Published: April 3, 2015


It is truly an honor to be considered as President-elect of our Academy. I pledge to work tirelessly to make a difference for you and our Academy. Together we are optimally positioned to lead our Academy, with one voice.

randolphHow would you lead our Academy in adapting to healthcare reform through advocacy, quality initiatives, and member engagement? In what ways could the Academy best empower members to participate and thrive in the evolving healthcare reform landscape?  Every major organization, including the AAO-HNSF, is not perfect and can fail at times in its service to the membership. What would you identify are the major flaws/shortcomings/failures in our Academy? How would you try to correct these issues?

It is truly an honor to be considered as President-elect of our Academy. I pledge to work tirelessly to make a difference for you and our Academy. Together we are optimally positioned to lead our Academy, with one voice.

I have served on the Board of Directors for five years and served as the International Coordinator chairing the International Steering Committee, implemented the AAO-HNS International Advisor system, as well as overseeing the AAO Pan-American, Humanitarian, and International Otolaryngology Committees. On the Board of Directors, I became familiar with strategic planning and budgeting processes that facilitate the Academy’s allocation of limited resources with competing missions of research, education, and advocacy. Experiences outside of the AAO-HNS working to expand otolaryngology in thyroid surgery through leadership roles in the American Thyroid Association, American Head and Neck Society, American Association of Clinic Endocrinology, and Harvard Medical School have taught me how to work with divergent groups to accomplish common goals.

The relentless trend of decreasing reimbursement, increasing practice expenses, administrative burdens, implementation of EMR/meaningful use, ICD-10, as well as practice pressures from non-physician providers, and MOC affect us all.

As President, I will empower our members by:

  • Exploring new models of care and reimbursement
  • Developing specialty-specific care quality metrics and initiatives targeting patient safety
  • Engaging Congress, regulatory agencies, and payers on issues specific to otolaryngology, and supporting otolaryngologists participating in ACOs
  • Engaging the medical community through our Guideline initiatives
  • Continuing to support research in our field
  • Continuing to improve and grow our Annual Meeting
  • Renewing the Academy’s work in the AMA CPT editorial panel and ongoing work with CMS reviewing reimbursement policies of private payers.

A weakness of the AAO-HNSF is its many competing and diverse missions. We must balance resources. I believe our leadership has obtained a good balance turning these competing missions into a strength by linking research, advocacy, and educational efforts.

To move forward we must engage 100 percent of our membership—to expand the cumulative work of our Academy. This will be the focus for my Presidential year if elected—to engage every member of our unified Academy. Important areas of membership engagement include:

  • Continuing efforts at specialty unity through the Specialty Society Advisory Council (SSAC)
  • Grassroots involvement with Congress, regulatory agencies, and private payers and through the ENT PAC
  • ENTConnect and social media to optimize and network Academy constituencies including the Board of Governors, Women in Otolaryngology, the Diversity Committee, Young Physicians, and Residents.

I believe in otolaryngology and the AAO. As your President, I would be calling on each of you to serve. Our Academy’s diversity and breadth of the talent optimally positions our Academy as a dynamic organization capable of meeting the challenges we face.  I will ask for your help and you may count on me to work tirelessly to lead our Academy and to continue to build this great institution with pride and commitment to our Academy. The Academy needs you.


More from April 2015 - Vol. 34 No. 03

Dr. Curotta, nurse, and a happy patient at Baucau, East Timor.
Australian otolaryngology outreachExpanded from the print edition
By John Curotta, FRACS, Director of the Department ENT Surgery, Head of the Discipline ENT Surgery, Sydney University, Australia, and Immediate Past President of ASOHNS Australian otolaryngologists provide clinic and surgical ENT services mainly to South Pacific island nations, to Papua New Guinea, and to Timor Leste. Our humanitarian missions are tasked to those with the least ability to access care and to training, mentoring, and supporting those who will continue their care when we leave. The islands in the South Pacific, while beautiful, are small, remote, and very dispersed—Tonga, Vanuatu, Cook Islands, Solomon Islands (Guadalcanal), Samoa, Tuvalu, and Kiribati are visited. Kiribati is halfway from Australia to Hawaii, and has only 100,000 people on 33 islands totalling 350 square miles land (about six times the size of the District of Columbia) dotted over 1.35 million sq. miles of ocean. So there is little movement within the country and major difficulties for teams to get there, then get around. Timor Leste (East Timor), with a population of 1.1 million, is one of the newest nations. It shares a border with Indonesia, population 250 million. Four out of five Timorese live on less than US $2 per day. At Independence 12 years ago there was one doctor and the remains of a couple of hospitals and 90 percent of the population was unable to read or write. This is already down to 50 percent and the Guido Valdares National Hospital is running well with a strong educational ethos. Our ENT team consists of a surgeon, anaesthesiologist, audiologist, and a nurse or sometimes a surgical resident. The standard tour is one week, with four to five trips to Timor each year. Microscopes have been prepositioned but all other special equipment and medications are taken in. The first day or two is clinical assessment, including audiology, and usually 50 to 150 patients are seen and about 20 offered surgery. Four to five mastoidectomies and eight to 12 myringoplasties are done. Reinforcing instruction and training of ear care nurses, supplying medications, and reminding these people in remote places that they are not forgotten probably give more benefit than our few surgeries can accomplish.
Whether physicians like it or not, politics play a significant role in healthcare. It is tempting to ignore this fact, but to do so is a disservice to our patients and our profession. Accepting and embracing the situation allows us the opportunity to ensure that the impact of legislative policies on our patients is understood and that the voice of the physician is heard. Go, team, go Though physicians are thought to be independent, in fact we work in teams on a daily basis. Whether we are in the operating room or the office, we work with the anesthesiologists, nurses, techs, medical assistants, and administrative staff to achieve the ultimate goal of high quality, efficient patient care. We could not achieve our goals if we were not working together in a concerted effort. When it comes to advocacy, however, physicians struggle with pulling together, especially when compared to groups such as the trial attorneys or various nonphysician providers. Also, politics is a numbers game, and success is often quantified by who can garner the most signatures, who can raise the most money, or who has the greatest number of supporters. To increase the impact of our specialty’s message, we need clout in the form of numbers. To do this, we need to increase Academy member involvement in our legislative and political programs. Members of Congress are increasingly savvy at deciphering the number of otolaryngologists (constituents) represented by a particular initiative. So, every person who gets involved in AAO-HNS’ respective legislative or political programs ultimately helps us to achieve our goals. This “head count” is very important! Look for ways to participate in legislative and political advocacy, and show Members of Congress that all otolaryngologists are interested in protecting high-quality patient care. No ‘i’ in team Life teaches us that one-to-one interactions make the greatest impressions. By reaching out to a Member of Congress, we have the opportunity to make our message personal. There is also the opportunity to educate. Physicians have the best perspective of the impact governmental policy has on the delivery of healthcare. Our patients may feel the effects, but in most cases, they are not aware of the policies that lead to those outcomes. And though they vote on the policies, most Members of Congress are not intimately aware of the impact those policies have on patients and the practice of medicine. As physicians, we are the bridge between our patients and our legislators, and we owe it to our patients to advocate for their care. Fortunately, through the In-district Grassroots Outreach (I-GO) program, the Academy has staff dedicated to assisting otolaryngologists with arranging individualized interactions. These events can be tailored to each member’s comfort level and range from one-to-one meetings, practice visits, fundraising events, or larger town hall events. There is no “I” in team, but there is an “I” in I-GO! So, the answer to the question whether advocacy is an individual or team sport is … YES. By combining efforts on an individual basis that make our message personal with a collective voice to make sure we are heard, we can achieve our advocacy and patient care goals. *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.