Legacy of Excellence Digital Flipbook

LEGACY OF EXCELLENCE

two members, both of whom called me independently to suggest I apply.” With the departure in 1999 of Academy EVP, Michael D. Maves, MD, MBA, the position of EVP had suddenly and unexpectedly become open. Dr. Nielsen initially responded to his colleagues’ suggestions with disbelief. He shared his thoughts with his wife, Becky, and he began to feel he could be, as he put it, “… a credible (even if I had no chance of success) candidate whose role in the application process would be to give the ‘everyman’ perspective of the community based otolaryngologist toward the EVP role and the Academy’s value to the rank-and-file members.” He went through the selection process, interviewing with the Search Committee chaired by Harold C. Pillsbury III, MD. G. Richard Holt, MD, was chosen by the committee, but Dr. Nielsen gained important experience and was told he had been a finalist. “I secretly congratulated myself for fulfilling my role in the selection process by interviewing for the position,” he concluded of that moment. A Second Shot Unexpectedly, the EVP position opened again 2002 and Dr. Nielsen received the message that his candidacy for the position would be welcomed. Dr. Nielsen said of that moment, “I was determined to be a strong voice for advocating for the role the EVP could and should play in the specialty’s growth and progress as great upheavals in science, education, politics, and healthcare delivery and financing were taking place.” The specialty had not as yet appointed an EVP from the private practice ranks or from west of the Mississippi. “I didn’t expect that to change. But I did feel my voice, my perspective, and my passion for how medicine was changing and needed to change in the fairly immediate future would aid in the selection process as determined by a search Committee headed by K.J. Lee, MD. Following a series of interviews, I was chosen by the committee and approved by the Board of Directors. No one was more surprised than I when I was offered the position,” Dr. Nielsen said. Becoming EVP in 2002 offered the perfect opportunity to pursue a cause near and dear to Dr. Nielsen, establishing a “quality-based” program. Seminal studies emerged during the 1990s in the medical literature, “To Err Is Human” and “Crossing the Quality Chasm,” that revealed significant gaps in

the quality of patient care. While working within the BOG, Dr. Nielsen had been following this new focus on healthcare’s quality. And as a result, he had been assigned through his roles in the BOG leadership and other committees to represent the Academy at a few national meetings convened to discuss quality improvement topics. “My reports back to the BOD were received perfunctorily and it was clear that even though they listened, the Board was not ready for significant change at that time,” he said. Societal Change: Building the Infrastructure As the new EVP, Dr. Nielsen felt he had been given a “bully pulpit” to convince and guide the organization in addressing its quality improvement as not only the right thing to do, but as an inevitable mandate that would be imposed, if not taken up within the specialty. He had powerful examples of other specialties working on quality care already. Primary care specialties were setting standards and developing programming to define and measure quality care. Medicare and other insurers had begun to establish standards for treatment effectiveness in payment considerations. Like most specialty societies, the AAO-HNS/F had functioned solely on the self-identified needs of its members, especially for education and support for their practice through advocacy. Dr. Nielsen drew a candid picture at the time of what this change would bring for the organization a decade forward. In the future, he conveyed, effectiveness and quality measures would guide care decisions upending long held traditions of physician autonomy. Dr. Nielsen and the AAO-HNS/F needed to help members meet the challenge. He said this meant, “stepping out ahead of the membership who were not yet aware of the magnitude and impact of coming changes in payment for healthcare; educating and informing them; and eliciting their willingness to champion change for the benefit of patients and their healthcare needs. Such lofty goals as these would require a fairly drastic culture change in how members would see and value their specialty society.” The Agenda with Determination Dr. Nielsen’s was clear about where he wanted to go. “It was my stated goal to help the Academy/Foundation adopt such a course and take a leadership role in the greater house of medicine in advancing quality improvement, medical error reduction, and setting standards for performance and outcomes measurement.

82