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Borgemenke S, Newsom D, Scheatzle P, Durstock N, Beverly EA. Modeling the importance of physician training in practice location for Ohio otolaryngologists. J Osteopath Med 2024:jom-2024-0035. [PMID: 39323255 DOI: 10.1515/jom-2024-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 08/19/2024] [Indexed: 09/27/2024]
Abstract
CONTEXT Underserved communities in southeastern Ohio and Appalachia face significant healthcare accessibility challenges, with the Midwest offering a lower density of healthcare providers compared to coastal regions. Specifically, underserved communities in southeastern Ohio and Appalachia are disadvantaged in otolaryngology care. OBJECTIVES This analysis aims to identify factors that lead otolaryngologists to a respective practice location, and if any of that influence comes from where otolaryngologists completed their medical education. METHODS The proportion of otolaryngologists who performed medical school, residency, and/or fellowship in Ohio was analyzed utilizing a three-sample test for equality. Multivariate logistic regression and Pearson prediction models were produced to analyze the impact of performing medical training (medical school, residency, and fellowship) in Ohio. RESULTS Going to medical school in Ohio significantly increases the odds of going to an otolaryngology residency in the state (p<0.001). Moreover, between medical school and residency, medical school was a significantly better predictor of otolaryngologists practicing in Appalachia (Δ Bayesian Information Criterion [BIC]>2) and southeast Ohio (ΔBIC>10). Medical school in state was also a better predictor of percent rural and median household income than residency (ΔBIC>10). The multivariate model of medical school and residency was significantly better than either predictor alone for the population (ΔBIC>2). All models predicting percent rural were significantly improved with the addition of a Doctor of Osteopathy (DO) degree (ΔBIC>10). CONCLUSIONS Where physicians complete their medical training (medical school, residency, and fellowship) in state has a significant impact on predicting their future place of practice. This study found that the location of such training has a positive predictive nature as to whether that physician will practice in a rural and underserved area in the future. Notably, the addition of being licensed as a DO also increased the probability of that physician practicing in a rural area.
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Affiliation(s)
- Samuel Borgemenke
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA
| | - D'Nair Newsom
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA
| | - Patrick Scheatzle
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA
| | - Nicholas Durstock
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA
| | - Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, 1 Ohio University, Athens, OH, USA
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Alkhalifah KM, Muteb Alanazi M, Almushayqih SI, Aljurayyed SM, Alanazi NS, Almazyad LT, Alenezi RZ, Almazyad RT, Elsayed Elboraei YA. Explore the Practice and Level of Knowledge of Otorhinolaryngology-Related Issues Among the Population of the Northern Borders Region in Saudi Arabia. Cureus 2023; 15:e51222. [PMID: 38288207 PMCID: PMC10823208 DOI: 10.7759/cureus.51222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE The objective of this study was to evaluate public practice and the level of knowledge of common otorhinolaryngology-related issues among the population of the Northern Borders region of Saudi Arabia. METHODS A descriptive cross-sectional questionnaire-based study was done in this research, employing data from 363 participants from the general population in the Northern Borders region of Saudi Arabia. The participants completed an online self-administered questionnaire and ensured anonymity. The questionnaire used in this study had been previously validated. RESULTS Most of the respondents involved in this study were aged above 20 years (n = 326, 89.8%), and 248 had a medical background (68.3%). The study results show that 139 (38.2%) of the respondents had a good knowledge level, while 224 (61.8%) had poor knowledge about otorhinolaryngology-related issues. The results established a statistically significant association between the demographic information of age, gender, education level, and the level of knowledge about otorhinolaryngology-related issues with p-values < 0.05 (0.001, 0.003, and 0.002), respectively. There were no statistically significant association between marital status, place of residence, occupation, medical background, and the level of knowledge about otorhinolaryngology-related issues (with p > 0.05). Conclusion: The study found that less than half of the participants had good knowledge of otorhinolaryngology; elder and female participants showed better understanding. Sociodemographic factors, such as age, gender, and education, were statistically linked to knowledge levels. The findings highlight a need for increased public awareness efforts by the medical community regarding otorhinolaryngology issues in Saudi Arabia.
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Affiliation(s)
- Khalid M Alkhalifah
- Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | | | | | | | | | | | | | - Renad T Almazyad
- College of Applied Sciences, Northern Border University, Arar, SAU
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Miller RH, McCrary HC, Gurgel RK. Assessing Trends in Fellowship Training Among Otolaryngology Residents: A National Survey Study. Otolaryngol Head Neck Surg 2021; 165:655-661. [PMID: 33618575 DOI: 10.1177/0194599821994477] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To summarize trends in otolaryngology fellowship applications, fellowships selected, and reasons for pursuing a fellowship. STUDY DESIGN One-page anonymous questionnaire. SETTING A survey was completed by examinees at the conclusion of their American Board of Otolaryngology-Head and Neck Surgery oral examination from 2011 to 2019. METHODS Data included age, gender, fellowship type, reasons for doing a fellowship, and type of practice that examinees will enter. Spearman correlation and Pearson chi-square tests were completed. RESULTS Over the 8-year study, 58% of the 2243 responding examinees did fellowships. The most frequently chosen fellowship was facial plastic surgery (25%), followed by pediatric otolaryngology (21%), head and neck surgery (19%), rhinology (13%), laryngology (9%), and neurotology (8%). The 2 most common reasons for doing a fellowship were desire for additional expertise beyond residency training (35%) and intellectual appeal (30%). Over the study period, the number of residents choosing to do a fellowship increased from 45.6% in 2011 to 61.5% in 2019, with a positive correlation between year and number of residents (r = 0.73, P = .036). When the data were stratified by gender, there were statistically significant differences in fellowship selection (P < .001), notably with women selecting pediatric otolaryngology at a higher frequency than men (30.9% vs 15.8%). CONCLUSION There is a statistically significant increasing trend of otolaryngology residents who choose to undergo further training in fellowship. These data from a large, long-term study will be valuable in planning for training and workforce needs in the future.
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Affiliation(s)
- Robert H Miller
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Hilary Caitlyn McCrary
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Utah, USA
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Utah, USA
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Abstract
A shortage of otolaryngologists is predicted for the coming decades, primarily because of an aging population and aging workforce. However, many factors affect the agility of the workforce to expand or contract. This article discusses what is known about factors of the current otolaryngology workforce, including trends in residency and fellowship training, diversity of the specialty, its geographic distribution, and the challenges of caring for an aging population. Predicting the shortage and possible solutions through modeling is complex and prone to errors caused by incomplete data and assumptions about otolaryngology's similarity to other specialties of medicine at large.
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Affiliation(s)
- Lauren M Cass
- Department of Otolaryngology Head and Neck Surgery, The University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 3010, Kansas City, KS 66106, USA.
| | - Joshua B Smith
- Department of Otolaryngology Head and Neck Surgery, The University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 3010, Kansas City, KS 66106, USA. https://twitter.com/JBSmithMD
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Harrill WC, Setzen G, Farquhar D, Pillsbury HC. Contemporary analysis of otolaryngic allergy. Laryngoscope 2019; 130:283-289. [PMID: 30982993 DOI: 10.1002/lary.28002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/20/2019] [Accepted: 03/26/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Investigate the current trends in otolaryngic allergy (OA). STUDY DESIGN Cross-sectional survey. METHODS Survey of active AAOA membership. RESULTS Response rate was 27.3%. Regional response distribution rates were proportional to the AAOA membership distribution within the United States (R2 = 0.95; P < 0.001), with no significant regional response bias demonstrated (P = 0.428). Self-reported duration to OA competency was 5.8 years. Physicians reporting OA competency were more likely to be board-certified (P < 0.001) and have AAOA fellowship status (P < 0.001). The AAOA was reported to be the most valuable educational resource toward achieving OA competency, with residency training being least valuable (P < 0.001). 91.5% of respondents' practices offered OA services. Subcutaneous injections predominated at twice the utilization of sublingual immunotherapy. Allergy immunotherapy tablets were rarely utilized. Home allergy shots were offered by 45.2% of respondents. In-office immunotherapy vial compounding was preferred (95.8%) to third-party vendors. 94% of AAOA respondents identified patient compliance to be an issue within OA. Non-inhalant allergy service integration included food allergy (63.5%), asthma (44.9%), allergic fungal sinusitis (43.8%), penicillin allergy (18%), stinging insect allergy (12.6%), and aspirin desensitization (3.9%). CONCLUSION Reported duration to OA competency after residency was surprisingly long. Further investigation of current and future educational/clinical training is warranted given clinical integration reported for OA. Otolaryngology is in the unique position to develop a comprehensive sino-allergy evidence-based strategy integrating the extensive diagnostic and medical treatment arms alongside the surgical expertise of the specialty within a clinical sino-allergy home concept. LEVEL OF EVIDENCE 5 Laryngoscope, 130:283-289, 2020.
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Affiliation(s)
- Willard C Harrill
- Carolina Ear, Nose & Throat/Sinus and Allergy Center, PA, Hickory, North Carolina, U.S.A.,Department of Otolaryngology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, U.S.A
| | - Gavin Setzen
- Albany ENT & Allergy Services, PC, Albany, New York, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, New York, U.S.A
| | - Douglas Farquhar
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, UNC Neuroscience Hospital, Chapel Hill, North Carolina, U.S.A
| | - Harold C Pillsbury
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, UNC Neuroscience Hospital, Chapel Hill, North Carolina, U.S.A
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Factors influencing the choice of practice location among Canadian otolaryngologists. The Journal of Laryngology & Otology 2019; 133:339-343. [PMID: 30924439 DOI: 10.1017/s0022215119000409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Little is known about what shapes the choice of employment location in a competitive surgical specialty like otolaryngology - head and neck surgery. This study aimed to identify factors important in determining practice location among Canadian otolaryngologists METHODS: An online survey was distributed nationally to active members of the Canadian Society of Otolaryngology - Head and Neck Surgery. The survey collected data on general demographics, current practice description, training location, factors deemed important in practice location decisions, and job satisfaction. RESULTS A total of 122 survey responses were collected, with a similar proportion of participants in academic versus community practice. The majority of respondents (73 per cent) practised in the same province as their residency training. Participants identified job vacancy, colleague interaction, spouse opinion and hospital services as important in the decision of practice location. CONCLUSION Key determinants of practice location among Canadian otolaryngologists include job vacancies, spouse opinion, and colleague interactions. Overall, Canadian otolaryngologists report high satisfaction with current employment.
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Morzycki A, Retrouvey H, Alhalabi B, Efanov JI, Al-Youha S, Ahmad J, Tang DT. The Canadian Plastic Surgery Workforce Analysis: Forecasting Future Need. Plast Surg (Oakv) 2018; 26:269-279. [PMID: 30450346 PMCID: PMC6236507 DOI: 10.1177/2292550318800328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Projecting the demand for plastic surgeons has become increasingly important in a climate of scarce public resource within a single payer health-care system. The goal of this study is to provide a comprehensive workforce update and describe the perceptions of the workforce among Canadian Plastic Surgery residents and surgeons. METHODS Two questionnaires were developed by a national task force under the Canadian Plastic Surgery Research Collaborative. The surveys were distributed to residents and practicing surgeons, respectively. RESULTS Two-hundred fifteen (49%) surgeons responded, with a mean age of 51.4 years (standard deviation [SD] = 11.5); 78% were male. Thirty-three percent had been in practice for 25 years or longer. More than half of respondents were practicing in a large urban center. Fifty-nine percent believed their group was going to hire in the next 2 to 3 years; however, only 36% believed their health authority/provincial government had the necessary resources. The mean desired age of retirement was 67 years (SD = 6.4). We predict the surgeons-to-population ratio to be 1.55:100 000 and the graduate-to-retiree ratio to be 2.16:1 within the next 5 to 10 years. Seventy-seven (49%) residents responded. Most were "very satisfied" with their training (61%) and operative experience (90%). Eighty-nine percent of respondents planned to pursue addqitional training after residency, with 70% stating that the current job market was contributing to their decision. Most residents responded that they were concerned with the current job market. CONCLUSIONS The results of this study predict an adequate number of plastic surgeons will be trained within the next 10 years to suit the population's requirements; however, there is concern that newly trained surgeons will not have access to the necessary resources to meet growing demands. Furthermore, there is an evident shortage of those practicing in rural areas. Many trainees worry about the availability of jobs, despite evidence of active recruitment. The workforce may benefit from structured career mentorship in residency and improved transparency in hiring practices, particularly to attract young surgeons to smaller communities. It may also benefit from a coordinated national approach to recruitment and succession planning.
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Affiliation(s)
- Alexander Morzycki
- The Canadian Plastic Surgery Research Collaborative, Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Canada
| | - Helene Retrouvey
- The Canadian Plastic Surgery Research Collaborative, University of Toronto, Toronto, Ontario, Canada
| | - Becher Alhalabi
- The Canadian Plastic Surgery Research Collaborative, McGill University, Montreal, Quebec, Canada
| | - Johnny Ionut Efanov
- The Canadian Plastic Surgery Research Collaborative, University of Montreal, Montreal, Quebec, Canada
| | - Sarah Al-Youha
- The Canadian Plastic Surgery Research Collaborative, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jamil Ahmad
- The Canadian Plastic Surgery Research Collaborative, University of Toronto, Toronto, Ontario, Canada
| | - David T. Tang
- The Canadian Plastic Surgery Research Collaborative, Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Canada
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Harrill WC, Melon DE, Seshul MJ, Katz MS, Zanation AM. Contemporary analysis of practicing otolaryngologists. Laryngoscope 2018; 128:2490-2499. [DOI: 10.1002/lary.27196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/26/2018] [Accepted: 02/28/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Willard C. Harrill
- Carolina Ear, Nose & Throat/Head and Neck Surgery Center, PA; Hickory North Carolina
- Department of Otolaryngology Wake Forest Baptist Medical Center; Winston-Salem North Carolina
| | - David E. Melon
- Department of Otolaryngology Wake Forest Baptist Medical Center; Winston-Salem North Carolina
| | - Merritt J. Seshul
- Department of Otolaryngology Wake Forest Baptist Medical Center; Winston-Salem North Carolina
| | - Marc S. Katz
- Carolina Ear, Nose & Throat/Head and Neck Surgery Center, PA; Hickory North Carolina
| | - Adam M. Zanation
- Department of Otolaryngology/Head and Neck Surgery and Neurosurgery; University of North Carolina at Chapel Hill; Chapel Hill North Carolina U.S.A
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Lango MN, Handorf E, Arjmand E. The geographic distribution of the otolaryngology workforce in the United States. Laryngoscope 2016; 127:95-101. [PMID: 27774588 DOI: 10.1002/lary.26188] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. STUDY DESIGN Cross-sectional study. METHODS The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files. Multiple linear regression tested the association of population, physician, and hospital factors on the supply of Medicare-enrolled otolaryngologists/HRR. RESULTS Two methods of measuring the otolaryngology workforce were moderately correlated across hospital referral regions (Pearson coefficient 0.513, P = .0001); regardless, the supply of otolaryngology providers varies greatly over different geographic regions. Otolaryngologists concentrate in regions with many other physicians, particularly specialist physicians. The otolaryngology supply also increases with regional population income and education levels. Using AMA-derived data, there was no association between the supply of otolaryngologists and staffed acute-care hospital beds and the presence of an otolaryngology residency-training program. In contrast, the supply of otolaryngology providers enrolled in Medicare independently increases for each HRR by 0.8 per 100,000 for each unit increase in supply of hospital beds (P < .0001) and by 0.49 per 100,000 in regions with an otolaryngology residency-training program (P = .006), accounting for all other factors. CONCLUSION Irrespective of methodology, the supply of otolaryngologists varies widely across geographic regions in the United States. For Medicare beneficiaries, regional hospital factors-including the presence of an otolaryngology residency program-may improve access to otolaryngology services. LEVEL OF EVIDENCE NA Laryngoscope, 127:95-101, 2017.
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Affiliation(s)
- Miriam N Lango
- Department of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center, and the Department of Otolaryngology, Temple University School of Medicine, Temple University Health System, Philadelphia, Pennsylvania, U.S.A
| | - Elizabeth Handorf
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania, U.S.A
| | - Ellis Arjmand
- Department of Surgery (Otolaryngology), Texas Children's Hospital, and the Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
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Hughes CA, McMenamin P, Mehta V, Pillsbury H, Kennedy D. Otolaryngology workforce analysis. Laryngoscope 2016; 126 Suppl 9:S5-S11. [PMID: 27576957 DOI: 10.1002/lary.26238] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/07/2016] [Accepted: 06/28/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. STUDY DESIGN Retrospective analysis of research databases, public use files, and claims data. METHODS The total number of otolaryngologists and current practices in the United States was tabulated using the databases of the American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Board of Otolaryngology, American College of Surgeons, Association of American Medical Colleges, National Center for Health Statistics, and Department of Health and Human Services. Otolaryngologists were identified as surgeons and classified into surgical groups using a combination of AMA primary and secondary self-reported specialties and American Board of Medical Specialties certifications. Data gathered were cross-referenced to rule out duplications to assess total practicing otolaryngologists. Data analyzed included type of practice: 1) academic versus private and 2) general versus specialty; and demographics: 1) urban versus rural, 2) patient age, 3) reason for visit (referral, new, established, surgical follow-up), 4) reason for visit (diagnosis), and 5) payer type. RESULTS Analysis from the above resources estimates the total number of otolaryngologists practicing in the United States in 2011 to be 12,609, with approximately 10,522 fully trained practicing physicians (9,232-10,654) and 2,087 in training (1,318 residents and 769 fellows/others). Based on 2011 data, workforce projections would place the fully trained and practicing otolaryngology workforce at 11,088 in 2015 and 12,084 in 2025 unless changes in training occur. The AAO-HNS Physicians Resource Committee performed an extensive analysis of collated data from multiple sources in 2014 and identified 10,800 practicing otolaryngologists and 2,087 in training. It is estimated that the current attrition rate is approximately 306 otolaryngologists per year. Percentage distribution of office visits by patient age was found to be 20% <15 years old, 7% 15 to 24 years old, 21% 25 to 44 years old, 32% 45 to 64 years old, 11% 65 to 74 years old, and 10% ≥75 years old. Reason for visit was 34% new, 29% chronic, 17% chronic with exacerbation, and 15% pre- or postsurgical follow-up. The top diagnoses consisted of otitis media, chronic sinusitis, and impacted cerumen. Payer mix consisted of 59% private insurance, 19% Medicare, and 12% Medicaid/Children's Health Insurance Program. CONCLUSIONS Despite past findings and predictions of 8,000 to 8,500 otolaryngologists practicing in the United States, collated data from above resources places the total at 12,887, with 10,800 fully trained and practicing in 2014. This 30% to 50% underestimation of the otolaryngology workforce has an impact on future predictions and resource utilization analysis. Even when this correction is considered, the available trained otolaryngologists required to serve the otolaryngologic health care needs of the US population are still insufficient and understaffed. The impact of an aging population and the estimated 30 to 47 million newly insured citizens under the 2010 Patient Protection and Affordable Care Act are also unprecedented variables that must be considered. Further analysis of differences in physician productivity and geographic population density, and model formation of current otolaryngology workforce utilization, are needed to predict future public health needs. LEVEL OF EVIDENCE NA Laryngoscope, 126:5-11, 2016.
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Affiliation(s)
- Charles Anthony Hughes
- Departments of Otolaryngology of the Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, U.S.A
| | | | - Vikas Mehta
- Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, U.S.A
| | - Harold Pillsbury
- University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - David Kennedy
- University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
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Vickery TW, Weterings R, Cabrera-Muffly C. Geographic Distribution of Otolaryngologists in the United States. EAR, NOSE & THROAT JOURNAL 2016. [DOI: 10.1177/014556131609500607] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We conducted a study to determine the demographic traits, training characteristics, and geographic distribution of otolaryngologists in the United States using publicly available data. We then correlated our findings with U.S. census data. Univariate analysis was performed to analyze results, with a p value of < 0.05 determined as significant. We used data from the American Board of Otolaryngology's list of 18,587 board-certified allopathic otolaryngologists through 2013 and the American Osteopathic Colleges of Ophthalmology & Otolaryngology–Head & Neck Surgery's list of 428 osteopathic otolaryngologists. From these two databases, 9,642 otolaryngologists met inclusion criteria, which included an active practice in the United States and an age of 70 years and younger. This group was made up of 8,185 men (84.9%) and 1,449 women (15.0%); we were not able to identify the sex of 8 otolaryngologists (0.1%). The median age of the women was significantly lower than that of the men (54 vs. 48 yr; p < 0.001). A total of 8,510 otolaryngologists (88.3%) graduated from a U.S. allopathic medical school, and 8,520 (88.4%) graduated from a U.S. allopathic residency program. We determined that 25.9% of otolaryngologists established their practice in the same metropolitan statistical area where they completed their residency training. Older practitioners (p < 0.001) and women (p < 0.001) were significantly more likely to stay in the same area than younger physicians and men. In terms of population, 61.8% of the otolaryngologists practiced in metropolitan areas with more than 1 million residents; by comparison, these areas represent only 55.3% of the total U.S. population, indicating that otolaryngologists are over-represented in larger U.S. cities.
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Affiliation(s)
- Thad W. Vickery
- Department of Otolaryngology, University of Colorado
School of Medicine, Aurora
| | - Robbie Weterings
- Department of Natural Resources and Environment,
Naresuan University, Phitsanulok, Thailand
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Marple BF. American Academy of Otolaryngic Allergy CME Report: Allergy; Scope of knowledge. Otolaryngol Head Neck Surg 2016; 136:8-10. [PMID: 17210324 DOI: 10.1016/j.otohns.2006.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 08/04/2006] [Indexed: 10/23/2022]
Affiliation(s)
- Bradley F Marple
- Department of Otolaryngology, Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9035, USA.
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Okera N, Escabasse V, Coste A, Albers AE. ORL residency in France: Satisfaction and training quality in 2013. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:327-32. [PMID: 26403653 DOI: 10.1016/j.anorl.2015.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the quality of ORL training in France and hierarchical relationships, working conditions and quality of life, based on a questionnaire answered by ORL residents and fellows. MATERIAL AND METHODS The anonymous questionnaire covered the following topics (106 questions): structure of training, supervision by superiors, involvement in teaching medical students, work for publication, working conditions, quality of life and practical and surgical skills. RESULTS One hundred and seventeen questionnaires were included, with 56% female respondents and 78% resident respondents. A total of 80% of respondents would choose the same training again, with overall satisfaction of 70%. In total, 71% felt appreciated, with responsibilities matching their level of training (85%). Supervisors were supportive (85%) and showed good teaching ability (92%). Residents were mainly guided by fellows (70%), or consultants (60%). Providing good training was an important aim for the training structures (78%). Respondents worked 11 hours per day, with a median of 4 duties per month; the post-duty rest-day was fully respected in the case of 38% of respondents. Surgical procedures were taught and delegated step by step, shared fairly between residents, in a large majority of cases. Training progression was in line with seniority. CONCLUSIONS Overall satisfaction, quality and supervision of ORL training were good in France. There remain geographical differences in terms of theoretical and surgical training.
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Affiliation(s)
- N Okera
- Département d'otorhinolaryngologie, chirurgie cervico-faciale, maxillo-faciale et plastique, Hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75010 Paris, France; Université Paris Diderot, UFR de médecine Paris VII - Denis Diderot, France
| | - V Escabasse
- Service d'otorhinolaryngologie, stomatologie et chirurgie cervico-faciale, Hôpital intercommunal de Créteil, 40, rue Verdun, 94000 Créteil, France; Université Paris Est Créteil Val-de-Marne, Unité Inserm 955, France
| | - A Coste
- Service d'otorhinolaryngologie, stomatologie et chirurgie cervico-faciale, Hôpital intercommunal de Créteil, 40, rue Verdun, 94000 Créteil, France; Université Paris Est Créteil Val-de-Marne, Unité Inserm 955, France
| | - A E Albers
- Klinik für Hals- Nasen-, Ohrheilkunde, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany
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Smith KA, Sommer DD, Grondin S, Rotenberg B, Tewfik MA, Kilty S, Wright E, Janjua A, Lee J, Diamond C, Rudmik L. Assessment of the current Canadian rhinology workforce. J Otolaryngol Head Neck Surg 2015; 44:15. [PMID: 25956996 PMCID: PMC4432821 DOI: 10.1186/s40463-015-0070-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/29/2015] [Indexed: 11/16/2022] Open
Abstract
Background The Canadian Rhinologic workforce and future needs are not well defined. The objective of this study was to define the current demographics and practice patterns of the Canadian Rhinologic workforce. Outcomes from this study can be used to perform rhinologic workforce needs assessments. Methods A national survey was administered to all Canadian otolaryngologists who were identified to have a clinical practice composed of >50% rhinology. Results 42 surgeons participated in the survey (65% response rate). The mean age was 46 (SD 10.1) years and the average age of planned retirement was 66 (SD 4.0). Eighty three percent of respondents had completed a rhinology fellowship and 17% practiced exclusively rhinology. Thirty three percent hold advanced degrees. Forty two percent of surgeons felt their access to operative time was insufficient. Six percent of surgeons reported not having access to image guided surgery. Fourteen percent felt that there were too many practicing rhinologists in Canada while 17% believed there were too few practicing rhinologists. Seventeen percent have advised their residents to pursue other fields due to a perceived lack of future jobs. Overall, 66% of respondents were satisfied with their income, and 83% were satisfied with their careers. Conclusions This study has demonstrated that there is a perceived mismatch between the current supply of Rhinology labor and the capacity to treat patients in a timely manner. Outcomes from this study will begin to improve Rhinologic workforce planning in Canada and reduce the gap between patient demand and access to high quality care.
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Affiliation(s)
- Kristine A Smith
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery; University of Calgary, Calgary, Alberta, Canada.
| | - Doron D Sommer
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
| | - Sean Grondin
- Division of Thoracic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
| | - Brian Rotenberg
- Department of Otolaryngology, Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.
| | - Marc A Tewfik
- Department of Otolaryngology, Head and Neck Surgery; McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
| | - Shaun Kilty
- Department of Otolaryngology, Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
| | - Erin Wright
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
| | - Arif Janjua
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
| | - John Lee
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
| | - Chris Diamond
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
| | - Luke Rudmik
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery; University of Calgary, Calgary, Alberta, Canada.
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Gruca TS, Nam I, Tracy R. Reaching rural patients through otolaryngology visiting consultant clinics. Otolaryngol Head Neck Surg 2014; 151:895-8. [PMID: 25281751 DOI: 10.1177/0194599814553398] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Providing otolaryngology care to rural populations is a major challenge. In this study, we focus on rural outreach by the otolaryngology workforce in Iowa, a state with a high proportion of rural residents. Using data from 2013, we find that almost half (46%) of Iowa-based otolaryngologists participate in outreach. Along with colleagues from adjoining states, Iowa otolaryngologists staffed more than 2100 in-person clinic days in 76 mainly rural sites. This system of rural outreach has expanded access from 20 to 85 of the 99 counties in Iowa. These efforts improve access for more than 1 million residents out of a total population of 3 million. However, this improved level of access comes at a cost as visiting otolaryngologists drove an estimated 17,000 miles per month. This established approach to serving rural patients may be negatively impacted by changes under the Affordable Care Act.
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Affiliation(s)
- Thomas S Gruca
- Tippie College of Business, University of Iowa, Iowa City, Iowa, USA
| | - Inwoo Nam
- College of Business and Economics, Chung-Ang University, Seoul, South Korea
| | - Roger Tracy
- Office of Statewide Clinical Education Programs, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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Mims JW. Epidemiology of allergic rhinitis. Int Forum Allergy Rhinol 2014; 4 Suppl 2:S18-20. [PMID: 25182349 DOI: 10.1002/alr.21385] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 06/29/2014] [Accepted: 06/30/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is the archetypal allergic disease otolaryngologists encounter. Epidemiologic studies inform providers of the association of rhinitis symptoms and allergy test results in the broader population. Understanding the epidemiological characteristics of AR is important for interpreting both rhinitis symptoms and allergy tests. METHODS Articles were selected based on literature review through PubMed and personal knowledge of the author. The largest and highest-quality studies were included. The search selection was not standardized. RESULTS Epidemiological studies demonstrate marked variability globally in the prevalence of both rhinitis symptoms and allergy tests. Self-reported seasonal or perennial rhinitis symptoms significantly overestimate the prevalence of AR defined by a positive history and positive allergy tests. Positive allergy tests are also common in those without self-reported rhinitis symptoms. CONCLUSION Interpreting rhinitis symptoms and allergy testing is enhanced by an understanding of the epidemiology of AR.
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Affiliation(s)
- James W Mims
- Department of Otolaryngology, Wake Forest School of Medicine, Winston Salem, NC
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Oker N, Escabasse V, Pensky H, Alotaibi N, Coste A, Albers AE. Training satisfaction and work environment in Otorhinolaryngology, Head and Neck surgery: a comparison between France and Germany. Eur Arch Otorhinolaryngol 2014; 271:2565-73. [PMID: 24777563 DOI: 10.1007/s00405-014-3046-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 04/01/2014] [Indexed: 11/26/2022]
Abstract
With the coalescing of Europe, increased mobility of professionals emerges. Initiatives to harmonize medical education were launched. In Otolaryngology, Head and Neck surgery (ORL) an European board examination was created to ensure standards. Quality of training, satisfaction and quality of life of residents and recent ORL specialists were compared to assess different aspects of work and hierarchical relationships in France (FRA) and Germany (GER) by means of an anonymous questionnaire. 120 FRA and 125 GER questionnaires were included. 78 % of respondents were residents. 86 % would choose the same training again. In both countries, a majority felt well considered with responsibilities adapted to their level of training and with supportive supervisors. Germans reported average daily work hours of 9.6 versus 11 in FRA with compensated overtime (76 %) and a possibility of part-time work (62 %), both nearly inexistent in FRA. In GER, the day-off after duty was more often respected. French attributed their seniors better pedagogic skills, taking time for explanations and providing better teaching. Offering a good training was a more important objective in French training centers (77 vs. 51 %). In both countries, surgical training relied on coaching. Research activities were comparable. The overall satisfaction with ORL training was high. Differences concerned structure of training, guidance by senior doctors and the working conditions. The study results provide guidance before choosing a program and may help to improve current training by identifying positive aspects that, if combined could lead to a convergence of programs. However, present high standards of education must be maintained.
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Affiliation(s)
- Natalie Oker
- Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
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Kim JSC, Cooper RA, Kennedy DW. Otolaryngology-head and neck surgery physician work force issues: an analysis for future specialty planning. Otolaryngol Head Neck Surg 2014; 146:196-202. [PMID: 24436481 DOI: 10.1177/0194599811433977] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To predict future trends in the otolaryngology workforce and propose solutions to correct the identified discrepancies between supply and demand. STUDY DESIGN Economic modeling and analysis. SETTING Data sets at national medical and economic organizations. SUBJECTS AND METHODS Based on current American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and National Residency Matching Program data sets, population census data, and historical physician growth demand curves, the future otolaryngology workforce supply and demand were modeled. Adjustments were made for projected increases in mid-level providers, increased insurance coverage, and the potential effects of lifestyle preferences. RESULTS There are currently approximately 8600 otolaryngologists in the United States. Estimated demand by 2025 is 11,127 based on projected population growth and anticipated increase in insurance coverage. With an average retirement age of 65 years and no increase in PGY-1 positions for the specialty, the number of otolaryngologists in 2025 will be approximately 2500 short of projected demand. This shortfall will not be adequately compensated by mid-level providers performing less intensive services and may be increased by lifestyle preferences and changing demographics among medical students and residents. The current geographic maldistribution of otolaryngologists is likely to be exacerbated. CONCLUSION The specialty needs to actively plan for the coming otolaryngologist shortage and train mid-level providers within the specialty. Failure to plan appropriately may result in a reduction in scope of practice of high-intensity services, which will likely remain a physician prerogative. Given the limited likelihood of a significant increase in residency slots, strong consideration should be given to shortening the base otolaryngology training program length.
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Affiliation(s)
- Jin Suk C Kim
- The Wharton School, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Bailey SE, Franzese C, Lin SY. Allergy education in otolaryngology residency: a survey of program directors and residents. Int Forum Allergy Rhinol 2013; 4:104-9. [DOI: 10.1002/alr.21256] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/18/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Sarah E. Bailey
- Department of Otolaryngology and Communicative Sciences; University of Mississippi Medical Center; Jackson MS
| | - Christine Franzese
- Department of Otolaryngology; Eastern Virginia Medical School; Norfolk VA
| | - Sandra Y. Lin
- Department of Otolaryngology; Johns Hopkins School of Medicine; Baltimore MD
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Creighton FX, Poliashenko SM, Statham MM, Abramson P, Johns MM. The growing geriatric otolaryngology patient population: A study of 131,700 new patient encounters. Laryngoscope 2012; 123:97-102. [DOI: 10.1002/lary.23476] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/26/2012] [Accepted: 05/08/2012] [Indexed: 11/06/2022]
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Mayer ML, Beil HA, von Allmen D. Distance to care and relative supply among pediatric surgical subspecialties. J Pediatr Surg 2009; 44:483-95. [PMID: 19302846 DOI: 10.1016/j.jpedsurg.2008.08.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 08/08/2008] [Accepted: 08/11/2008] [Indexed: 12/20/2022]
Abstract
BACKGROUND/PURPOSE The aim of this study is to describe geographic proximity to and quantify relative supply of 7 pediatric surgical specialties in the United States. METHODS Data from the 2005 American Medical Association Physician Masterfile and the Claritas Pop-Facts Database were used to calculate subspecialty-specific, population-weighted, straight-line distances between each zip code centroid and the nearest provider. These same data sources were used to calculate the percentage of hospital referral regions with a provider, the percentage of the younger than 18 years population living within selected distances of providers, and provider-to-population ratios for each of the pediatric surgical subspecialties. Further, we calculated the correlation between practice locations and children's hospitals offering pediatric surgical services. RESULTS Across pediatric surgical specialties, average distances to the nearest provider ranged from 27.1 miles for pediatric surgery to 100.9 miles for pediatric cardiothoracic surgery. The average population-weighted distance to a provider was less than 30 miles for pediatric surgery and pediatric ophthalmology only. For 5 of the 7 pediatric surgical specialties studied, approximately one quarter of the younger than 18 years population lives more than 1-hour drive from a provider. Provider-to-younger than 18 years population ratios range across hospital referral region from 0.04 per 100,000 for pediatric cardiothoracic surgery to 0.97 per 100,000 for pediatric surgery. The correlation between pediatric surgeons and children's hospitals offering services was 0.72. CONCLUSIONS Although the practice locations of pediatric surgical subspecialties parallel the geographic distribution of children in the United States, large percentages of the younger than 18 years population must travel long distance to receive care from these providers. Large coefficients of variation reveal substantial maldistribution. These findings lay the groundwork for workforce assessments of the pediatric surgical subspecialties and underscore the need for future studies that assess access barriers for children in need of surgical care.
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Affiliation(s)
- Michelle L Mayer
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Raynor EM. Practice Patterns in Academic Otolaryngology 2006: A Tool for the Future. EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808701209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although the American Academy of Otolaryngology–Head and Neck Surgery conducts a workforce survey annually, no study has been conducted to examine practice patterns as they pertain specifically to academic otolaryngology. Therefore, I developed the Academic Otolaryngologist Survey for this purpose. This survey, conducted in 2006, was mailed to 856 practicing otolaryngologists in the United States; 230 responded, for a return rate of 26.9%. Of the 230 respondents, 94% practiced full-time, 97% worked with otolaryngology residents and were hoard certified, and 67% had fellowship trainingin one or more subspecialties. The most commonly reported fellowships were in pediatric otolaryngology, facial plastic surgery, head and neck, and otology/neurotology. Respondents answered that they felt practice patterns had changed. Unlike the private-practice sector, academic otolaryngology is seeing a shift from generalists to subspecialists. The subspecialization becoming prevalent in academic otolaryngology may ultimately alter resident training. Therefore, academic programs need a balance of general and subspecialized otolaryngologists in order to train residents for practice.
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Affiliation(s)
- Eileen M. Raynor
- From the Department of Otolaryngology, University of Florida/Jacksonville Health Science Center, Jacksonville, Fla
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Hepworth EJ, Bucknor M, Patel A, Vaughan WC. Nationwide survey on the use of image-guided functional endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006; 135:68-73. [PMID: 16815185 DOI: 10.1016/j.otohns.2006.01.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Accepted: 01/10/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate impressions and usage of sinus surgery image-guided surgical (IGS) systems by ENT surgeons in the United States. STUDY DESIGN AND SETTING A survey was mailed to selected practicing ENT physicians, investigating regional information, practice type, IGS usage patterns, perceived benefits and limitations, and usage of the 61795 surgery code. RESULTS Seventy-three percent of respondents use IGS. Nonusers respond that it provides no benefit or is too expensive. Eighty percent of respondents replied that IGS may allow for increased safety in certain procedures. Most users attempt reimbursement with the 61795 code. CONCLUSION IGS usage is increasing but appears to be perceived as expensive and nonbeneficial in certain situations. Most respondents, however, felt that IGS may lead to safer surgery in certain situations, including revision and frontal procedures. Several factors appear to limit routine use including ease of use, technical setup, code reimbursement, and initial purchase costs. SIGNIFICANCE IGS use appears to be increasing. The most frequent users appear to agree with the previously issued AAO-HNS guidelines regarding appropriate indications. Expanded use may depend on ease of use, reimbursement, and affordability. EBM RATING D-5.
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Affiliation(s)
- Edward J Hepworth
- Associates of Otolaryngology, P.C., 950 E. Harvard Avenue, Denver, CO 80210, USA.
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Cannon CR, Giaimo EM, Lee TL, Chalian A. Special report: reassessment of the ORL-HNS workforce: perceptions and realities. Otolaryngol Head Neck Surg 2004; 131:1-15. [PMID: 15243549 DOI: 10.1016/j.otohns.2004.02.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This Workforce Study re-examined the current scope and geographic distribution of Otolaryngology practice and assessed the otolaryngologists' role in relation to other specialists in the diagnosis and treatment of disorders of the ear, nose, throat, and related structures of the head and neck. Study design A national survey and review of federal, corporate and administrative databases, coupled wih a focus group of otolaryngologists, were analyzed to compile physician manpower figures, state and regional demographic data, and prediction modeling of Managed Care and FFS environments. RESULTS The current and predicted workforce supply and demographic data support a geographic and proportionate increase in the number of otolaryngologists practicing and entering the workforce. Additional findings involving the role of the specialty specifically identified an increase in the treatment of allergic disease within the Managed Care sector and a diminution of the gatekeeper concept. Demographic findings represent a stable age distribution of 40 to 49 and 50 to 59 year old otolaryngologists, with a noted increase in the number of women entering the field. Empiric data reflects the continuous, diverse and dominant role otolaryngologists maintain in the treatment and care of patients with otolaryngologic and head and neck disease. CONCLUSIONS This study continues the effort to identify otolaryngology workforce demographic profiles and make recommendations for a future national practice model. Continuous reassessment of the specialty is required.
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Affiliation(s)
- C Ron Cannon
- Head and Neck Surgical Group, Jackson, MS 39296, USA
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Parker MJ, Lucas J. Adding allergy to your practice. Otolaryngol Clin North Am 2003; 36:837-54. [PMID: 14743776 DOI: 10.1016/s0030-6665(03)00060-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The ability to blend the management of allergic disease into the general treatment of head and neck disease is core to the otolaryngologist's role as regional specialist of the upper aerodigestive tract. Allergy training is now considered an integral component of the residency curriculum established by the American Board of Otolaryngology. By obtaining any needed additional training through organizations such as the AAOA and by validating that education by obtaining fellowship status in the AAOA, the postgraduate otolaryngologist who adds allergy to his or her practice will find the techniques to be safe, effective, and of great benefits to patients.
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Affiliation(s)
- Michael J Parker
- Community General Hospital, Physicians Office Building North, Suite 35, Broad Road, Syracuse, NY 13215, USA.
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Otolaryngic allergy in the new millennium. Curr Opin Otolaryngol Head Neck Surg 2002. [DOI: 10.1097/00020840-200206000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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