Published: February 23, 2016

AMA HOUSE OF DELEGATES REPORTIssues affecting otolaryngology

The American Medical Association (AMA) House of Delegates (HOD) held its November 2015 Interim Meeting in Atlanta, GA. Representing the Academy were Liana Puscas, MD, MHS, delegation chair; delegates Michael S. Goldrich, MD, and Shannon P. Pryor, MD; alternate delegates Robert Puchalski, MD, and Academy EVP/CEO, James C. Denneny III, MD.

By Liana Puscas, MD, MHS, Chair, AAO-HNS Delegation to the AMA House of Delegates

hearingaidThe American Medical Association (AMA) House of Delegates (HOD) held its November 2015 Interim Meeting in Atlanta, GA. Representing the Academy were Liana Puscas, MD, MHS, delegation chair; delegates Michael S. Goldrich, MD, and Shannon P. Pryor, MD; alternate delegates Robert Puchalski, MD, and Academy EVP/CEO, James C. Denneny III, MD.

In response to two prior resolutions asking for the AMA to evaluate the issue of hearing aid coverage by Medicare and other health plans, the AMA’s Council on Medical Service prepared a report addressing this topic. After discussion of the report’s recommendations at the HOD and its reference committees, and with amendments supported by the AAO-HNS, existing AMA policy was amended to read:

  1. That the AMA continue to support early hearing detection and intervention to ensure that all infants receive proper hearing screening, diagnostic evaluation, intervention and follow-up in a timely manner.
  2. That the AMA advocate that the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program be used as the model for any essential health benefits package for children.
  3. That the AMA support public and private health insurance coverage that provides all hearing-impaired infants and children access to appropriate physician-led teams, hearing services, and devices, including digital hearing aids.
  4. That the AMA support hearing aid coverage for children that, at minimum, recognizes the need for replacement of hearing aids due to maturation, change in hearing ability, and normal wear and tear.
  5. That the AMA encourage private health plans to offer optional riders that allow their members to add hearing benefits to existing policies to offset the costs of hearing aid purchases, hearing-related exams, and related services.
  6. That the AMA support coverage of hearing tests administered by a physician or physician-led team as part of Medicare’s benefit.

The AMA also voted to support a ban on direct-to-consumer advertising (DTCA) for prescription drugs and implantable medical devices. Only the U.S. and New Zealand allow DTCA. While this practice does raise awareness of certain diseases and therapies, which may improve the health of patients, overall the HOD decided a ban against the practice was in the best interest of patients. Since the ultimate goal of DTCA is to drive utilization of a specific product, the potential educational benefits of DTCA were outweighed by the increased cost of new drugs when similarly effective cheaper options are available, and by the cost in time that occurs when physicians must specifically address the patients’ demands for these new drugs rather than spending the time dealing with more pressing health issues of their patients.

The next meeting of the AMA HOD is scheduled for June 11-15, 2016, in Chicago, Il. With questions regarding this report and other AMA HOD activities, please contact

More from March 2016 - Vol. 35, No. 02

New task forces focus on education
By Sonya Malekzadeh, MD, AAO-HNSF former Coordinator for Education The AAO-HNS/F has assembled four education task forces to address important issues concerning our Members and the profession. I am honored to be involved in many of these efforts and to serve as chair for two of these groups. The Simulation Task Force was formed in 2011 to define the current state of simulation, to investigate its role and future potential in otolaryngology-head and neck surgery, and to provide educational resources for AAO-HNS Members. Under the leadership of Ellen S. Deutsch, MD, the Simulation Task Force has accomplished: Initiation of Simulation Open Forums, at both the Combined Otolaryngology Spring Meetings (COSM) and the AAO-HNSF Annual Meeting & OTO EXPOSM, has brought together like-minded individuals to discuss interests, challenges, and opportunities in simulation. An active ENTConnect community engages simulation Members in ongoing collaboration and exploration. Launch of the SimTube Project, a national initiative for simulation-based educational research with the immediate goal of assessing the usefulness of a low-cost, low-tech simulator in learning myringotomy and tube placement, and the larger goal of establishing an infrastructure that could support multiprogram collaboration for more complex simulation-based educational research in the future. More than 60 U.S. residency programs now participate in the study. Numerous Annual Meeting Miniseminars highlighting current education efforts and advanced technology in simulation while also demonstrating the value of simulation in quality of care and systems improvement. Recognizing the expanding role of simulation in education, research, and quality, the task force has recently submitted an application to become a Foundation committee. This new designation will permit a formal and permanent structure for furthering Member opportunities and engagement. Dr. Deutsch and Gregory J. Wiet, MD, will chair the committee. The Comprehensive Curriculum Task Force stemmed from the 2013 Board of Directors Strategic Planning meeting where Academy leadership acknowledged the need for a core curriculum in otolaryngology. The Otolaryngology Comprehensive Curriculum will serve as a lifelong, continually expanding learning and assessment tool for otolaryngology professionals. The content and structure will meet the needs of students, residents, allied health colleagues, and all practicing physicians engaged in MOC and lifelong learning. The online format will cover the otolaryngology scope of knowledge, provided in various educational formats, to guide and address cognitive and technical skills. The “living” content will be kept current with frequent updates so users can be assured they are participating in a rich and growing educational program. The task force believes this to be an ideal opportunity to unite the specialties around education, reduce duplicative efforts across societies, and to provide a comprehensive education platform for our specialty. A working group comprised of society representatives is finalizing a list of topics and performing an inventory of all existing education content across the specialties. This information will inform the development of future education programming. The Intraoperative Nerve Monitoring Task Force, in existence since fall 2015, will address key issues relevant to facial nerve monitoring during otologic and neuro-otologic surgery. With representation from the American Neurotology Society (ANS) and the American Otological Society (AOS), the task force will focus on: Determining current practice in training and performance of nerve monitoring among Academy Members and Residency Program Directors. Developing education activities that will provide uniform and standardized training for otolaryngologists to safely and successfully perform the procedure. Clarifying the AAO-HNS/F perspective on intraoperative nerve monitoring within the specialty. AAO-HNS President Sujana S. Chandrasekhar, MD, proposed the latest group, Advanced Practice Professionals (APP) Education Task Force. With the growing presence of mid-level providers in otolaryngology practices, it is imperative that we provide our colleagues with proper education and training in our field. These efforts will improve their contributions to our practices and patients while also educating AAO-HNS Members on the benefits of including APPs in the profession. In collaboration with the APP societies, including SPAO-HNS, the task force will design educational programing and provide resources that will allow advanced practice providers and otolaryngologist-head and neck surgeons to work synergistically to improve patient care. “I have every confidence that this task force will put together a comprehensive ENT APP curriculum, utilizing many Academy resources. Establishing such an educational outline will really help our Members as they seek to incorporate APPs into their practices” said Dr. Chandrasekhar. Karen T. Pitman, MD, and Peter D. Costantino, MD, will serve as chairs of this new task force. Academy task force Members are working hard on topics critical to the Academy and the profession. “These education task forces really complement the work of the education committees by addressing new and innovative education opportunities for our Members,” said Richard V. Smith, MD, coordinator for Education. If you are interested in more information or contributing to any of these projects please email