Interview with K. J. Lee M.D., President of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS).
AO/Beck: Good Morning Dr. Lee, thank you for your time this morning.
Lee: Hi Dr. Beck. Thank you too, it's nice to catch up with you again.
AO/Beck: Dr. Lee, for the readers who know you only as the President of the AAO-HNS, can you please tell me a little about your professional education and career?
Lee: I am Class of 1962 at Harvard, and then went on to medical school at Columbia University in New York City graduating in 1965. My otolaryngology residency was at Mass Eye and Ear at Harvard, and I completed residency in 1970. Following that, I served in the US Army during the Viet Nam war. After my military experience, I joined a private practice in New Haven, and I have been here since 1972. I have served on the Board of Directors of the AAO-HNS for over a decade, and I have been president for the last year.
AO/Beck: This past year has certainly been noteworthy for the hearing healthcare professions. Would you please tell me your thoughts regarding this past year?
Lee: It has been an extraordinarily busy year, and a wonderful year too. In fact, I'd very much like to thank the AAO-HNS, the staff and the volunteers for all they have done over the past year. Their accomplishments have been spectacular, and they are the ones who deserve the credit. It has been an amazing experience for me and I am grateful to all of the people who pitched in and helped get the work accomplished, and for allowing me this opportunity.
AO/Beck: Dr. Lee, how many otolaryngologists are in the AAO-HNS?
Lee: There are approximately 10 thousand.
AO/Beck: Dr. Lee, can you please tell me your thoughts regarding the relationship and the roles of ENTs, audiologists and hearing instrument specialists?
Lee: I view audiologists and hearing instrument specialists and ENTs as parts of a team of colleagues working together for the benefit of the patients. We all have different levels of education, different titles and different attributes. When we work together we improve care for the patients. The audiologist and the hearing instrument specialists are not subservient to otolaryngologists, they simply follow a different track of training. We respect each and every one of them. I think we may have placed too much emphasis on the exact definitions of these professions in the past, and perhaps that wasn't the best place to focus our energies. What I think we need to focus on is how to work together and bring about positive changes and influences for the three professions and most importantly, for the patients. That is the message I have tried to deliver as president of the AAO-HNS, and that is the message I have heard you present too.
In this day and age when the insurance companies and regulators are bashing healthcare providers, we should show them that we can work together and not fall into the trap of attacking each other directly or indirectly. Don't let them divide and conquer.
AO/Beck: Yes, I agree. I think the focus has to be on the patients and how to best meet their needs. I believe the best way for the professional organizations to lead us into the future is for ASHA, AAA, IHS and AAO-HNS to sit down at a table and decide what the goals are, and then focus on accomplishing the goals. As long as there is mutual respect, the goals can and will be accomplished. Additionally, I'd like to see positive declarations about hearing, hearing healthcare, hearing aids, cochlear implants, and perhaps a whole series of messages that we can jointly present to the public to preserve hearing, promote hearing healthcare, and to increase the awareness of the amazing tools we have available within our industries.
Lee: Absolutely right. History tells us that the greatest advances and progress come from collaborations. The squabbling and turf wars are a waste of valuable time and resources and they really serve no one's best interest. The more important message is that there are many solutions and alternatives for hearing loss, and our goal should be to increase these messages to the public. We need to increase the concept of the hearing healthcare team working together. As you know, 80% of the 28 million hearing impaired people in the USA are not accessing and benefiting from any hearing healthcare professionals. In medical groups we have neurosurgeons, plastic surgeons, and ENTs all working together all of the time, and it really is a good model.
In our practice, we work with audiologists and hearing instrument specialists that are outside of our group, and we cross refer to them, we respect them, and it works very well. We also have audiologists working within one large ENT practice and they do very well professionally and financially. To me, hearing healthcare professionals' success is based on their skills and knowledge, and that is the model in New Haven and across the country. It does not matter which camp you belong to.
AO/Beck: Dr. Lee, what are your thoughts on the distance learning Au.D. programs?
Lee: I believe it is admirable that the audiology profession is active in the lifelong learning process that all professionals believe in. The attempt to increase knowledge and skills through appropriate training can only help those with hearing problems. As the transition occurs, I believe it is essential that we find ways to integrate the skills and talents of Au.D.'s into a cohesive system to benefit everyone. IHS has a distance learning program too, and distance education is the current trend. I know many physicians are getting their MBAs through distance education, it's the same idea. As long as the program is of high quality - that's great! Distance education allows professionals to increase their knowledge without having to quit work, move on campus, and leave the family! More education is always better, provided one does not surreptitiously use it for unethical business gains.
AO/Beck: Very good. I wonder if you would give me your views on business and medical ethics?
Lee: That could be a whole book - and we don't have the time now. Nonetheless, let me give you a few of my thoughts. I think the two topics (professional and business ethics) are intimately intertwined. The professionals on the front line, seeing the patients have to balance those two issues daily to be certain they address them fairly and equitably. The audiologist, the dispenser or the ENT cannot, and probably should not separate themselves entirely from business issues. If the practice cannot survive financially, then there is no health care! So the bottom line is to act fairly and appropriately and to always keep the needs of the patient as paramount. The professional who knows nothing about the rent, the payroll, the insurance payments and related business issues, cannot do their best to take care of the patient. The best professionals are well rounded and knowledgeable about business issues as well as the professional issues.
AO/Beck: Dr. Lee, can you imagine that something along the lines of the AHHTI can be successfully launched in the near future with participation from the AAO-HNS, the AAA, ASHA and IHS?
Lee: Yes. I think it is possible and desirable. I want to encourage these groups to meet, to talk together, decide on mutually beneficial ideas and decide how to best present a united front and work together to serve the public and to support our professions. I think working together is the key to success, and we all need to pull in the same direction. Maybe the AHHTI will serve as the first step in the process, but perhaps not the final step.
Let's take the example of the Yul Brynner Society to help educate the public regarding head and neck cancer. It has the support of ENT's, oral surgeons, general surgeons, oncologists, radiotherapists, speech pathologists, etc. There are certainly turf issues at the professional levels locally, but together, we collaborate on certain PR material to help the public avoid head and neck cancer or get early diagnosis and treatment.
There are many other such forums. The American Heart Association does not debate in public whether the cardiologists or the cardiac surgeons are more qualified. It sends the collaborative message regarding diet, exercise, etc. The American Lung Association does not debate whether ENT's or pulmonologists or thoracic surgeons should do the bronchoscopies. Locally at each hospital, it sorts itself out. The message by the American Lung Association is to STOP smoking, sponsoring a national smoke free day.
AO/Beck: Dr. Lee, you have been very generous with your time. Thank you for meeting with me and thank you for sharing your thoughts on these important matters.
Lee: My pleasure Dr. Beck. I have enjoyed the time with you. I send all the readers of Audiology Online my best wishes, and I thank you for helping get the message out.
AO/Beck: Thanks Dr. Lee.
For more information on the American Academy of Otolaryngology - Head and Neck Surgery, please click here.
