Treating facial trauma: The otolaryngologists' experience

http://www.ncbi.nlm.nih.gov/pubmed/22095952

Otolaryngol Head Neck Surg. 2011 Nov 16. [Epub ahead of print]
The Otolaryngologist's Cost in Treating Facial Trauma: American Academy of Otolaryngology--Head and Neck Surgery Survey.
McCusker SB, Schmalbach CE.
Source
Yokota Air Base, Japan.

Abstract
Objectives. (1) To define practice patterns and perceptions of junior otolaryngologists treating maxillofacial/neck trauma. (2) To identify manners in which the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) can meet future trauma needs.Study Design. Cross-sectional survey.Setting. Academic and private otolaryngology practices.

Methods. A 26-question survey was designed to identify demographics, practice patterns, perceptions, and areas for improvement in maxillofacial/neck trauma care. It was distributed anonymously to AAO-HNS members completing residency from 2005 to 2009. Analysis included descriptive statistics and χ(2) comparisons.

Results. Of 1343 otolaryngologists, 444 (33%) responded. A total of 85% of responding physicians treat maxillofacial/neck trauma, and 64% identify trauma as an ideal part of their practice. Sense of duty (54%), institutional requirements (33%), and enjoyment (32%) are the most common reasons for treating trauma. Major deterrents include patient noncompliance (60%) and lifestyle limitations (47%). Five respondents (3.1%) have been involved in a trauma-related lawsuit. While insufficient reimbursement is a major deterrent to treating trauma (52%), only 36% would increase their volume if reimbursement improved. Increased educational opportunities represent the most common request to the AAO-HNS (59%), followed by AAO-HNS focus on improved reimbursement and tort reform (28%).

Conclusion. Most junior otolaryngologists treat maxillofacial/neck trauma on a monthly basis. A total of 64% identify trauma as a component of their ideal practice. They report being well to very well trained in all facets of trauma, with the exception of vascular and laryngotracheal injuries; but they desire additional education, such as courses and panels. Universal concerns include inadequate reimbursement, limited pool of treating physicians, and lack of practice guidelines.