There is a growing crisis in America’s hospitals because of a shortage of both otolaryngologists and other on-call specialists. This crisis causes delays in patient care and may impact the quality of care provided to patients. Otolaryngologists, through their special training in the management of adult and pediatric airway emergencies, facial trauma, foreign bodies and other head and neck emergencies are a vital component of the emergency medical system.
Hospitals have a legal obligation to provide screening and stabilization services to all patients that seek emergency care. As part of this obligation, hospitals are required to maintain a list of physicians who are on-call to treat patients in the emergency department. Otolaryngologists have graciously accepted this responsibility in the past as a requirement related to their utilization of hospital services. Many otolaryngologists no longer have the former tight hospital links, in addition to lacking contractual relationships with the hospital’s payers and this effectively results in the physician providing uncompensated or undercompensated care. Additionally, such in-hospital care often delays care to the ill patients waiting in their office, or adversely affects a physician’s personal life. Physicians can no longer afford to underwrite these hospital services. Given the many rapidly evolving reimbursement models and increasing overhead expenses including the additional liability associated with providing emergency care, these costs to physicians can no longer be sustained, nor can they be recouped. Most otolaryngologists still practice as a small business – as a small group or solo practice. Accordingly, providing uncompensated hospital services adversely impacts their business and translates into the inability to invest in IT infrastructure, forced reductions in their own staffing levels or benefits, or an inability to provide quality care to their patients.
It is the position of the American Academy of Otolaryngology—Head and Neck Surgery that hospitals which include otolaryngology services through their emergency department and/or hospital consulting service should compensate otolaryngologist-head and neck surgeons at fair market value for providing on-call services. This compensation should be in addition to any reimbursement received for patient care provided.
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Workshops held in cities nationwide will help otolaryngologists, their staff, and other healthcare professionals code correctly, learn risk reduction strategies, and organize business systems.