Abstract
#HeForShe: How to Be an Advocate for Your Women Colleagues
Brette C. Harding, MD, MS (moderator); Christine B. Franzese, MD; Alexander G. Chiu, MD; Sujana S. Chandrasekhar, MD
Session Description:
While we continue to make strides for women in otolaryngology, recent literature has shown that women in this field are continuing to face discrimination and sexual harassment at all levels, from medical students to attendings. Frustrating situations that women experience on a daily basis can range from smaller incidents, such as patients or consulting teams addressing a male medical student rather than the female chief resident or attending, to inappropriate sexual comments and blatant sexual harassment. In addition, it is important to note that minority women face further discrimination. Improvements in the work environment that have been achieved so far have been due not only to strong women but to men in the field who have recognized injustices and work hard to correct these. Men and women will need to work together to decrease the inequalities that are still facing women in otolaryngology today. This panel aims to provide participants with the ability to recognize mistreatment of women and give them the tools needed to address these inequalities in the moment.
Outcome Objectives:
(1) Understand the state of gender disparities in otolaryngology today. (2) Recognize and address real-life scenarios of discrimination against women otolaryngologists. (3) Develop strategies to create an inclusive working and learning environment.
#What? 3.0 Social Media in Otolaryngology: Creating Your Brand
Hayley L. Born, MD (moderator); Leslie R. Kim, MD; Clarice Brown, MD; Steven M. Gold, MD
Session Description:
Social media presence is becoming an increasingly important aspect of building a successful medical practice and professional network. In this panel, cosponsored by the American Academy of Otolaryngology–Head and Neck Surgery’s Section for Residents and Fellows (SRF), Young Physicians Section (YPS), and Women in Otolaryngology (WIO) Communications Committee, we will introduce the many social media outlets and how they are used in medicine. Moderated by a #millenial SRF member, we will hear from 3 representatives within this field: an academic facial plastic surgeon with an Instagram following of more than 22,000 people, a young female pediatric otolaryngologist who has helped establish a vibrant online community for female black otolaryngologists, and a self-identified social media novice whose Instagram @drbooger has more than 69,000 followers. Building on successful panel discussions of the past 2 years, this year’s panel will focus on building a brand and an online community. These panelists will discuss the varied ways they utilize social media in their professional lives and how to refine your online presence.
Outcome Objectives:
(1) Understand the different modalities of social media and the uses of social media in the context of medical practice. (2) Gain insight into expert perspectives of residents, fellows, young physicians and prominent women in medicine. (3) Learn about best practices for building a brand and a community through social media.
Bullying in the Workplace: How to Recognize and Respond
Katherine Kavanagh, MD (moderator); Ellen M. Friedman, MD; Jo A. Shapiro, MD; Eugenia M. Vining, MD
Session Description:
Bullying and undermining behavior occur with regularity in the workplace, including hospitals, office settings, academics, and medical education. In surgery, some bullying and undermining behaviors have been normalized as difficult personalities, workplace hierarchy, or simply the status quo, which makes recognizing and addressing these behaviors difficult. Despite seeming “normal,” bullying and undermining behavior have negative consequences on wellness, surgical education, and even patient safety. Although unprofessional behavior is not uncommon, surgeons may feel ill-equipped to recognize and respond to bullying or undermining. Bystanders are often unsure of how to respond and may be concerned about becoming a victim themselves or negatively affecting their own career advancement. In this panel discussion, we will discuss how bullying and undermining may present in a range of practice environments—academics, private practice, and the hospital (operating room, consults, emergency room)—making this panel relevant to all practicing otolaryngologists, advanced practitioners, and trainees. Our panelists will discuss how to identify bullying and undermining behaviors that may be encountered in each of these practice areas and will provide strategies to address and respond to unprofessional behavior. We will present examples of bullying and undermining behavior and discuss responses to these difficult situations.
Outcome Objectives:
(1) Discuss bullying and undermining in the workplace and list examples that may be encountered in varying practice types. (2) List ways to address bullying such as communication techniques, conflict management, and peer feedback. (3) Apply skills in identifying and addressing bullying and undermining behaviors to example situations.
Centering URiM Clinicians: A Road Map to Enhancing Diversity in Otolaryngology
Michael J. Brenner, MD (moderator); Dana M. Thompson, MD, MS, MBA; Valerie A. Flanary, MD; Erynne A. Faucett, MD
Session Description:
Underrepresented in medicine (URiM) practitioners are pivotal as we strive for inclusive excellence amid an increasingly diverse health care and societal landscape. As surgical subspecialists, otolaryngologist–head and neck surgeons have traditionally defined excellence narrowly in terms of diagnostic acumen, technical prowess, and patient outcomes. While such meter sticks are critical for mastery, failure to recognize the context in which care takes place is limiting. For example, it can obscure the connection of our daily work and professional identity to national efforts around diversity, inclusion, and racial justice. This panel seeks to bridge this gap, explaining the rationale and strategies for diversifying the otolaryngology workforce. The panelists consider why a specialty more reflective of society strengthens the profession and advances patient-centered care. The session draws on evidence not only from the scientific literature but also the literature of diverse disciplines—from the work of Pulitzer Prize–winning author Isabelle Wilkerson to the work of Camara Phyllis Jones in advancing the science and practice of anti-racism to the jurisprudence legacy of Kimberlé Crenshaw, whose seminal work in critical race theory demonstrated how race, class, and gender inequities are inextricably intertwined. While many otolaryngologists celebrate the legacy of Ruth Bader Ginsberg in advancing women’s rights, far fewer recognize the parallel work across over 3 decades on intersectionality, which underpins the strategy for centering URiM women in diversity efforts. This panel identifies structural barriers to improving diversity within the specialty and solutions. Otolaryngology continues to have an underrepresentation of racial and ethnic minorities. The specialty must therefore redouble efforts, becoming more purposeful in mentoring, recruiting, and retaining underrepresented populations. The concept of an AIM (all-inclusive multiculturalism) workplace is discussed as a strategy to foster trust, internal motivation, and satisfaction and resources are offered.
Outcome Objectives:
(1) Describe evidentiary basis and rationale for centering URiM otolaryngologists in efforts directed at cultivating a more diverse, equitable, and inclusive specialty. (2) Reveal how contemporary thinking on race and medicine derived from public health, sociology, and economics can inform efforts to enhance diversity and inclusive excellence in otolaryngology. (3) Identify structural interventions that can enhance patient care and diversity, with emphasis on practices and policies that mitigate bias, promote anti-racism, and improve recruitment and retention.
Counseling, Shared Decision Making, and Palliative Surgery
Larissa Sweeny, MD (moderator); Susan D. McCammon, MD; Norman D. Hogikyan, MD; Andrew M. Coughlin, MD
Session Description:
As physicians, our goals are to practice beneficence and nonmaleficence. When it comes to patients facing terminal or unrecoverable illnesses or those at high risk for morbid outcomes following treatment, the best path to these goals becomes less clear. There is a lack of professional practice standards for physicians to follow in these difficult clinical and ethical scenarios. Through collective experience and expertise this program hopes to provide ethical guidance for surgical decision making. This panel will include case examples, direction on how to balance surgical outcomes and patient quality of life, and tools and resources for informed and shared decision making by all parties.
Outcome Objectives:
(1) Offer guidance so participants can consider evidence-based best practice in the context of the patient’s values and prognosis. (2) Inform so participants can describe clinical and ethical considerations to maintain balance between surgery and quality of life. (3) Provide resources to facilitate informed discussions with patients and families.
Defining and Achieving Professional Equity in Different Financial Models
Robin W. Lindsay, MD (moderator); Cherie-Ann O. Nathan, MD; Michael G. Stewart, MD, MPH; Eric J. Moore, MD
Session Description:
The Association of American Medical Colleges report Promising Practices for Understanding and Addressing Salary Equity at U. S. Medical Schools, published in 2019, identified the gender wage gap in academic otolaryngology to be 77 cents on the dollar. A pay gap was identified to exist across all academic ranks. Over a career, this wage gap compounds to a multimillion dollar wealth gap. We must all take an active role in eliminating this pay gap for the future of our specialty. The report highlighted several best practices to ensure salary equity and discusses recommended first steps to take to kick-start a salary initiative. Commitment from institutional leadership to understand and address salary inequity is a vital first step to correcting salary inequities. This panel brings together leaders in otolaryngology from diverse institutional financial models whose departments have made salary equity a priority. We will discuss various compensation models from salaried, to relative value unit based, to cash models and the many variations of each of these plans. Recognizing that there is no perfect model, we will discuss the importance of transparency and the benefits and the negatives of each of these different compensation models. The panelist will discuss how non–revenue-generating activities are accounted for in their compensation plan to incentivize clinical, administrative, and unfunded research activities. In addition, we will discuss different institutional financial models and how these models affect individual departments. Lastly, we will discuss the importance of not only initiating a equitable compensation policy but also developing and using a system of interval equity review processes to identify outliers and how to proactively correct inequities that are discovered.
Outcome Objectives:
(1) Analyze the differences between compensation models. (2) Be able to explain the importance of salary equity and a transparent compensation plan. (3) Understand how to implement a reoccurring equity review process.
Developing Professional Expertise: Plan, Publish, and Present
Rachel A. Georgopoulos, MD (moderator); Stacey L. Ishman, MD, MPH; Bevan Yueh, MD, MPH; Daniel C. Chelius Jr, MD
Session Description:
In the article “The Making of an Expert,” K. Anders Ericsson et al stated, “Consistently and overwhelmingly, the evidence showed that experts are always made, not born.” Developing professional expertise is very feasible, but it does require choosing an appropriate career niche, developing innovative research, and being able to demonstrate knowledge and proficiency. This is attainable with the right mentorship, dedication, and perseverance. The panelists will discuss practical aspects of identifying and developing a career niche. In addition, technical aspects of presenting nationally, whether as a panelist or expert lecturer, will be discussed. This includes practical tips on how to choose a topic to present, how to seek presenters, and techniques for successfully moderating panels. Lastly, the experts will discuss how to develop a research portfolio, including maturing projects into publications.
Outcome Objectives:
(1) Understand how to choose a niche for career development. (2) Demonstrate ways to develop a research portfolio aimed toward reinforcing career goals. (3) Identify opportunities to present and demonstrate expertise in a chosen career niche.
Diversity, Inclusion, and Equity in Practice: Divisions to the Institution
Erynne A. Faucett, MD (moderator); Carrie L. Nieman, MD, MPH; Cristina Cabrera-Muffly, MD; David J. Brown, MD
Session Description:
For decades, otolaryngology–head and neck surgery (OHNS) has lagged behind other specialties in terms of racial and ethnic representation throughout the field—from residents to faculty to departmental and national leadership. Black, Indigenous, and other people of color are traditionally considered to be underrepresented in medicine. OHNS has not significantly increased representation among these groups at the same rate as other specialties. In part due to limited numbers, it has been difficult to create an inclusive culture with an emphasis on recruitment, retention, and career advancement for underrepresented groups. National events around social justice have refocused the need for continued efforts to build capacity around diversity, inclusion, and equity within OHNS to strengthen our institutions and improve patient care. Multiple studies demonstrate the importance of ethnic and racial representation among physicians to improve patient outcomes and mitigate health care disparities. This presentation will cover tangible examples of how to imbue and sustain a commitment to diversity, inclusion, and equity within daily practice at an organizational level. The speakers will cover ongoing efforts within the context of a residency program, department, and institution that can be applied more broadly to any organization or practice setting. Efforts include processes to reduce bias in applicant selection and interviewing and build an anti-racist culture with a focus on allyship. The role of top-down leadership will also be discussed. The presentation will serve as a primer to understanding the role of the individual and the organization in advancing a culture committed to inclusion and equity within OHNS.
Outcome Objectives:
(1) Summarize current standing of racial and ethnic representation within OHNS. (2) Identify practical approaches to integrate efforts around diversity, inclusion, and equity into your organization. (3) Discuss your individual and organization’s role in supporting an inclusive culture through allyship and anti-racist actions.
Don’t Be Duped! Sussing out the Science in Outcomes Research
Derek J. Lam, MD, MPH (moderator); David O. Francis, MD; Erin Kirkham, MD, MPH; Jay F. Piccirillo, MD
Session Description:
Although the quantity of published research continues to grow rapidly, quality has not necessarily kept pace. Low-quality studies with problems in study design, statistical methods, and interpretation of results are unfortunately fairly common. This session offers a brief review of common methodological problems, with specific examples drawn from published studies. What are common sources of bias that are rarely mentioned or addressed? Why is a P value not the best way to report (or interpret) results? What is an effect size and how is it measured? How can you detect whether results have a high probability of being false negatives or false positives? These and other questions will be addressed
Outcome Objectives:
(1) Recognize limitations in study designs and methodologies common in otolaryngology. (2) Discuss strategies to avoid common errors in study design and statistical analysis. (3) Interpret study quality based on effect size measures and confidence intervals rather than P values.
Effective Sponsorship Is Essential for Career Advancement and Increased Diversity
Mark E. Prince, MD (moderator); Cherie-Ann O. Nathan, MD; Carol R. Bradford, MD, MS; Kelly Michele Malloy, MD
Session Description:
Effective sponsorship is essential to career development and increasing diversity in our field. It is vital that current leaders and aspiring leaders understand the factors that result in successful sponsorship. There continues to be significant challenges to increasing diversity in many medical fields, including otolaryngology, as well as in leadership positions. Mentorship is consistently recognized as an important factor in assisting individuals with diverse backgrounds to achieve their career goals. Sponsorship is less well understood and less often discussed as a mechanism to ensure career success and to increasing diversity in leadership. Sponsorship, in addition to mentorship, is critical for successful career advancement and is essential for increasing diversity in our field. Sponsorship requires a different set of skills and is conducted in a framework that is unique from mentorship. It is essential that current leaders and others utilize sponsorship as a purposeful and carefully conducted career advancement strategy. This panel will provide an evidence-based review of sponsorship, demonstrate the differences between mentorship and sponsorship through a discussion of representative cases, and provide practical advice for sponsors and those seeking sponsorship. The information provided will be important to a large audience, including otolaryngologists in private and academic practice, young physicians, researchers, residents and medical students, advanced practice providers, and leaders.
Outcome Objectives:
(1) Compare important differences between mentorship and sponsorship. (2) Recognize sponsorship opportunities and their potential impact. (3) Implement more effective sponsorship strategies.
Finding the Right Practice 101: Know Your Options
Danielle C. Warner, MD (moderator); Simone Bridges; Matthew Brown; Susan R. Cordes, MD
Session Description:
The presentation is designed to help both senior residents and established physicians navigate the job market. We will discuss the questions you should be asking when looking for a job and the resources that are available to make the process easier. The panel will include industry representatives involved in physician recruitment for both temporary and permanent positions. We will explain various practice models and the pros and cons of each. Finally, the panel will discuss LocumTenens and how it can be used as a tool to learn about different systems, geographic locations, and even vet a potential practice. The moderator will draw from personal experiences in different practice environments and hopefully help others avoid the mistakes made along the way.
Outcome Objectives:
(1) Analyze different practice environments, examine the pros and cons of each, and determine which environment would best achieve your personal career goals. (2) Learn the right questions to ask when vetting a practice group or hospital and how to recognize red flags. (3) Demonstrate knowledge of the available career resources, including those from online, medical societies, mentorship, and networking.
Gender, Sex, and the Otolaryngologist in the 21st Century
Minka L. Schofield, MD, MPH (moderator); Ryan Nesemeier, MD; Scott R. Chaiet, MD, MBA; Noriko Yoshikawa, MD
Session Description:
Terminology and understanding of the spectrum of gender identities and expression has evolved throughout the years and challenges “traditional norms.” Furthermore, most undergraduate and graduate medical education programs lack formal instruction on how the current medical environment affects those who exist outside the binary and how to best reduce inequities. This is an issue that affects not only patients but also providers and staff and often leads to discomfort, isolation, and marginalization. It is important as health care professionals to be aware of this changing landscape and how best to improve comfort for all.
Outcome Objectives:
(1) Delineate the spectrum of gender identity, expression, biological sex, and sexual orientation. (2) Discuss the importance of this issue as it relates to health care delivery and disparities. (3) Present best practices to improve inclusivity within medical environments.
How to Develop New Device or Treatment Ideas in Otolaryngology
Peter Santa Maria, PhD, MBBS (moderator); Robson Capasso, MD; Anaïs Rameau, MD; Ashley Seehusen, PhD
Session Description:
Otolaryngologists are innovative thinkers, and with the right know how, they can understand whether their idea is worth pursuing and then how to implement it into a potential new treatment or device. We will take the attendees through a process to get involved in becoming innovators within the specialty, prototyping new ideas, implementing these into the clinic, and interacting with industry. Attendees will be encouraged to bring their ideas to the session so they can walk through the process using their own examples. We will give examples of ways to protect ideas when interacting with an industry and also how to engage industry to become involved.
Outcome Objectives:
(1) Explain the components that go into the implementation of getting a new idea to the clinic. (2) Discuss and practice a method for evaluating an idea that can impact otolaryngology practice. (3) Recognize the way to interact with industry to protect your idea.
Incorporating Allyship/Anti-bias Programs Into Otolaryngology: The Tennessee Commitment Initiative
Sandra Stinnett, MD (moderator); Jennifer McLevy-Bazzanella, MD; Neal Beckford, MD; Anas Eid, MD
Session Description:
The diversity of the United States continues to increase at a rate far beyond that of the medical workforce. Otolaryngology consistently ranks significantly lower in gender and ethnic diversity compared with other subspecialties. To date, there is scarce literature characterizing the number and extent of diversity and inclusion initiatives and their impact on the field of otolaryngology. The surgical and clinical environment can allow conscious and unconscious bias to become prevalent due to the inherent automaticity that frequently takes place during rapid, and under stressful, conditions. The Tennessee Commitment Initiative is a program we have incorporated at University of Tennessee Health Science Center–Memphis that provides tools for identifying implicit and explicit biases, as well as teaching skills on countering bias through allyship. These competencies play an integral role in fostering a supportive environment and initiating open dialogue for all members of our specialty. Through this panel, we will discuss our experience and aim to (1) teach otolaryngology practitioners ways to identify implicit and explicit biases (both internal and external) via assessment tools that have been validated utilized in literature, (2) understand current anti-bias and allyship literature as it pertains to otolaryngology, and (3) identify opportunities to incorporate allyship as well as diversity and inclusion programs in otolaryngology practices and otolaryngology departments.
Outcome Objectives:
(1) Understand that initiatives to improve diversity, equity, and inclusion in otolaryngology inevitably require self-reflection and professional development of everyone involved. (2) Access resources for building self-awareness as it relates to implicit and explicit bias. (3) Appreciate common barriers to confronting bias and understand the importance of providing the foundational skills to facilitate allyship in a flexible, accessible manner.
Leadership Lessons: Strategies for Success
Mona M. Abaza, MD, MS (moderator); Carol R. Bradford, MD, MS; Jennifer J. Shin, MD, SM; Lee D. Eisenberg, MD, MPH
Session Description:
While we are trained as surgeons to be leaders in the clinical realm, we can sometimes struggle in our other responsibilities—administrative, didactic, and so forth. Our expert panel discusses different strategies to develop your skills as a leader. This session will offer advice on important aspects of leadership and resumé building. Speakers will address analysis and understanding personality traits, tips on how to be prolific in scientific publications, negotiating skills, and emotional intelligence.
Outcome Objectives:
(1) Recognize personality types to know how to use this knowledge to lead and collaborate. (2) Use techniques on how to be prolific with scientific publications and learn negotiation skills and techniques to meet your contractual needs. (3) Understand emotional intelligence and how to use this knowledge to lead and collaborate.
Making an Impact: Slides That Sell!
Ellen S. Deutsch, MD, MS (moderator); Christine B. Franzese, MD; Jennifer A. Villwock, MD
Session Description:
Have you ever wondered how to create a good hook to catch your audience’s interest? During a slide presentation have you ever said to your audience, “I know this is hard to read, but. . .”? Will a pie chart or bar graph or some other image present your data in the most meaningful manner? Should you speak quickly or slowly? How can you make the best use of speaker’s notes? Whether your presentations are for academic, organizational, or practice management purposes, there is an art to getting your message across successfully. This presentation will address effective communication principles that will engage your audience and provide ideas to help you create informative graphs, figures, and visual abstracts. We will work through problematic examples together, demonstrating choices in color, font, layout, and other factors. Many techniques to enhance visual display for text, data, and videos are simple to implement using Microsoft Excel and PowerPoint, but there are other software options, such as LucidChart, Biorender, Tableau, and QIMacro, that can be used to create beautiful graphs and figures. Display formats such as Prezi can be used to create dynamic presentations. We invite you to join us in learning to create “slides that sell.”
Outcome Objectives:
(1) Create more engaging and persuasive presentations. (2) Manipulate graphs and figures to improve their effectiveness. (3) Select the optimal format for your own presentations.
Mentorship and Sponsorships: Utilizing Your Relationships to Succeed in Practice
Sarah Mowry, MD (moderator); Robert Cullen, MD; Candace E. Hobson, MD; P. Ashley Wackym, MD
Session Description:
Several key relationships can be developed to facilitate career advancement. These relationships can be either mentorship or sponsorship affiliations. Mentorship involves transfer of knowledge and guidance from an experienced person to a less experienced person or novice. Mentorship relationships often discuss lived experiences to impart wisdom. Different types of mentorship relationships are recognized as including structured vs informal, short term vs long term, and active vs passive; the benefits of each type will be discussed. Sponsorship uses the resources of the experienced partner to actively promote and advocate directly for their junior partner. Sponsors use their social and professional networks to “open doors” for the sponsored partner. Some professional relationships involve aspects of both sponsorship and mentorship. Mentorship and sponsorship are important for all physicians and can be formative for those just entering practice, private and academic alike. Key features of successful mentorship and sponsorship partnerships will be discussed. Panelist include a senior academician, a seasoned private practitioner, and a junior faculty member. Each panelist will discuss their experiences as mentors, mentees, and sponsors/sponsored partners. The difference between academic and private practice relationships will also be explored. Audience polling will be utilized to assess the broader experiences of the group. Attendees will learn 3 key behaviors they can apply to their own mentorship and sponsorship relationships to facilitate their own career advancement.
Outcome Objectives:
(1) Define and differentiate between mentorship and sponsorship. (2) List behaviors in the mentor–mentee relationship that foster success of the partnership. (3) Identify key personality traits in successful mentors and mentees.
Minding the Gap: How COVID-19 Widens Gender Disparities, Actionable Solutions
Erynne A. Faucett, MD (moderator); Carol R. Bradford, MD, MS; Maie A. St. John, MD, PhD; Sarah N. Bowe, MD
Session Description:
Gender differences in reimbursement and career development are deeply rooted in surgery. Relative to their male counterparts, women surgeons have been paid lower mean incomes, shouldered more work at home, and experienced slower career advancement. Female otolaryngologists are paid 77 cents on the dollar relative to male colleague, are underrepresented in leadership positions, and have significantly lower average academic rank. The pandemic has greatly widened this professional chasm between men and women surgeons, hindering advancement of women physicians’ careers and stymieing leadership growth. Compared with male colleagues, women in medicine bear substantially more responsibility for dependent care, teaching of children, and performing domestic duties during the COVID-19 pandemic. These structural differences impede women physicians’ clinical and academic productivity, creating a formidable barrier to career advancement or to achieving equal compensation. These challenges also have potentially corrosive effects on morale, affecting well-being, resilience, and risk of burnout and other aspects of mental health. It is therefore imperative for organizations to recognize the unbalanced effects of the pandemic and work-life ramifications for women physicians across the career continuum. Whereas the past decade has witnessed progress in narrowing gender inequities, the pandemic has placed such gains on unstable footing, with the possibility of a precipitous fall without anticipatory measures. This session will present data on the current state of the gender gap and will cover strategies for organizations and their leaders to manage the widening of disparities in career/professional advancement, compensation, and productivity for women within otolaryngology and medicine.
Outcome Objectives:
(1) Summarize data on prepandemic gender inequities within otolaryngology–head and neck surgery (OTO-HNS). (2) Identify the impact of COVID-19 pandemic on women in OTO-HNS at home and at work. (3) Present strategies for institutions and their leaders to prevent widening of disparities in career advancement, productivity, and compensation for women within OTO-HNS.
New Age Mentoring: Navigating the Uncharted With Vision and Equity
Michael J. Brenner, MD (moderator); Carol R. Bradford, MD, MS; Sonya Malekzadeh, MD; Howard W. Francis, MD, MBA
Session Description:
This panel explores the changing face of mentorship and professional development amid technological disruption, virtual learning, and calls for racial justice. For individuals aspiring to a career in otolaryngology–head and neck surgery, mentorship can shape destiny. Mentorship helps assure safe passage into the specialty, and it influences the arc of professional development across the career continuum. Even before the novel coronavirus disease 2019 (COVID-19) pandemic, technology and social networking were transforming mentorship in otolaryngology. Now, in an increasingly virtual world, where in-person interactions are the exception, mentorship plays an even more pivotal role. Mentors serve as trusted guides, helping learners navigate accelerating trends toward early specialization, competency-based assessments, and key milestones. However, several structural barriers render the playing field unlevel. For medical students, cancellation of visiting clerkships, in-person rotations, and other face-to-face interactions may limit access to mentors. The pandemic and virtual landscape particularly threaten the already-leaky pipeline for underrepresented medical students. These challenges may persist into residency and later career stages, where structural inequities continue to subtly influence opportunities and pairings of mentors and mentees. Hence, overreliance on serendipitous encounters can exacerbate disparities, even amid societal mandates for equity. The decision to take deliberate steps toward mentoring outreach and engagement has profound implications for what otolaryngology will look like in years to come. This session introduces the concept of new age mentoring, shining a light on how to modernize practices. The key shifts are from passive to active engagement, from amorphous to structured relationships, and from hierarchical dynamics to bidirectional mentoring. Success is predicated on intentional outreach and purposefulness in championing diversity, equity, and inclusion within the progressively technology-driven landscape.
Outcome Objectives:
(1) Understand the potential barriers to mentorship and professional development, encompassing challenges of work–life balance, limited access to mentors of diverse backgrounds, and structural factors. (2) Identify how new mentoring paradigms surmount traditional barriers through providing structured mentoring frameworks, embracing the vision of the mentee, and allowing for reverse mentoring. (3) Describe multifaceted interventions that promote inclusivity in a virtual mentoring landscape, including leveraging social media platforms, local and national forums, and networking resources.
The Partnership Between High-Quality Self and High-Quality Care
Soham Roy, MD (moderator); Heather M. Weinreich, MD, MPH; Ellen S. Deutsch, MD, MS; David E. Eibling, MD
Session Description:
Delivery of safe, high-quality care remains a primary guiding principle in otolaryngology. However, it is more challenging to provide optimal surgical care when the physician delivering care is in suboptimal personal, emotional, or physical condition. Physician wellness can positively or negatively affect ongoing safety and quality care efforts in patient care delivery, as patient safety and outcomes significantly affect physician wellness. In this panel, otolaryngology experts in quality, safety, and physician wellness will discuss the significance of physician wellness and how bad outcomes and near misses can adversely affect both physicians and patients. Physician wellness emerges from a combination of personal coping processes and system supports. The panelists will identify system barriers and cultural impedances along with facilitators to improve wellness and resiliency. They will also discuss “second victim syndrome” and describe organizational factors that affect many practicing otolaryngologists. While otolaryngologists can take steps to help themselves and colleagues cope with the stressors and challenges of patient care, health care systems are also vital in supporting efforts to improve wellness and increase quality and safety. Compelling personal stories, coupled with strategies for personal and institutional growth, will be utilized to help attendees develop awareness of the impacts of quality and wellness in ongoing patient care.
Outcome Objectives:
(1) Examine and analyze the integrated relationship between physician wellness, safety, and quality care delivery. (2) Develop strategies for personal growth in dealing with adverse or suboptimal outcomes in manners that increase physician wellness and improve safe, quality care. (3) Identify institutional approaches that can be implemented to improve surgeon and system cultures, including peer-to-peer support, enterprise support systems, and adaptive systems for health care delivery.
Pathways to Parenthood: Shared Challenges in Family Planning and Otolaryngology
Catherine Kennedy, MD (moderator); Mona M. Abaza, MD, MS; Debbie A. Aizenberg, MD; Leslie R. Kim, MD, MPH
Session Description:
Otolaryngology is a profession that requires years of intense training and practice that peak during family-planning years. Female otolaryngologists face difficulty balancing a busy surgical career with their potential desire to have children and often encounter multiple roadblocks. Women surgeons face double the infertility rates over the general population, report increased use of assisted reproductive technologies, and have higher rates of complications during pregnancy. Logistical obstacles further complicate the problem, including lack of universal leave policy and expected strain on colleagues and the department. In a survey of American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Women in Otolaryngology members, 44% believe their department leaders are not supportive of women starting families during training. All these factors may explain why women surgeons are older at the time of first birth and have fewer children when compared with the average American woman. The consequences of delaying childbirth can be life altering for many women, their babies, and their families. This presentation will bring to light the challenges that women otolaryngologists face with fertility and family planning. The panel features 3 women who will share their experiences, reflect on their decisions, and provide practical suggestions for how they balance parenthood with their careers. The panel will highlight findings from a recent survey of women AAO-HNS members on pregnancy and fertility and comment on the American Board of Medical Specialties’s announcement to offer 6 weeks of protected parental leave during residency, effective July 2021. We invite women and men in otolaryngology, in all practice types and settings, including trainees, program directors, leaders, and allies to be part of this important discussion on how we can eliminate the real and perceived barriers to parenthood to create a supportive environment.
Outcome Objectives:
(1) Recognize the challenges that women otolaryngologists face with pregnancy and fertility. (2) Examine the different approaches to balancing an otolaryngology career with parenthood. (3) Understand policy changes for protection of parental leave and discuss strategies to support the growing number of female otolaryngologists who desire both a career and a family.
Practical Tips to Kick-Start Your Academic Career
Jeffrey C. Liu, MD (moderator); Cristina M. Baldassari, MD; Samantha Anne, MD; Daniel C. Chelius Jr, MD
Session Description:
This panel will be presented by 4 past chairs of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Young Physicians Section (YPS) who will discuss their career paths. As these past chairs age out of YPS, pathways for their activities and leadership in academia will be presented. Topics will include accomplishing successful research, establishing focused clinics programs, valuing lessons learned from YPS leadership, and furthering involvement in AAO-HNS leadership after YPS. Equally important, suggestions on balancing a fulfilling family/home life will be shared. All panelists are married with young children; the difficulties met daily in supporting work–life balance while meeting academic expectations will be explored. Pitfalls to avoid and what we learned from our failures will also be discussed.
Outcome Objectives:
(1) Recognize how AAO-HNS participation can help support an academic career. (2) Explore specific challenges to work–life balance in the early career. (3) Identify pitfalls and mistakes experienced by others in their early careers as a cautionary tale.
Put Me in Coach: Importance of Mentorship, Coaching, and Sponsorship
Claire M. Lawlor, MD (moderator); Rahul K. Shah, MD, MBA; Carol R. Bradford, MD, MS; Dana M. Thompson, MD, MS, MBA
Session Description:
This panel explores the role of mentorship, coaching and sponsorship as they pertain to career development. American Academy of Otolaryngology–Head and Neck Surgery President Carol Bradford will discuss the role sponsorship played in her career and in becoming dean of The Ohio State University College of Medicine, as well as how she sponsors mentees. Dr Rahul Shah will address the role professional coaching played in his path to hospital administration, as well as how to seek professional assistance. Dr Dana Thompson will discuss mentorship and sponsorship, with emphasis on their importance for those underrepresented in medicine (URM). Patti J. Ayers is an executive coach specializing in health care and president and founder of Turning Point Consulting. She will share her 29-year coaching experience, including coaching models, benefits, and practical tips for finding a coach who meets your needs.
Outcome Objectives:
(1) Learn to identify sponsors to help you reach your professional goals, whether they are within your specialty, hospital leadership, or other areas. (2) Explore how to become a sponsor for others, including URM colleagues. (3) Discuss what professional coaches offer and how to engage a coach.
Recognition and Remedying Microaggressions in the Workplace: Building Better Diversity
H. Steven Sims, MD (moderator); David J. Brown, MD; Gina D. Jefferson, MD; Troy Woodward, MD
Session Description:
A working definition of microaggressions is “brief and commonplace daily verbal, behavioral, and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative slights and insults to marginalized individuals and groups.” Even if unintentional, this behavior produces harm and undermines a healthy work community. This session will help clinicians identify and address microaggressions not only to create a “safe” space, but to foster a brave space. The panel will discuss personal histories with microaggressions and offer advice about how to remedy this workplace and societal illness.
Outcome Objectives:
(1) Familiarize the audience with microaggressions, implicit bias, and harm. A shared understanding of the language is the basis for meaningful conversation. (2) Use personal experiences to teach about the events themselves and the enduring harm they can cause. The panelists will provide example vignettes and share the important aspect of how they responded. (3) Discuss strategies to identify and remedy this behavior. We want to promote not only a safe space, but a brave space to build genuine community.
Shared Decision Making Across Otolaryngology in a Post-COVID World
Kara D. Meister, MD (moderator); Lauren A. Bohm, MD; Andrew G. Shuman, MD; Paul Hong, MD
Session Description:
There is growing literature describing the application of shared decision making (SDM) in otolaryngology. This course will present the significance of SDM in today’s otolaryngology practice, introduce guiding ethical principles, and suggest models for practice. Decision support tools, such as decision aids, websites, and app-based programs, will be reviewed. The panel will describe how the COVID-19 pandemic and emergence of telehealth influences how we can continue to communicate and make decisions effectively. Differences in SDM across cultural, social, and age groups will be discussed. Finally, the panelists will identify facilitators and barriers to implementing SDM into everyday practice.
Outcome Objectives:
(1) Understand the principles and ethical underpinnings of SDM in medical and surgical otolaryngology care. (2) Recognize and suggest strategies to overcome challenges in SDM, including time constraints, cultural and professional barriers, and inexperience. (3) Promote a multimedia model for SDM in the otolaryngology clinic, including providing information and supporting deliberation. She’s Going to Sue—20 Years After Dr. Brodsky’s Pay Equity Lawsuit, the Gender Gap Wages Valerie A. Flanary, MD (moderator); Sujana S. Chandrasekhar, MD; Carol R. Bradford, MD, MS; Kathleen Yaremchuk, MD, MSA Session Description: In 2001 Dr. Linda Brodsky successfully sued the State University of New York at Buffalo for pay inequity in violation of the Civil Rights Act of 1964 and the Equal Pay Act of 1963 and for retaliation because she complained. “Winning” resulted in some financial restitution, but the personal repercussions from pursuing legal action were significant, and, 20 years later, our specialty continues to see salary and career advancement inequity for women and others that are underrepresented in medicine. In 2020 women physicians made less than men in all medical specialties, but the gender salary gap was the largest in otolaryngology, where women make 77.9% of what men earn (22.1% wage gap), and the gap was higher than in the previous year. There are many contributors to this gender gap, including various remuneration models, unfair distribution of procedures, and unrecompensed roles. These can be deliberate or arise from common misconceptions; they will be discussed and debunked. Institutional and departmental strategies for transparency and opportunities to gain equity will be discussed by legal, human resource experts, and women otolaryngology leaders with stories to tell. Diversity, inclusion, and equity should not just be the buzz words of the time. Acting deliberately to shape our workforce so that it represents our patients and draws from varying experiences is the way to strengthen our specialty. Outcome Objectives: (1) Discover current data surrounding gender wage gap in medical specialties. (2) Know Title VII of the Civil Rights Act of 1964 and the Equal Pay Act of 1963 protect against retaliation for complaining about pay inequity. (3) Raise the issue of gender salary parity and how to obtain information within their institutions regarding salaries and public disclosure in state and not-for-profit institutions.
Systemic Bias and Workforce Inequity: Care Quality and Value Effects
Brooke M. Su, MD, MPH (moderator); Karthik Balakrishnan, MD, MPH; Emily F. Boss, MD, MPH; David J. Brown, MD
Session Description:
Themes of inequity, injustice, and health disparities are woven through the history of medicine. The national and specialty-wide conversation about these critical problems has evolved in the past year in parallel with major social movements around the world. In combination with the COVID-19 pandemic, these conversations have shed light on ways in which privilege, disadvantage, and systemic biases have contributed to diminished quality of medical care and exacerbated disparities in health outcomes. This panel, sponsored by the American Academy of Otolaryngology–Head and Neck Surgery Patient Safety and Quality Improvement Committee and featuring national experts in health care quality, value, and diversity, justice, and inclusion will complement other sessions at this meeting addressing inequities in health care. In this panel, we will focus specifically on how systemic bias and workforce inequity directly contributes to disparate, low-quality, and low-value health care. We will focus on racism, sexism, and anti-LGBTQ+ bias in both the workforce and in treatment of patients, providing a review of current knowledge on the effects of these biases on the quality of surgical care in the United States, including effects on provider–patient interaction, treatment recommendations, and adherence to these recommendations. We will then address ways in which inequities in the otolaryngology workforce further limit opportunities for patient–physician racial concordance and exacerbate disparities in patient outcomes and strategies to begin addressing workforce diversity and inclusion problems. These issues will be examined for both academic and nonacademic practice settings. We will connect quality to costs of care to discuss how systemic bias affects the value of surgical care delivered to patients of different privilege and how this difference in value perpetuates injustice in health care.
Outcome Objectives:
(1) Define privilege, bias, equality, equity, inclusion, and justice as individual constructs in the context of medical, and specifically otolaryngologic, care. (2) Summarize current knowledge of the effects of systemic racism, sexism, and anti-LGBTQ+ bias on workforce equity and quality of care in otolaryngology. Demonstrate specific examples in otolaryngology. (3) Relate the effects of these biases to the value of otolaryngologic care.
Understanding Concepts of Gender and Developing a Supportive Gender-Affirming Practice
Rahul Seth, MD (moderator); P. Daniel Knott, MD; VyVy N. Young, MD; Seth Pardo, PhD
Session Description:
Transgender patients may have unique medical, surgical, and social circumstances. Otolaryngologists may not be accustomed to these circumstances or the evolving concepts and terminologies associated with gender identity, gender dysphoria, and self-perception. This panel aims to develop or increase diversity awareness so that the clinician may provide inclusive and knowledgeable care to transgender patients. Often, transgender patients have experienced health care disparities and negative biases in their health care. We provide data demonstrating these issues and suggest improved tactics to promote an inclusive environment. A key aspect of the discussion will focus on transgender health and community. Specifically, we will discuss the importance of developing partnerships with community trans health clinics. With a multidisciplinary team approach, effective care can be delivered. Further, we will discuss perioperative considerations of hormone therapy, government and insurance coverage, and the importance of using diverse resources in the care of the transgender patient. Further, we will discuss the changing vocabulary and medical-legal framework of gender affirming surgery of the face, neck, and voice.
Outcome Objectives:
(1) Develop awareness of transgender care in otolaryngology by understanding key concepts within gender identity, gender dysphoria, and self-perception. (2) Appreciate health care disparities, insurance coverage challenges, and societal biases transgender patients face. (3) Learn about key community relationships that foster development of a supportive gender-affirming practice.
Walking a Tightrope: The Path to Effective Leadership for Women
Minka L. Schofield, MD, MPH (moderator); Oneida A. Arosarena, MD; Carrie L. Francis, MD; Cecelia E. Schmalbach, MD, MSc
Session Description:
The gender landscape is changing as it relates to women being represented in medicine. Greater than 50% of medical school students are female, but the distribution of women leaders fails to follow a similar trajectory. Women are outnumbered by men in leadership roles, but there is a trend toward increasing diversity within organizations to enhance organizational efficiency, increase revenue and promote innovation. Educational differences do not explain the paucity of women in leadership roles since women tend to achieve advanced degrees to the same extent or more than men. Glass-ceiling effects, work–life balance concerns, and lack of development programs targeting women have been identified as factors contributing to this disparity. Another factor is the perception of women as effective leaders, which can contribute to their advancement and the ability of followers to be guided by them. Furthermore, systems of oppression in our society intersect to unfairly influence the perception of women as leaders. Similar to other surgical specialties, women in otolaryngology–head and neck surgery are underrepresented in departmental and senior leadership positions. It is crucial for our members to understand these differences to better support the advancement of women into leadership roles and enhance diversity within institutions and professional organizations.
Outcome Objectives:
(1) Contrast the leadership traits and styles of men and women and the intersectionality of these differences with other societal factors. (2) Discuss the role of implicit gender bias on the perception of women as effective leaders. (3) Discuss best practices for women to be viewed as effective leaders and to support women as leaders.
Why Diversity, Inclusion, and Racism Matter for Otolaryngologists in 2021
Rodney J. Taylor, MD, MSPH (moderator); William McDade, MD, PhD; David J. Brown, MD; Carrie L. Francis, MD
Session Description:
The year 2020 illuminated many racial and social inequities in the United States. We as otolaryngologists and the patients we serve are significantly affected by these same racial and social dynamics. This panel of experts will discuss why race, diversity, and inclusion are important topics for otolaryngologists in 2021. Specifically, the panel will explore (1) how both otolaryngology residency programs and private practice otolaryngologists across the country can respond and have already responded to be more inclusive, open, and anti-racist; (2) how racism affects outcomes for common otolaryngology conditions; and (3) what challenges are faced by physicians of color and how to be strong allies for our colleagues of color.
Outcome Objectives:
(1) Explain what it means to be racist and anti-racist and describe why workforce diversity matters for otolaryngologists. (2) Recognize health care inequities faced by patients of color and discuss best practices to address these obstacles. (3) Implement anti-racist policies at your home workplace and become a strong advocate for your colleagues of color.