Otolaryngology ~ Head and Neck Surgery Volume 112 Number 5
Instruction Courses -- Tuesday
prehensive plan of capitating services for a population of...
Otolaryngology ~ Head and Neck Surgery Volume 112 Number 5
Instruction Courses -- Tuesday
prehensive plan of capitating services for a population of patients. The demands placed on otolaryngologists to determine if they are receiving equitable reimbursement under such a payment system are different than those that we have traditionally used in fee-for-service reimbursement schemes. The purpose of this presentation is to present to practicing otolaryngologists a logical method of assessing their own practice costs and estimating an equitable reimbursement rate for their practice. This will be done using elementary accounting techniques and an explanation of the essentials of capitation. A number of illustrative models from the senior author's own experience as the provider for a capitated health plan for otolaryngology services in a major metropolitan area will be used to illustrate the features and factors necessary for practicing otolaryngologists to successfully manage their own capitated arrangements.
COURSE 3740- I One-period course ($20)
R o o m N O C C - 103 3:00-4:00
OtitisMedia 1995--An Update for the General Otolaryngologist CRAIG S.DERKAY, MD Norfolk, Va.
Educational objectives: To discuss objectively with their referring physicians the recent otitis media literature and to critically evaluate the "landmark" otitis media articles of the past year.
Ongoing clinical research concerning otitis media in children is spread out between the various otolaryngology and pediatric journals. This situation makes it particularly difficult for the practicing clinician to keep up with the latest advances. Those clinicians who make the effort to stay abreast of the research emanating from both disciplines complain that bias exists under this system--pediatric studies tend to conclude that nonsurgical management strategies are superior, whereas otolaryngology studies tend to conclude that surgical management strategies are superior. This course will review the recent otitis media literature across both disciplines and attempt to provide the practicing otolaryngologist with a balanced view. Topics to be discussed include the relative roles of systemic steroids and long-term prophylactic antibiotics vs. the placement of ventilation tubes in the management of chronic middle ear effusions, newly available antirnicrobials in the management of acute and recurrent otitis media, and practical recent advances in predicting the need for surgical intervention in children with otitis media.
COURSE 3741-I O n e - p e r i o d course ($20)
P 147
Room NOCC-104 3:00-4:00
Voice Evaluation: State of the Art GREGORYA. GRILLONE,MD, and GEORGECHARPIED,PhD
Boston, Mass.
Educational objectives: To perform a collection of patient information, videolaryngoscopy, videolaryngostroboscopy, and acoustic data using a rigorous data collection scheme and to use a computerized interface for digitizing acoustic, video and patient data into a multimedia database for archiving and retrieval.
Voice evaluations have dramatically changed our ability to manage patients with voice disorders. Dynamic studies such as video laryngostroboscopy give us detailed information about the vibrating pattern of the vocal fold cover. Videolaryngoscopy using flexible fiberoptic scopes allows visualization of the larynx during connected speech. Acoustic recording provides objective data about pitch and intensity. This objective documentation provides a permanent record which is useful for patient teaching, for review cases with other voice and health care professionals, as well as for education of students of otolaryngology and speech pathology. It also provides medicolegal documentation of the findings. It is very helpful in determining efficacy of medical, surgical or voice therapy. Indications for and general techniques of video laryngostroboscopy, videolaryngoscopy and acoustic recording will be discussed. Emphasis will be placed on use of standardized forms for obtaining accurate and detailed voice history as well as for recording the objective data. Use of standardized tasks for obtaining objective data will be reviewed. Normal findings as well as examples of abnormal findings from videolaryngostroboscopy, videolaryngoscopy and acoustic analysis will be discussed. Computerization of data will be discussed. This will include transfer of information to a multimedia database which will allow for the retrieval of type-written reports, digitized video movies and acoustic samples from voice evaluation as a computerized archive. The software and hardware setup necessary to allow for data archiving and retrieval will be discussed.