Contemporary analysis of practicing otolaryngologists.

OBJECTIVES/HYPOTHESIS: To investigate contemporary issues facing practicing otolaryngologists including workforce dynamics, ancillary service modeling, otolaryngic allergy integration, ambulatory surgery center utilization, and relevant certificate of need legislation.

STUDY DESIGN: A cross-sectional survey analysis of academic and private practicing otolaryngologists in North and South Carolina in 2016.

METHODS: A cross-sectional survey was e-mailed to 510 practicing otolaryngologists in North and South Carolina.

RESULTS: A 21.3% survey response rate was achieved. Otolaryngology workforce was defined by horizontal aggregation of otolaryngologists into larger group models, with fewer solo practitioners being replaced by younger otolaryngologists or employing otolaryngology extenders. Excluding academic practice, few otolaryngologists have chosen direct hospital employment as a career option, although otolaryngologists with fewer years of practice are pursuing that option with greater frequency. Ancillary services showed audiology and hearing aid services being the most common, followed by otolaryngic allergy, point-of-service computed tomography, and ultrasound. Although otolaryngologists tend to avoid vertical integration, ambulatory surgery center (ASC) ownership trends favor a joint venture model with a hospital system partner. Most otolaryngologists favor changes to certificate of need legislation to improve patient access to these lower-cost facilities, regardless of whether they currently utilize or have access to an ASC.

CONCLUSIONS: Otolaryngology is uniquely positioned to adapt and respond to current paradigm shifts within ambulatory medicine. Further analysis is needed to prepare current and future otolaryngologists for the demands and opportunities these challenges pose as patient-centered care models and consumer dynamics shape future patient expectations and utilization of healthcare.

LEVEL OF EVIDENCE: 5. Laryngoscope, 2490-2499, 2018.