Published: April 3, 2015


The strength of the AAO-HNS/Foundation lies in the active engagement of its Members. Our organization is a major representative of otolaryngology on the national level.

waxHow 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?

The strength of the AAO-HNS/Foundation lies in the active engagement of its Members. Our organization is a major representative of otolaryngology on the national level. What makes us strong is the widespread participation by the majority of otolaryngologists in this country. Our ability to unify the diverse subspecialty interests and maintain lines of communication with these groups is another fundamental basis of our strength. These groups each have expertise in many aspects of healthcare reform. My experience as treasurer, president, and executive member in many of these organizations will help to maintain the lines of communication and the collaboration within our specialty. I will continue to foster open communication and collaboration with all the specialty societies, utilizing their expertise to build consensus.

The continued evolution of healthcare reform is going to affect all aspects of otolaryngology practice. Utilizing our network of knowledgeable colleagues who are actively involved on local, state, or national levels, I think I can increase our political know-how to advocate in the best interest of our patients and Members. We must advocate for the best care for all, all the time.

When it comes to participation in the evolving healthcare reform landscape, we must be seen as competent to sit at the table. Our leadership in development of quality initiatives, clinical indicators, and evidence-based medicine will be instrumental in demonstrating the credibility and commitment to healthcare reform at a national level. By being in the forefront and having the information available, we will be leading the discussion as opposed to just participating. Already the AAO-HNS/Foundation involves as many Members of the Academy as possible in this program. My experience in the educational activities of the AAO-HNS/Foundation will allow me to navigate the process. I intend to bring in the best leaders from private practice, academia, administration, and the general Membership to form a strong front that can represent our patients and our interests.

Like all large organizations, we must adapt to keep resources and strategic goals of the Academy in alignment with the contemporary desires of our diverse Membership. Although data from electronic survey tools can be valuable, it has limitations and often face-to-face meetings of key stake holders is the best way to successfully steer major change within in the organization. While the Academy has wonderful leadership and dedicated staff it is important to engage the expertise of the Membership in a more direct fashion. I intend to convene forums where interested individuals can pursue and voice their opinion. Having sessions at the Annual Meeting or at state level meetings to garner opinions and feedback will allow us to apply the Academy resources in a way that will have the greatest impact on our Membership. Adding this important aspect to our meetings will allow us to correct deficiencies and keep abreast of evolving events. We must not remain static but evolve with the changing horizons of education, healthcare reform, and clinical practice.



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.