Special 125th Anniversary Issue – Bulletin

"Inspired leadership at all levels in the Academy and our medical practices, built on a foundation of mutual respect, trust, shared aspirations, and goals, will allow us to further grow as a high-achieving culture and to function as a high-performance specialty yielding astonishing results in propelling our profession to new heights in the next 125 years!"

that needs to be told as these benefits come with significant strings attached. PE has not seen meaningful penetration in otolaryngology. High-performing medical practices (independent, integrated, academic) will require strong physician leadership as it relates to strategy, alignment, and accountability. Operational capability and execution will ensure future success. Whatever the model, in order to provide high-impact clinical care, the practice must be physician-led and team-based, with strong attention to both operational performance and financial performance. Patient Care AAO-HNS and practicing otolaryngologists will continue to demonstrate the value that we provide based on quality pathways and evidence-based research, working with specialty societies and industry partners to enable best care parameters for all groups, utilizing advanced registry functions to guide and improve patient care. The trend will continue for providing patient care in lower-cost settings, transitioning from hospital-based care to ambulatory settings, including office-based practice/surgery and ambulatory surgery centers as well. The role of digital health and technology in patient care was discussed earlier. Telehealth technology and remote patient monitoring will likely see increased adoption, although to a lesser extent in otolaryngology. This has the potential to drive new patient acquisition, additional revenue, and reduce patient leakage, while improving patient access and satisfaction and closing gaps in care. In conclusion, while there are many challenges ahead, there are great opportunities arising from future disruption in healthcare as well. Inspired leadership at all levels in the Academy and our medical practices, built on a foundation of mutual respect, trust, shared aspirations, and goals, will allow us to further grow as a high-achieving culture and to function as a high-performance specialty yielding astonishing results in propelling our profession to new heights in the next 125 years!

including contracted hospital relationships, are mechanisms for enhancing private practice independence and practice efficiency through larger scale enterprises, while maintaining independence. There is also increasing interest in management service organizations, where a nonprofessional entity can provide nonclinical administrative services. For example, billing and collections, administrative staff, HR, IT, and marketing services to professional practices through an administrative services agreement, lowering cost, and improving efficiency through economy of scale. Other factors challenging both private practice and employed physician models include future supply of otolaryngologists, the cost of higher education, the increasing role of subspecialization, the role of advanced practice providers, and other unpredictable changes in healthcare (pandemic) and healthcare reform. For those otolaryngologists who will choose to transition to an employment model, it is important to set an accurate valuation for your practice, evaluate the right partner, and assess for common goals to identify strategic options to set a course for sustainability with shared vision and mission that is patient-centered. Finally, private equity (PE) firms promote themselves as being able to provide independent practices immediate cash payments, future payouts in a resale, and capital infusion to meet value-based care needs and leadership to generate practice growth while ensuring they will not interfere with clinical operations and day-to-day management. There is a “rest of the story”

transparency, important to both patients and regulators alike. In addition, digital and other emerging technologies, such as AI, robotic process automation, cognitive computing, and VR/AR, will automate and augment tasks performed by most physicians and many surgeons. Otolaryngologists and the AAO-HNS will need to stay at the forefront of evaluating, developing, and implementing these technologies that will shape the future of our specialty in decades ahead. Practice Types Models of otolaryngology practice will continue to evolve, shaped by a variety of factors, including geographic location, practice size, insurance distribution, and other market forces. Well capitalized practices likely have invested in the data infrastructure to utilize data tracking and outcomes measurement to ensure they're distinguishing themselves in a more outcomes-oriented marketplace. As physicians, we will need to continuously reassess our practice environment, business model, opportunities and vulnerabilities, and financial stability in order to remain competitive and viable. The trend toward employed physician practice will likely continue; however, other provider practice models, including solo practice (limited), small-group, large single specialty group, multispecialty organization, and single tax-ID structures will remain as alternatives to the employed model. There is also increasing interest in the concierge (direct pay) model in certain markets. Single tax-ID operations, clinically integrated networks, and joint ventures,

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SPECIAL EDITION: 125TH ANNIVERSARY AAO-HNS BULLETIN ENTNET.ORG/BULLETIN