep, Member, 14 Thomas D. Killam, CAE, Staff Liaison Credentials and Membership Committee Pierre Lavertu, MD, Committee Chair, 15 Nicolas BuSaba, MD, Member, 15 Cecelia Damask, DO, Member, 15 Edward J. Damrose, MD, Member, 14 Brendan Gaylis, MD, Member, 14 Ronda A. Hamaker, MD, Member, 15 Michael S. Harris, MD, Member, 14 Ellie Maghami, MD, Member, 15 Nitin A. Pagedar, MD, Member, 14 Matthew J. Provenzano, MD, Member, 14 Eileen M. Raynor, MD, Member, 15 Cecille G. Sulman, MD, Member, 14 Joshua Tokita, MD, Member, 14 Chad A. Zender, MD, Member, 14 Lily Love, MD, Consultant, 14 Lani Cadow, Staff Liaison Diversity Committee Lisa Perry-Gilkes, MD, Committee Chair, 14 Melynda A. Barnes, MD, Member, 15 Candice C. Colby, MD, Member, 15 Opeyemi Daramola, MD, Member, 15 Suzanne Kim Doud Galli, MD, PhD, Member, 14 Valerie A. Flanary, MD, Member, 15 Carrie L. Francis, MD, Member, 14 Tamer Abdel-Halim Ghanem, MD, PhD, Member, 15 Soha N. Ghossaini, MD, Member, 15 Mohammed A. Gomaa, MD, Member, 14 Ted H. Leem, MD, Member, 15 Christina M. McAlpin, MD, Member, 14 Miriam I. Saadia-Redleaf, MD, Member, 15 Farrah N. Siddiqui, MD, Member, 14 Tulio A. Valdez, MD, Member, 15 Kimberly N. Vinson, MD, Member, 15 Jesse G. Wardlow, Jr, MD, Member, 15 Troy D. Woodard, MD, Member, 14 Noriko Yoshikawa, MD, Member, 14 Phyllis B. Bouvier, MD, Consultant, 14 Jimmy J. Brown, DDS, MD, Consultant, 14 Glenn S. Kanamori, MD, Consultant, 14 Randal A. Otto, MD, Consultant, 14 Duane J. Taylor, MD, Consultant, 14 Janelle Tait, Staff Liaison History and Archives Committee Lawrence R. Lustig, MD, Committee Chair, 15 Marc D. Eisen, MD, PhD, Committee Chair-Elect, 15 Jason L. Acevedo, MD, Member, 14 Gregory J. Artz, MD, Member, 14 Joel H. Blumin, MD, Member, 14 John M. Carter, MD, Member, 14 Calhoun D. Cunningham III, MD, Member, 14 David R. Edelstein, MD, Member, 14 Stephen R. Hoff, MD, Member, 14 John K. Jarboe, MD, Member, 15 Christopher M. Johnson, MD, Member, 14 Kiran Kakarala, MD, Member, 14 C. Robert Pettit, MD, Member, 14 Christopher P. Poje, MD, Member, 15 Jeremy D. Prager, MD, Member, 14 Anais Rameau, MD, Member, 14 Samuel H. Selesnick, MD, Member, 15 Steven J. Wang, MD, Member, 14 Eric P. Wilkinson, MD, Member, 14 William A. Wood, MD, Member, 14 Catherine R. Lincoln, CAE, MA (Oxon), Staff Liaison Development Committee Nikhil J. Bhatt, MD, Committee Chair, 15 Sujana S. Chandrasekhar, MD, Member, 14 Lee D. Eisenberg, MD, MPH, Member, 14 Stacey L. Ishman, MD, MPH, Member, 14 Thomas B. Logan, MD, Member, 15 Phillip L. Massengill, MD, Member, 15 Spencer C. Payne, MD, Member, 14 Anna M. Pou, MD, Member, 14 Ira D. Uretzky, MD, Member, 14 Pell Ann Wardrop, MD, Member, 14 Mark K. Wax, MD, Member, 15 Ken Yanagisawa, MD, Member, 15 Jay S. Youngerman, MD, Member, 15 John W. House, MD, Consultant, 14 Mary McMahon, CFRE, Staff Liaison Ron Sallerson, Staff Liaison Media and Public Relations Committee Wendy B. Stern, MD, Committee Chair, 15 Lauren Bohm, MD, Member, 14 Marcella R. Bothwell, MD, Member, 14 C.W. David Chang, MD, Member, 14 Hamad Chaudhary, MD, Member, 14 Antoine Eskander, MD, Member, 14 Christina M. Gillespie, MD, Member, 15 Christopher R. Grindle, MD, Member, 14 Steven T. Kmucha, MD, JD, Member, 14 Priya D. Krishna, MD, Member, 15 Allen C. Lam, MD, Member, 14 Sonya Malekzadeh, MD, Member, 14 Christina M. McAlpin, MD, Member, 14 James E. Saunders, MD, Member, 15 Gordon J. Siegel, MD, Member, 15 Chelsey J. Smith, MD, Member, 14 Gordon H. Sun, MD, Member, 15 Duane J. Taylor, MD, Member, 15 Dale A. Tylor, MD, Member, 14 Julie L. Wei, MD, Member, 14 Boris Chernobilsky, MD, Consultant, 15 Rajesh S. Kakani, MD, Consultant, 15 Spencer C. Payne, MD, Consultant, 14 Lindsey Walter, Staff Liaison Women in Otolaryngology Governing Council Susan R. Cordes, MD, WIO Chair, 14 Mona M. Abaza, MD, WIO Chair-elect, 14 A. Kristina E. Hart, MD, WIO Historian, 15 Marcella R. Bothwell, MD, WIO Information Officer/Secretary, 14 Elizabeth A. Dunham, MD MPH, WIO Member-at-Large, 14 Shannon P. Pryor, MD, WIO Immediate Past Chair, 14 Pell Ann Wardrop, MD, WIO Financial Officer, 14 Linda S. Brodsky, MD, Member, 14 Richard N. Carson, Jr., Staff Liaison Bethany D. Clifton, Staff Liaison Young Physicians Section Monica Tadros, MD, Committee Chair, 14 Ayesha N. Khalid, MD, Committee Chair-elect, 14 Lauren C. Anderson de Moreno, MD, Member, 15 Leslie Asbury, MD, Member, 14 Daniel C. Chelius Jr, MD, Member, 15 Maura Cosetti, MD, Member, 14 Gregory R. Dion, MD, Member, 14 Carrie L. Francis, MD, Member, 15 Mary E. Gorman, MD, Member, 14 Trevor G. Hackman, MD, Member, 14 David L. Horn, MD, Member, 14 Jonathan C. Kopelovich, MD, Member, 14 Jeffrey C. Liu, MD, Member, 15 Alexander R. Manteghi, MD, Member, 14 Abby R. Nolder, MD, Member, 14 Jeremy D. Prager, MD, Member, 15 Jeffrey C. Rastatter, MD, Member, 14 Amy Richter, MD, Member, 14 Michelle M. Roeser, MD, Member, 14 Sarah L. Rohde, MD, Member, 14 Lawrence M. Simon, MD, Member, 15 Kevin F. Wilson, MD, Member, 14 David H. Hiltzik, MD, Consultant, 15 Michael E. Stadler, MD, Consultant, 15 Rhoda Wynn, MD, Consultant, 15 Carrie Hanlon, Staff Liaison Richard N. Carson, Jr., Staff Liaison Section for Residents and Fellows In-Training (SRF) Kanwar Kelley, MD, JD, Chair, 14 John Carter, MD, Vice-Chair, 15 Hamad Chaudhary, MD, Member- at-Large, 15 Meghan Wilson, MD, Information Officer, 14 Sanjeet Rangarajan, MD, BOG Governor, 14 Margaret Carter, MD, BOG Public Relations Representative, 14 David Cohen, MD, BOG Legislative Representative, 14 Bethany D. Clifton, Staff Liaison Richard N. Carson, Jr., Staff Liaison Patient Groups Steering Committee Wendy B. Stern, MD, Committee Chair, 14 John T. Lanza, MD, Member, 15 Robert T. Sataloff, MD, DMA, Member, 14 David E. Tunkel, MD, Member, 15 Jeanne McIntyre, CAE, Staff Liaison Geriatric Otolaryngology Committee Robert T. Sataloff, MD, DMA, Committee Chair, 14 Daniel H. Coelho, MD, Member, 14 David R. Edelstein, MD, Member, 15 Seth Chalmers Janus, MD, Member, 15 William I. Kuhel, MD, Member, 15 Christopher G. Larsen, MD, Member, 15 Kelly Michele Malloy, MD, Member, 14 Susan D. McCammon, MD, Member, 14 Brian J. McKinnon, MD MBA, Member, 14 Kourosh Parham, MD PhD, Member, 15 Michael J. Pitman, MD, Member, 14 Elliot Regenbogen, MD, Member, 14 John H. Shelby, MD, Member, 14 Ozlem E. Tulunay-Ugur, MD, Member, 15 Courtney C. J. Voelker, MD, DPhil, Member, 14 Stephen J. Wetmore, MD, Member, 14 Yuri Agrawal, MD, Consultant, 15 Karen M. Kost, MD, FRCSC, Consultant, 15 Jeanne McIntyre, CAE, Staff Liaison Pediatric Otolaryngology Committee David E. Tunkel, MD, Committee Chair, 15 Kathleen Billings, MD, Member, 14 Shelagh A. Cofer, MD, Member, 14 Joshua A. Gottschall, MD, Member, 14 Steven L. Goudy, MD, Member, 14 Eliav Gov-Ari, MD, Member, 15 Russel Kahmke, MD, Member, 14 Timothy Lander, MD, Member, 14 Jeremy D. Meier, MD, Member, 14 Joshua R. Mitchell, MD, Member, 14 Laura L. Neff, MD, Member, 14 Maria T. Pena, MD, Member, 15 James W. Schroeder, Jr, MD, Member, 14 Denise Sherman, MD, Member, 14 Joshua B. Silverman, MD, PhD, Member, 15 Jeffrey P. Simons, MD, Member, 14 Margaret L. Skinner, MD, Member, 14 Melissa L. Somers, MD, Member, 14 Wasyl Szeremeta, MD, MBA, Member, 14 D.J. Trigg, MD, Member, 14 Julie L. Wei, MD, Member, 14 David R. White, MD, Member, 14 Matthew T. Brigger, MD, Consultant, 14 Megan Marcinko, Staff Liaison CPT and Relative Value Committee John T. Lanza, MD, Committee Chair, 15 Pete S. Batra, MD, Member, 15 Robert A. Battista, MD, Member, 14 William R. Blythe, MD, Member, 14 Pryor S. Brenner, MD, Member, 14 Martin J. Citardi, MD, Member, 14 James C. Denneny III, MD, Member, 14 Stephanie Joe, MD, Member, 14 Jivianne Lee, MD, Member, 15 Peter Manes, MD, Member, 14 Bradley F. Marple, MD, Member, 14 William P. Potsic, MD, Member, 14 Clark A. Rosen, MD, Member, 15 Lawrence M. Simon, MD, Member, 14 Mark J. Syms, MD, Member, 14 Peter C. Weber, MD, MBA, Member, 14 Bevan Yueh, MD, MPH, Member, 15 Yolanda D. Heman-Ackah, MD, Consultant, 15 Charles F. Koopmann Jr, MD, MHSA, Consultant, 15 Brendan C. Stack, Jr, MD, Consultant, 15 Moises A. Arriaga, MD, MBA, Society Representative, 15 Kay W. Chang, MD, Society Representative, 15 Ian N. Jacobs, MD, Society Representative, 15 Wayne M. Koch, MD, Society Representative, 15 Jenna Minton, Esq, Staff Liaison Jane T. Dillon, MD, Ex-Officio, 15 Albert L. Merati, MD, Ex-Officio, 15 Richard W. Waguespack, MD, Ex-Officio, 15 Research and Quality Steering Committee John S. Rhee, MD MPH, Committee Chair, 14 Bevan Yueh, MD MPH, Committee Chair-Elect, 14 Scott E. Brietzke, MD, MPH, Member, 14 David R. Friedland, MD, PhD, Member, 16 Christine G. Gourin, MD, Member, 15 David W. Roberson, MD, Member, 15 Richard M Rosenfeld, MD, MPH, Member, 15 Rodney J. Schlosser, MD, Member, 15 Seth R. Schwartz, MD, MPH, Member, 15 Rahul K. Shah, MD, FAAP, Member, 15 Jean Brereton, MBA, Staff Liaison Research Advisory Board Beven Yueh, MD, MPH, Chair John S. Rhee, MD, MPH, AAO-HNSF Coordinator for Research and Quality Amy M. Donahue, PhD, Federal, NIDCD, NIH Representative Judy R. Dubno, PhD, ARO Representative Michael D. Seidman, MD BOG Representative Debara L. Tucci, MD, At-Large, Basic Science Representative D. Bradley Welling, MD, PhD, ABOto Representative Kris Schulz, MPH, Immediate Past Chair Marion E. Couch, MD, PhD, At-Large, Basic Science Representative Steve Rauch, MD, Immediate Past Chair David L. Witsell, MD, MHS, Immediate Past Research Coordinator Stephanie L. Jones, Staff Liaison Advisory Council on Quality Rahul K. Shah, MD, Committee Chair, 14 Jacob Asher, MD, Member, 14 Lee D. Eisenberg, MD, MPH, Member, 14 Michael G. Glenn, MD, MPH, Member, 14 Kylanne Green, Member, 14 Stacey L. Ishman, MD, MPH, Member, 14 Robert H. Miller, MD, MBA, Member, 14 David R. Nielsen, MD, Member, 14 John S. Rhee, MD, MPH, Member, 14 Richard M. Rosenfeld, MD, MPH, Member, 14 Seth R. Schwartz, MD, MPH, Member, 14 Kathleen L. Yaremchuk, MD, Member, 14 Jean Brereton, MBA, Staff Liaison Outcomes Research and EBM Committee Scott E. Brietzke, MD MPH, Committee Chair, 14 Jennifer J. Shin, MD SM, Committee Chair-Elect, 14 Greg E. Davis, MD MPH, Member, 15 David R. Friedmann, MD, Member, 14 Lisa E. Ishii, MD, MHS, Member, 15 Stacey L. Ishman, MD, MPH, Member, 14 Eric J. Kezirian, MD MPH, Member, 15 Samir Khariwala, MD, Member, 14 Stella Lee, MD, Member, 15 Walter T. Lee, MD, Member, 14 Stephanie Misono, MD, MPH, Member, 14 Seth R. Schwartz, MD MPH, Member, 15 Stephanie Shintani Smith, MD, Member, 14 Marc C. Thorne, MD, Member, 14 Giri Venkatraman, MD, MBA, Member, 14 Julie L. Wei, MD, Member, 14 Debra G. Weinberger, MD, Member, 15 Seth M. Cohen, MD MPH, Consultant, 14 Laura J. Orvidas, MD, Consultant, 14 Melissa A. Pynnonen, MD, Consultant, 14 Maureen Corrigan, Staff Liaison Stephanie L. Jones, Staff Liaison Patient Safety and Quality Improvement Committee David W. Roberson, MD, Committee Co-Chair, 15 Rahul K. Shah, MD, FAAP, Committee Co-Chair, 15 Emily F. Boss, MD, MPH, Member, 15 Michael J. Brenner, MD, Member, 15 Ellen S. Deutsch, MD, Member, 15 Berrylin J. Ferguson, MD, Member, 14 Jedidiah J. Grisel, MD, Member, 15 Selena E. Heman-Ackah, MD, MBA, Member, 14 Scharukh Jalisi, MD, Member, 14 Mimi S. Kokoska, MD, Member, 15 Jonathan C. Kopelovich, MD, Member, 14 Michael E. McCormick, MD, Member, 15 Brian Nussenbaum, MD, Member, 15 Ryan K. Sewell, MD, Member, 15 Margaret L. Skinner, MD, Member, 15 Giri Venkatraman, MD, MBA, Member, 15 Daniel L. Wohl, MD, Member, 14 John J. Zappia, MD, Member, 15 Reginald F. Baugh, MD, Consultant, 15 Lee D. Eisenberg, MD, MPH, Consultant, 14 Matthew A. Kienstra, MD, Consultant, 14 Edward J. Shin, MD, Consultant, 15 Carl H. Snyderman, MD, MBA, Consultant, 14 Robert J. Stachler, MD, Consultant, 14 Michael E. Stadler, MD, Consultant, 15 Jean Brereton, MBA, Staff Liaison Rhinology, Allergy, Immunology, and Infectious Diseases Steering Committee Paul T. Fass, MD, Committee Chair, 15 Farrel J. Buchinsky, MBChB, Member, 15 James W. Mims, MD, Member, 15 Scott P. Stringer, MD, Member, 14 Thomas D. Killam, CAE, Staff Liaison Allergy, Asthma, and Immunology Committee James W. Mims, MD, Committee Chair, 15 Jay Chavda, MD, Member, 15 Cecelia Damask, DO, Member, 14 Nathan A. Deckard, MD, Member, 14 Adil A. Fatakia, MD, MBA, Member, 14 Jean Kim, MD, PhD, Member, 15 Benjamin D. Liess, MD, Member, 14 Amber U. Luong, MD, PhD, Member, 15 Jacques C. Peltier, MD, Member, 15 Michael P. Platt, MD, Member, 14 Minka L. Schofield, MD, Member, 15 Samuel E. Sprehe, MD, Member, 14 Elina M. Toskala, MD, PhD, Member, 14 Sarah K Wise, MD, Member, 14 Karen H. Calhoun, MD, Consultant, 15 Douglas E. Dawson, MD, Consultant, 14 William R Reisacher, MD, FACS, FAAOA, Consultant, 14 Maria C. Veling, MD, Consultant, 14 Stephanie L. Jones, Staff Liaison Infectious Disease Committee Farrel J. Buchinsky, MBChB, Committee Chair, 15 Fuad M. Baroody, MD, Member, 15 Swapna K. Chandran, MD, Member, 14 Joseph E. Dohar, MD, Member, 14 Eliav Gov-Ari, MD, Member, 14 Karin S. Hotchkiss, MD, Member, 14 Titus Sunday Ibekwe, MBBS, FWACS, Member, 14 Ken Kazahaya, MD, MBA, Member, 14 Evelyn A. Kluka, MD, Member, 14 Yosef P. Krespi, MD, Member, 14 Abby R. Nolder, MD, Member, 14 Jeremy T. Reed, MD, Member, 14 Matthew W. Ryan, MD, Member, 15 Eric W Sargent, MD, Member, 14 Segun Segun-Busari, MBBS, FWACS, Member, 14 Alan H. Shikani, MD, Member, 14 Elizabeth P. Sundean, MD, Member, 14 Michael P. Underbrink, MD, Member, 14 Tulio A. Valdez, MD, Member, 15 Adam Mikial Zanation, MD, Member, 14 Nancy H. Appelblatt, MD, Consultant, 14 William O. Collins, MD, Consultant, 14 Seckin Ulualp, MD, Consultant, 14 Gene Cunningham, MS, Staff Liaison Rhinology and Paranasal Sinus Committee Scott P. Stringer, MD, Committee Chair, 14 Joseph Han, MD, Committee Chair-Elect, 14 James H. Atkins, Jr, MD, Member, 15 Pete S. Batra, MD, Member, 14 Michael S. Benninger, MD, Member, 14 Jose M. Busquets Ferriol, MD, Member, 14 Alexander G. Chiu, MD, Member, 14 Nathan A. Deckard, MD, Member, 14 Christine Blanche Franzese, MD, Member, 14 Satish Govindaraj, MD, Member, 14 Stacey T. Gray, MD, Member, 15 Yosef P. Krespi, MD, Member, 14 Andrew Lane, MD, Member, 15 Jivianne Lee, MD, Member, 15 Kevin W. Lollar, MD, Member, 15 Jeremy D. Meier, MD, Member, 14 John F. Pallanch, MD, Member, 14 Aaron N. Pearlman, MD, Member, 15 Eric S. Rosenberger, MD, Member, 14 Matthew W. Ryan, MD, Member, 14 Peter John Wormald, MD, FRACS, FRCS, Member, 15 Mark A. Zacharek, MD, Member, 14 Felix W. K. Chu, MD, Consultant, 14 Ayesha N. Khalid, MD, Consultant, 14 Jenna Minton, Esq, Staff Liaison Treatment Modalities Steering CommitteeJerry M. Schreibstein, MD, Committee Chair, 14 Subinoy Das, MD, Member, 15 Anand K. Devaiah, MD, Member, 14 Edmund A. Pribitkin, MD, Member, 14 Gavin Setzen, MD, Member, 14 Jean Brereton, MBA, Staff Liaison Complementary/Integrative Medicine Committee Edmund A. Pribitkin, MD, Committee Chair, 14 Gregory J. Artz, MD, Member, 15 Seth M. Brown, MD MBA, Member, 14 Ara A. Chalian, MD, Member, 14 Edward S. Cohn, MD, Member, 14 Agnes Czibulka, MD, Member, 15 Hansel M. Debartolo, Jr., MD, JD, Member, 14 Joseph R. Di Bartolomeo, MD, Member, 15 Michael J. Kelleher, MD, Member, 15 Lily Love, MD, Member, 14 John P. Maddalozzo, MD, Member, 14 Tomoko Makishima, MD, PhD, Member, 15 Matthew C. Miller, MD, Member, 14 Jing Shen, MD, Member, 15 Malcolm B. Taw, MD, Member, 14 Marilene B. Wang, MD, Member, 14 Keith M. Wilson, MD, Member, 15 Dain G. Oswald, Staff Liaison Imaging Committee Gavin Setzen, MD, Committee Chair, 14 Elizabeth A. Blair, MD, Member, 14 Jay Chavda, MD, Member, 15 David R. Friedmann, MD, Member, 14 Neil Gildener-Leapman, MD, Member, 15 James A. Hadley, MD, Member, 14 Michael S. Harris, MD, Member, 14 Selena E. Heman-Ackah, MD, MBA, Member, 14 Hung J. Kim, MD, Member, 15 Christopher Klem, MD, Member, 14 R. Christopher Miyamoto, MD, Member, 14 Lisa A. Orloff, MD, Member, 14 Karen T. Pitman, MD, Member, 14 Robert Pizzutiello Jr, MS, Member, 14 Matthew J. Provenzano, MD, Member, 14 Joseph Scharpf, MD, Member, 14 Robert A. Sofferman, MD, Member, 14 Jolene Eicher, Consultant, 14 Jenna Kappel, MPH, MA, Staff Liaison Medical Devices and Drugs Committee Anand K. Devaiah, MD, Committee Chair, 14 Michael Broniatowski, MD, Member, 14 Edward J. Damrose, MD, Member, 14 James J. Daniero, MD, Member, 14 Riccardo D’Eredita, MD, Member, 15 Paul C. Frake, MD, Member, 14 Ethan B. Handler, MD, Member, 14 Rajesh S. Kakani, MD, Member, 15 Eric J. Kezirian, MD MPH, Member, 14 John T. Lanza, MD, Member, 14 Kenneth H. Lee, MD, PhD, Member, 14 Eric A. Mann, MD, PhD, Member, 14 Kevin D. Pereira, MD, MS(ORL), Member, 15 Frank L Rimell, MD, Member, 15 Scott R. Schoem, MD, Member, 14 Davud Baradaran Sirjani, MD, Member, 15 Howard D. Stupak, MD, Member, 14 Rhoda Wynn, MD, Member, 15 Steven M. Gold, MD, Consultant, 14 Ofer Jacobowitz, MD, PhD, Consultant, 14 Jennifer L. Long, MD, PhD, Consultant, 14 Royce Mueller, MD, Consultant, 14 Udayan K. Shah, MD, FAAP, Consultant, 14 Harrison Peery, Staff Liaison Medical Informatics Committee Subinoy Das, MD, Committee Chair, 15 Gregory A. Ator, MD, Member, 14 Patrick C. Barth, MD, Member, 14 Alexander H. Gelbard, MD, Member, 14 Lawrence J. Gordon, MD, Member, 15 Joseph E. Hart, MD, MS, Member, 14 Allen S. Ho, MD, Member, 15 KJ Lee, MD, Member, 14 Lance Anthony Manning, MD, Member, 14 Sachin Pawar, MD, Member, 14 Joseph W. Rohrer, MD, Member, 14 Joshua D. Rosenberg, MD, Member, 14 Afser Shariff, MD, Member, 14 Gordon H. Sun, MD, Member, 14 Shelby G. Topp, MD, Member, 14 Eloy Villasuso III, MD, Member, 14 Jason Moche, MD, Consultant, 14 Jeffrey E. Terrell, MD, Consultant, 14 Mike Robey, Staff Liaison Education Steering Committee Sonya Malekzadeh, MD, Committee Chair, 15 J. Randall Jordan, MD, Member, 15 Bradley W. Kesser, MD, Member, 15 Catherine R. Lintzenich, MD, Member, 15 Karen T. Pitman, MD, Member, 14 Brent A. Senior, MD, Member, 14 Brendan C. Stack, Jr, MD, Member, 14 Peter A. Weisskopf, MD, Member, 14 Stacey L. Ishman, MD, MPH, Consultant, 14 Daniel J. Kirse, MD, Consultant, 14 Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Sukgi S. Choi, MD, Ex-Officio, 14 Core Otolaryngology and Practice Management Education Committee Brendan C. Stack, Jr, MD, FACE, Committee Chair, 14 Manali S. Amin, MD, Member HSC WrkGp, 16 Reginald F. Baugh, MD, Member, 14 Scott E. Brietzke, MD MPH, Member HSC WrkGp, 18 David J. Brown, MD, Member HSC WrkGp, 18 Vasu Divi, MD, Member, 14 Roger W. Farmer, MD, Member, 15 Eric M. Gessler, MD, Member HSC WrkGp, 16 Christopher Gouveia, MD, Member, 15 David M. Jakubowicz, MD, Member, 15 Anita S. Jeyakumar, MD MS, Member, 14 Ana H. Kim, MD, Member, 14 Charles F. Koopmann, Jr., MD MHSA, Member, 14 H. Baltzer LeJeune, MD, Member HSC WrkGp, 16 Johnathan D. McGinn, MD, Member, 14 Mark E. Prince, MD, Member, 14 Christopher H. Rassekh, MD, Member, 14 Elie E. Rebeiz, MD, FACS, Member, 14 Aaron K. Remenschneider, MD, Member, 14 Rahul K. Shah, MD, FAAP, Member HSC WrkGp, 14 Nina L. Shapiro, MD, Member, 14 Edward J. Shin, MD, Member, 15 Lawrence M. Simon, MD, Member HSC WrkGp, 16 Mark A. Zacharek, MD, Member HSC WrkGp, 14 Sonya Malekzadeh, MD, BOD Liaison, 15 Richard W. Waguespack, MD, Consultant, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Facial Plastic and Reconstructive Surgery Education Committee J. Randall Jordan, MD, Committee Chair, 15 Fred G. Fedok, MD, Consultant, 15 Patrick C. Angelos, MD, Member, 14 Todd M. Brickman, MD, Member, 14 Anthony E. Brissett, MD, Member HSC WrkGp, 14 Paul J. Carniol, MD, Member HSC WrkGp, 14 Scott R. Chaiet, MD, Member, 14 John J. Chi, MD, Member, 14 Benjamin W. Cilento, MD, Member, 14 Robert W. Dolan, MD, Member, 14 Suzanne Kim Doud Galli, MD, PhD, Member, 14 Rebecca Fraioli, MD, Member, 14 Clinton D. Humphrey, MD, Member, 15 Andrea Jarchow, MD, Member, 14 J. Randall Jordan, MD, Member HSC WrkGp, 18 Robert M. Kellman, MD, Member HSC WrkGp, 14 Maurice M. Khosh, MD, Member, 14 Kate E. McCarn, MD, Member, 14 Steven Ross Mobley, MD, Member, 15 Eunice E. Park, MD MPH, Member HSC WrkGp, 18 Edmund A. Pribitkin, MD, Member, 14 John S. Rhee, MD, MPH, Member, 14 Neil Tanna, MD, Member, 14 Travis T. Tollefson, MD, MPH, Member HSC WrkGp, 16 Ivan Wayne, MD, Member, 14 Sonya Malekzadeh, MD, BOD Liaison, 15 Stephen S. Park, MD, Consultant, 14 Sherard A. Tatum, III, MD, Consultant, 14 Theresa A. Hadlock, MD, Society Representative, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Donna J. Millay, MD, Ex-Officio, 15 General Otolaryngology Education Committee Karen T. Pitman, MD, Committee Chair, 14 Lauren C. Anderson de Moreno, MD, Member, 15 Steven S. Ball, MD, Member, 15 Matthew L. Carlson, MD, Member, 15 Robert H. Chun, MD, Member, 15 James I. Cohen, MD, PhD, Member HSC WrkGp, 18 Anand K. Devaiah, MD, Member HSC WrkGp, 14 Stacey T. Gray, MD, Member, 15 Meir D. Hershcovitch, MD, Member, 14 Amy Clark Hessel, MD, Member HSC WrkGp, 16 Kanwar S. Kelley, MD, JD, Member, 15 Phillip S. LoSavio, MD, Member, 15 Ian K. Mcleod, MD, Member HSC WrkGp, 14 C. Elliott Morgan, MD, DMD, Member HSC WrkGp, 14 Minka L. Schofield, MD, Member HSC WrkGp, 16 Jeffrey J. Stanley, MD, Member, 14 Rodney J. Taylor, MD, MSPH, Member HSC WrkGp, 16 Erich P. Voigt, MD, Member, 14 Preston D. Ward, MD, Member, 14 Robert A. Weatherly, MD, Member, 14 B. Tucker Woodson, MD, Member, 14 Philip E. Zapanta, MD, Member HSC WrkGp, 18 Michael Zoller, MD, Member, 14 Sonya Malekzadeh, MD, BOD Liaison, 15 Kevin Fung, MD, FRCSC Consultant, 14 Sam J. Daniel, MD, FRCSC, Society Representative, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Allan M. Rubin, MD, PhD, Ex-Officio, 14 Head and Neck Surgery Education Committee Richard V. Smith, MD, Committee Chair, 14 Benoit J. Gosselin, MD, Member, 14 Christian Hasney, MD, Member, 14 Chase Heaton, MD, Member, 15 Benjamin L. Judson, MD, Member, 15 Samir Khariwala, MD, Member, 14 Greg Krempl, MD, Member HSC WrkGp, 15 Stephen Y. Lai, MD, PhD, Member, 14 Alexander Langerman, MD, Member, 14 Ted H. Leem, MD, Member HSC WrkGp, 19 Derrick T. Lin, MD, Member, 14 Kelly Michele Malloy, MD, Member, 15 Oleg N. Militsakh, MD, Member, 15 Matthew C. Miller, MD, Member, 14 Michael G. Moore, MD, Member, 14 Matthew O. Old, MD, Member, 15 Urjeet Patel, MD, Member, 15 Yash J. Patil, MD, Member HSC WrkGp, 15 Mark E. Prince, MD, Member HSC WrkGp, 17 Liana Puscas, MD, Member, 14 Jeremy D. Richmon, MD, Member, 15 William R. Ryan, MD, Member, 15 Joseph Scharpf, MD, Member HSC WrkGp, 15 Bradley Schiff, MD, Member HSC WrkGp, 19 Yelizaveta Shnayder, MD, Member, 14 Bhuvanesh Singh, MD, PhD, Member HSC WrkGp, 17 Steven M. Sperry, MD, Member, 14 Michael E. Stadler, MD, Member, 15 John W. Werning, MD, DMD, Member, 14 Jeffrey S. Wolf, MD, Member HSC WrkGp, 17 Sonya Malekzadeh, MD, BOD Liaison, 15 Dennis H. Kraus, MD, Consultant, 14 Alfred A. Simental, Jr, MD, Consultant, 15 Joseph C. Sniezek, MD, Consultant, 15 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Gregory J. Artz, MD, Ex-Officio, 15 Laryngology and Bronchoesophagology Education Committee Catherine R. Lintzenich, MD, Committee Chair, 15 Lee M. Akst, MD, Member HSC WrkGp, 19 James A. Burns, MD, Member HSC WrkGp, 15 Thomas L. Carroll, MD, Member HSC WrkGp, 17 Neil N. Chheda, MD, Member, 14 Edward J. Damrose, MD, Member, 14 Brad W. DeSilva, MD, Member HSC WrkGp, 17 Ellen S. Deutsch, MD, Member, 15 Alexander H. Gelbard, MD, Member, 14 Amanda C. Hu, MD, Member, 15 Romaine F. Johnson, MD, Member, 14 Katherine A. Kendall, MD, Member, 14 Priya D. Krishna, MD, Member HSC WrkGp, 17 Claudio F. Milstein, PhD, CCC-SLP, Member, 14 Matthew C. Mori, MD, Member, 15 Michele P. Morrison, DO, Member, 15 Robert H. Ossoff, DMD, MD, Member, 14 Noah P. Parker, MD, Member, 14 Linnea Peterson, MD, Member HSC WrkGp, 15 Kristina W. Rosbe, MD, Member HSC WrkGp, 15 David E. Rosow, MD, Member HSC WrkGp, 19 Maya G. Sardesai, MD, MEd, Member, 14 Chih-Kwang Sung, MD, Member HSC WrkGp, 17 Sonya Malekzadeh, MD, BOD Liaison, 15 Mona M. Abaza, MD, Consultant, 15 Kenneth W. Altman, MD, PhD, Consultant, 15 Kevin Fung, MD, FRCSC, Consultant, 14 Robert F. Ward, MD, Consultant, 15 Gayle E. Woodson, MD, Consultant, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Otology and Neurotology Education Committee Bradley W. Kesser, MD, Committee Chair, 15 Simon I. Angeli, MD, Member HSC WrkGp, 15 Seilesh Babu, MD, Member, 15 David M. Barrs, MD, Member HSC WrkGp, 19 Marc L. Bennett, MD, Member, 15 Matthew Carfrae, MD, Member, 14 Daniel H. Coelho, MD, Member, 15 James V. Crawford, MD, Member, 15 Jennifer Derebery, MD, Member, 14 John C. Goddard, MD, Member, 15 Richard K. Gurgel, MD, Member, 14 Brandon Isaacson, MD, Member HSC WrkGp, 15 Darius Kohan, MD, Member HSC WrkGp, 19 John P. Leonetti, MD, Member, 14 Cliff A. Megerian, MD, Member HSC WrkGp, 17 Bradley P. Pickett, MD, Member, 15 Mindy Rabinowitz, MD, Member, 15 J. Thomas Roland Jr, MD, Member HSC WrkGp, 17 Maroun Semaan, MD, Member, 14 George Wanna, MD, Member, 14 Cameron C. Wick, MD, Member, 14 Erika A. Woodson, MD, Member, 15 Daniel M. Zeitler, MD, Member, 14 David S. Haynes, MD, Consultant, 14 Calhoun D. Cunningham III, MD, Society Representative, 15 Blake C. Papsin, MD, FRCSC, Society Representative, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Pediatric Otolaryngology Education Committee Kenny H. Chan, MD, Committee Chair, 14 Cristina Baldassari, MD, Member, 14 Matthew T. Brigger, MD, Member, 14 Eunice Y. Chen, MD PhD, Member, 14 William O. Collins, MD, Member HSC WrkGp, 16 Nira A Goldstein, MD, MPH, Member, 15 Carlos Gonzalez Aquino, MD, Member, 15 Johannes Fredrik Grimmer, MD, Member HSC WrkGp, 16 Anita S. Jeyakumar, MD MS, Member, 15 Liane Barbara Johnson, MD, FRCSC, Member HSC WrkGp, 14 Shelby C. Leuin, MD, Member, 14 Joshua M. Levy, MD, Member, 14 R. Christopher Miyamoto, MD, Member HSC WrkGp, 14 Kevin D. Pereira, MD MS(ORL), Member, 15 Diego A. Preciado, MD PhD, Member HSC WrkGp, 14 Jeffrey C. Rastatter, MD, Member HSC WrkGp, 18 Luke J. Schloegel, MD, Member, 14 Andrew R. Scott, MD, Member, 14 Marc C. Thorne, MD, Member HSC WrkGp, 16 David R. White, MD, Member, 15 Patricia J. Yoon, MD, Member, 14 Carlton J. Zdanski, MD, Member HSC WrkGp, 18 Sonya Malekzadeh, MD, BOD Liaison, 15 Sukgi S. Choi, MD, Consultant, 14 Stacey L. Ishman, MD, MPH, Consultant, 15 Daniel J. Kirse, MD, Consultant, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Rhinology and Allergy Education Committee Brent A. Senior, MD, Committee Chair, 14 Fuad M. Baroody, MD, Member HSC WrkGp, 15 Pete S. Batra, MD, Member, 15 Benjamin Saul Bleier, MD, Member HSC WrkGp, 19 John D. Burgoyne, MD, Member, 14 Felix W. K. Chu, MD, Member, 15 Christopher A. Church, MD, Member HSC WrkGp, 17 Samer Fakhri, MD, FRCSC, Member HSC WrkGp, 15 Adam J. Folbe, MD, Member HSC WrkGp, 15 David R. Friedmann, MD, Member, 14 Parul Goyal, MD, MBA, Member, 15 Stacey T. Gray, MD, Member, 15 Oswaldo A. Henriquez Ajami, MD, Member, 15 Ashutosh Kacker, MD, Member, 14 Esther Kim, MD, Member, 15 Devyani Lal, MD, Member HSC WrkGp, 19 Annie S. Lee, MD, Member, 14 Jivianne Lee, MD, Member, 15 Stella Lee, MD, Member, 15 Amber U. Luong, MD, PhD, Member HSC WrkGp, 15 Li-Xing Man, MSc MD, Member, 15 Peter Manes, MD, Member, 15 Zara M. Patel, MD, Member, 15 Maria T. Pena, MD, Member, 15 David Poetker, MD MA, Member HSC WrkGp, 17 Allen M. Seiden, MD, Member, 14 Wade Swenson, MD, Member, 15 Rakesh K. Chandra, MD, Consultant, 14 Bryan May, Staff Liaison Audrey Shively, MSHSE, MCHES, CCMEP, Staff Liaison Advisory/Other Groups Instruction Course Advisory Committee Sukgi S. Choi, MD, Committee Chair, 16 Max M. April, MD, Member, 14 Paolo Campisi, MD, Member, 14 Daniel C. Chelius, Jr, MD, Member, 14 Joseph Han, MD, Member, 14 Brandon Isaacson, MD, Member, 15 J. Randall Jordan, MD, Member, 15 Todd T. Kingdom, MD, Member, 14 Catherine R. Lintzenich, MD, Member, 14 J. Scott Magnuson, MD, Member, 15 Ron B. Mitchell, MD, Member, 14 Edmund A. Pribitkin, MD, Member, 14 Clark A. Rosen, MD, Member, 14 Brent A. Senior, MD, Member, 14 William H. Slattery III, MD, Member, 14 Jeffrey S. Wolf, MD, Member, 14 Kathleen L. Yaremchuk, MD, MSA, Member, 14 Kenny H. Chan, MD, Consultant, 14 Eduardo M. Diaz, Jr., MD, Consultant, 14 Paul W Gidley, MD, Consultant, 14 Allison M. Holzapfel, MD, Consultant, 14 Brian A. Moore, MD, Consultant, 15 Karen T. Pitman, MD, Consultant, 14 Phillip C. Song, MD, Consultant, 15 Brendan C. Stack, Jr., MD, FACE, Consultant, 14 Eben L. Rosenthal, MD, Ex-Officio, 16 Tami Rollins, CMP, CEM, Staff Liaison Program Advisory Committee Eben L. Rosenthal, MD, Committee Chair, 16 Dole P. Baker, Jr, MD, Member, 14 Emiro E. Caicedo Granados, MD, Member, 14 Charles A. Elmaraghy, MD, Member, 15 Philip A. Harris, MD, Member, 14 Eric J. Kezirian, MD, MPH, Member, 14 Jennifer C. Kim, MD, Member, 15 John H. Krouse, MD, PhD, Member, 15 Daniel J. Lee, MD, Member, 14 Alan G. Micco, MD, Member, 14 Cherie-Ann O. Nathan, MD, Member, 15 Michael D. Seidman, MD, Member, 14 Russell B. Smith, MD, Member, 14 Mark J. Syms, MD, Member, 14 Dana M. Thompson, MD, MS, Member, 14 Patrick J. Antonelli, MD, Consultant, 14 Sujana S. Chandrasekhar, MD, Consultant, 14 Michael R. Holtel, MD, Consultant, 14 Christopher H. Rassekh, MD, Consultant, 14 B. Tucker Woodson, MD, Consultant, 14 Robert P. Zitsch III, MD, Consultant, 14 Tami Rollins, CMP, CEM, Staff Liaison Sukgi S. Choi, MD, Ex-Officio, 16 John S. Rhee, MD, MPH, Ex-Officio, 14 2013 CORE Study Section Reviewers David R. Friedland, MD, PhD, Chair Jay O. Boyle, MD, Chair Rodney J. Schlosser, MD, Chair Christine G. Gourin, MD, Chair-Elect Dunia Abdul-Aziz, MD Waleed M. Abuzeid, MD Oliver F. Adunka, MD Nishant Agrawal, MD Yuri Agrawal, MD Sun M. Ahn, MD Henry P. Barham, MD Carol M. Bier-Laning, MD Benjamin Saul Bleier, MD Jonathan M. Bock, MD Emily F. Boss, MD, MPH Michael J. Brenner, MD Trinitia Y. Cannon, MD Dylan K. Chan, MD, PhD Teresa V. Chan, MD Steven S. Chang, MD Alan G. Cheng, MD Dinesh K. Chhetri, MD Steven B. Chinn, MD, MPH John J. Christophel, MD Marion E. Couch, MD PhD Adam DeConde, MD Raj C. Dedhia, MD Gregory R. Dion, MD Jayme R. Dowdall, MD Carole Fakhry, MD Robert L. Ferris, MD, PhD David O. Francis, MD Jonathan R. George, MD, MPH Nira A. Goldstein, MD, MPH John H. Greinwald, Jr, MD Samuel P. Gubbels, MD Rebecca J. Hammon, MD Ronna Hertzano, MD, PhD Alexander T. Hillel, MD Michael E. Hoffer, MD Eric H. Holbrook, MD Monica Hoy, MD Timothy E. Hullar, MD Clifford R. Hume, MD, PhD Lisa E. Ishii, MD, MHS Stacey L. Ishman, MD, MPH Mark J. Jameson, MD PhD Nancy P. Judd, MD Benjamin L. Judson, MD Alexandra E. Kejner, MD Adam J. Kimple, MD, PhD Stephen Y. Lai, MD PhD Andrew Lane, MD Jonathan H. Law, MD Timothy S. Lian, MD Jeffrey C. Liu, MD Brenda L. Lonsbury-Martin, PhD Tomoko Makishima, MD, PhD Stephen C. Maturo, MD I-fan Theodore Mau, MD PhD Bryan R. McRae, MD Eduardo Mendez, MD Stephanie Misono, MD, MPH Luc G. Morris, MD Jeffrey S. Moyer, MD Rick F. Nelson, MD, PhD Robert C. O’Reilly, MD Henry C. Ou, MD Thomas J. Ow, MD Albert H. Park, MD Jayant Pinto, MD Karen T. Pitman, MD Diego A. Preciado, MD, PhD Liana Puscas, MD Vijay R. Ramakrishnan, MD Murugappan Ramanathan, Jr., MD Aaron K. Remenschneider, MD Vicente A. Resto, MD, PhD Claus-Peter Richter, MD, PhD Pamela C. Roehm, MD, PhD Peter S. Roland, MD Cecelia E. Schmalbach, MD Nicole C. Schmitt, MD Nathan M. Schularick, MD Carol G. Shores, MD, PhD Andrew G. Shuman, MD Andrew Sikora, MD, PhD Bhuvanesh Singh, MD, PhD Zachary M. Soler, MD Matthew E. Spector, MD Michael E. Stadler, MD Amar C. Suryadevara, MD Bruce K. Tan, MD Richard M. Tempero, MD, PhD Travis T. Tollefson, MD, MPH Michael P. Underbrink, MD Ravindra Uppaluri, MD, PhD Eric W. Wang, MD Steven J. Wang, MD Edward M. Weaver, MD, MPH Debra G. Weinberger, MD Heather M. Weinreich, MD Sarah K. Wise, MD Bradford A. Woodworth, MD Adam Mikial Zanation, MD Jing Zheng, PhD Sarah S. O’Connor, Staff Liaison Stephanie L. Jones, Staff Liaison Physician Payment Policy (3P) Workgroup James C. Denneny III, MD, Committee Co-Chair, 16 Jane T. Dillon, MD, Committee Co-Chair, 15 Peter S. Batra, MD, 14 Emily F. Boss, MD, MPH, Member, 14 Jane T. Dillon, MD, Member 15 Lee D. Eisenberg, MD MPH, Member 14 Charles F. Koopmann, Jr., MD, MHSA, Member 14 Wayne M. Koch, MD, Member 14 John T. Lanza, MD, Member 14 Joseph E. Leonard, MD, Member, 14 Robert R. Lorenz, MD, MBA, Member, 14 Peter M. Manes, MD, Member, 14 Bradley F. Marple, MD, Member 14 Robert J. Stachler, MD, Member, 14 Brendan C. Stack, Jr., MD, Member, 14 Michael Setzen, MD, Member, 14 Richard W. Waguespack, MD, Member 14 Jenna Kappel, MPH, MA, Staff Liaison Ad Hoc Payment Model Workgroup James C. Denneny III, MD, Workgroup Chair, 14 Emily F. Boss, MD, MPH, 14 Jane T. Dillon, MD, 14 Lisa E. Ishii, MD, MHS, 14 Robert R. Lorenz, MD, 14 Richard M. Rosenfeld, MD, MPH, 14 John S. Rhee, MD, MPH, 14 J. Pablo Stolovitzky, MD, 14 Richard W. Waguespack, MD, 14 David R. Nielsen, MD, Advisor, 14 Jean Brereton, MBA, Staff Liaison Jenna Kappel, MPH, MA, Staff Liaison Specialty Society Advisory Council (SSAC) Richard M. Rosenfeld, MD, MPH, Committee Chair, 15 (ASPO) Milan R. Amin, MD, Member, 16 (ABEA) Brian B. Burkey, MD, Member, 16 (AHNS) Roberto A. Cueva, MD, Member, 16 (AOS) Edward H. Farrior, MD, Member, 16 (AAFPRS) Paul Fass, MD, Member, 14 (AAOA) Marvin P. Fried, MD, Member, 14 (ALA) Michael J. McKenna, MD, Member, 16 (ANS) James N. Palmer, MD, Member, 15 (ARS) Richard W. Waguespack, MD, Member, 14 (AAO-HNS) Kathleen L. Yaremchuk, MD, MSA, 14 (TRIO) Thomas D. Killam, CAE, Staff Liaison
02_Hart_Joe
Thanksgiving and the Academy
Joseph E. Hart, MD Waterloo, IA Member, BOG Executive Committee This is the time of the year we set aside to reflect on our lives. For each of us, Thanksgiving is a personal time to ponder and possibly act on the things we are thankful for. First of all, I would have to be thankful for the life I was given, and the freedoms we hold dear. I have so much to be thankful for.  This includes my family, my community (local, state, and national), and my colleagues and staff. We are people who long to relate to one another. We learn this very early in our lives. We are incredibly dependent for years. Our desire for relationships continues as we make our way through our lives. We continue to learn, all along the journey. Our Academy and Board help us with those self-improvement efforts, to be better physicians and healers. Where would we all be, without our education, research, and support from our Academy? I started serving within the American Academy of Otolaryngology-Head and Neck Surgery because one of my state colleagues said it needed me and they thought I could do this. I was hesitant, but asked my former vice-chairman if the AAO-HNS needed someone like me. He almost yelled at me on the phone, “Yes,” was the answer. I am glad he encouraged me. The otolaryngologists and staff I have met over the years are impressive. Their expertise is wide ranging. They are able to make connections with key decision-makers on the state and national level. They are fiscally responsible and give us quite a return on the cost of our annual membership. They have sought out effective partners, sometimes in surprising corners. They have a near and long-term vision of the specialty and seek out new and effective ways to attain these goals.  They also have been encouraging to me at every juncture. They give me great pride in my work with the Academy and its Board of Governors. I feel as if I serve my patients and their families better, by “going to bat” for them on a bigger playing field. I would encourage you all to consider volunteering. It has been rewarding. We all have realized how difficult it can be for others in the political or healthcare realm (including insurance) to really hear what we are saying as physician leaders. This is another integral part of being patient advocates. Our Academy staff knows the Congressional offices and the Congressional support staff. Their presence is respected and quite effective. Our support of their activities help them forward our message. We have many ways of supporting the AAO-HNS. Giving to the Academy Foundation through the Millennium Society or Hal Foster, MD Endowment Society, among others, can help sustain the work that began so long ago. Another important and fruitful way to support each other is through the ENT PAC, the Academy’s Political Action Committee. Our PAC has a very high success rate for bipartisan support of candidates who understand and support medicine’s role. Please look into that as an option as you consider how to best help shape the future of medicine. These are some of the ways you can show your thankfulness. We all have many gifts. It is up to each person to determine how to use those gifts. Even a small financial gift can make a difference. Don’t underestimate your personal contribution. We all have very important stories to tell about thankfulness in our lives. One of mine was very specific. On my first day in the operating room as an otolaryngology resident, my chairman stopped before a complicated endoscopy case for a cancer patient, and looked at me. He said we should get down on our knees every night to thank God for a state-of-the-art facility, knowledgeable staff, and patients who trust us with their lives. That set the tone for my residency experience. At many points in my life, I have relied on my education to help with medical and surgical treatment for my extended family. I am very thankful for the help that was given to us at so many points. There is a significant story that stood out for our family. It is a personal one for me. One of my best friends went on to become a pediatric otolaryngologist. Our third daughter was born with a very complicated ear, nose, and throat problem. He, among many other talented people, saved her life. The whole tertiary team has been dedicated to her and our family from the beginning. They have helped my whole family with this journey. She will graduate from high school soon. Where would I be without him, and them? He also doesn’t accept much attention for all that he, the department, and the hospital did for my wife, family, and me. I am thankful for these humble, dutiful, and wonderful people.
David R. Nielsen, MD AAO-HNS/F EVP/CEO
‘We All Live Downstream’
How well do we recognize the legacy we inherit from teachers, trainers, mentors, parents, early pioneers in science, or others who have gone before? Whether we speak of our professional life, or our rich cultural heritage, or our political freedom, we stand on the shoulders of giants—of those who blazed the trail or pioneered new ground. To paraphrase the prophet Moses, we all “live in cities we did not build and drink from wells we did not dig.” (Deuteronomy 6:10-11) Is there an implication from this truism for our behavior? Is there a “So what?” buried in this recognition? Besides being grateful or occasionally celebrating or honoring the memory of earlier contributors, mentors, or leaders, are we obligated in any way to act differently or to do something in response to our “inheritance”? I am confident that each of us, without external prompting, would immediately answer with a firm “yes.” I believe this from seeing the pioneering spirit being passed from teacher to student; from my observation of the culture of selfless behavior displayed by our members engaged in humanitarian efforts and teaching; from the incontrovertible evidence of your volunteerism, sacrifices, and leadership in advancing the science and the practice of medicine, and of putting your patients’ needs first. It shows up in how we parent our children in our families and exercise our right of political engagement, which is the heritage of every American, to participate and have a voice in our government. Part of the obligation we inherit to respond to the legacy of pioneers who preceded us, is the development of our own leadership skills and being true to the values that enrich our lives. As a prominent corporate executive, Andrea Jung describes the feeling in her career that, having been passed over for the CEO position at the company she loved and wanted to remain with and lead, she was offered a more lucrative position as CEO of another company. Sensing that she was in a hurry to advance her career, a friend and board member advised her to stay, with the words, “Follow your compass, not your clock.” She loved what her company stood for and the great influence for good it represented. She stated that she then realized that she would prefer to be number two in a company with this positive impact on society than to be number one in another company without it. [True North, p. 154] We live in a time of great change and even uncertainty about certain elements regarding the practice of medicine. There is so much focus on what will be different about our future that we spend too little time ensuring what will not change. Being true to our “compass,” the one that led us to become physicians and otolaryngologists in the first place, we can assure our patients that providing them with the highest quality of care possible will NOT change. We can assure those we train in our residency programs that this is an incredible specialty with a bright future of innovation, service, and personal satisfaction. We can assure our medical students and those considering medicine as a career that the best years for physicians and medicine are still ahead of us. And, most important, we can assure the nation and the world that the profession of medicine can be trusted with the stewardship of continuing to save lives, reduce pain and suffering, and improve the quality of life for everyone. Not long ago, I saw a bumper sticker that read, “We all live downstream.” While the point of that particular message was an environmental one, the greater lesson is likewise about legacy: the impact of the lives of our forebearers, and the inescapable influence that flows downstream from our lives and actions. I join with you in accepting the challenge of assuring that downstream from our actions, our work, and our lives will be the clear, cool, and refreshing legacy of success in establishing better care, better health, and better lives for everyone. I urge you to use the Academy and Foundation to share your expertise, refresh your knowledge, expand your friendships and associations, hone your leadership skills, recharge your batteries, and renew your enthusiasm for this great profession.
Richard W. Waguespack, MD AAO-HNS/F President
On AAO-HNS Membership
I originally joined the American Academy of Otolaryngology—Head and Neck Surgery in 1980. Aside from my decision to go to medical school, this was the best decision that I have ever made for my professional development! As a Resident My journey with the Academy began when Byron J. Bailey, MD, a past president of the AAO-HNS, sent us as residents to the meeting in Dallas, TX, in 1977. My mentor, the late Cary N. Moon, MD, of Charlottesville, VA, was a candidate for the presidency in 1980 as I completed my residency; he encouraged me to join the Academy. It was a natural extension of my professional growth to join and attend. From the perspective of continuing education and professionalism, there was no question I would join and attend most annual meetings. The fact that the 1980 meeting was in Anaheim, CA, close to Disneyland, which my young family could visit, had nothing to do with the decision. As a Young Physician Early on, the main benefit was continuing education and networking, although I am not sure we were using the term then. I joined other specialty-related societies, but none has had the scope or reach of the Academy. My first formal role in the Academy was appointment to the Medical Devices and Drugs Committee in 1985. Richard L. Mabry, MD, was the chair and later became a mentor on a number of levels. Several years later, in 1993, I was placed on the Program Advisory Committee, my first education-related service. It was an honor and privilege to be one of the only committee members in community-based, rather than academic, practice. In the late 1980s, I became interested in the Board of Governors (BOG), since I had done work with the Alabama Society of Otolaryngology and, in 1989, was named to the BOG Socioeconomic and Grassroots Committee. At Mid-Career At this point in my career, my practice was mature enough and children old enough (and my wife understanding enough) for me to continue in Academy volunteerism, mainly education and socioeconomic focused. As my father and my professional mentors had explained and led by example, there was a duty to serve the profession and specialty that had done so much for me and my family. As one works with other like-minded people in the Academy, it reinforces the desire to continue and begin to mentor those who follow. My transition from private to academic medicine simply gives me an added perspective and opportunity to help bring along younger practitioners, from the occasional med student to residents to younger faculty. At this stage, the need for continuing education is still there and while there are many venues from which to obtain this, the Academy is still the best single source for me and many colleagues, especially general otolaryngologists. In the research, quality, and health policy spheres, no other organization better represents our specialty than the Academy and—to paraphrase Neil O. Ward, MD, MAL, another mentor and past president—I serve to the best of my ability at the pleasure of the Academy and Mrs. Waguespack.