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Academy Responds to President’s Remarks on Tonsillectomies Reprinted from the September 2009 Bulletin

path. Without collaboration, no legislation or regulation delivers its promise. The Academy is at the table. It has excelled at bringing about the discussion of hard topics among disparate positions. Such activity is methodical and intense. The specialty needs its members. Now more than ever, when medicine faces economic issues and concerns about physician conflict of interest, member support is essential.” On July 22, 2009, during President Barack Obama’s press briefing discussing the progress of healthcare reform, the President made several statements regarding the motives of physicians when considering whether to perform a tonsillectomy. Responding to a question on what the public might expect regarding potential reductions in benefits or denials of coverage, President Obama replied, “Part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works…. to free doctors, patients, hospitals to make decisions based on what’s best for patient care.” But he suggested that physicians might be influenced to perform tonsillectomy surgeries based on reimbursement rates, in a situation where medical management might be equally efficacious. Members immediately began contacting Academy leadership to express their disappointment about the message the President was sending to the media and public. The next morning the Academy issued a press statement directly addressing the President’s comments. The statement, which was sent out to more than 500 separate media outlets, the White House, and Congress, said: “We, too, are in favor of evidence-based medicine that supports quality patient care. President Obama’s statement highlights the complexity of medical decisions like this. However, the AAO-HNS is disappointed by the President’s portrayal of the decision making processes by the physicians who perform these surgeries. In many cases, tonsillectomy may be a more effective treatment, and less costly, than prolonged or repeated treatments for an infected throat. “For the past several years, the Academy has been developing clinical guidelines based on evidence and

J. Regan Thomas, MD, 2010-2011 President, reiterated that point in the April 2011 Bulletin , “The complex environment of medicine requires more of each of us than it did yesterday. Sometimes that requires that we are heard in legislative venues for quality care. Sometimes that requires that we develop an understanding of the complex issues that bring about the best result for patient care.” outcomes research, including ‘Quality of Life after Tonsillectomy,’ a January 2008 supplement to the journal Otolaryngology—Head and Neck Surgery . We are in agreement with the President’s statement that physicians, patients, and hospitals should make the decisions, based on the evidence, about what’s best for patient care.” After the press release was sent out, the Academy posted the statement to www.entnet.org, tweeted the statement over the official AAO-HNS Twitter feed and included a notice about it in the Academy e-newsletters, including the News and The ENT Advocate. The statement was also shared with our colleagues in the greater house of medicine. In addition, Academy President-elect Ronald B. Kuppersmith, MD, MPH, appeared on Fox News’ America’s Newsroom program on July 28 to further elaborate on why the Academy felt it was necessary to speak out about President Obama’s remarks. Dr. Kuppersmith not only represented the concerns of AAO HNS members, but also the frustration that physicians and surgeons in all specialties felt when they heard the President’s remarks. In addition, the Academy worked with the American Society of Pediatric Otolaryngology (ASPO) to develop a fact sheet entitled “Tonsillectomy Facts in the U.S.”

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