Ear, nose, and throat surgeons are uniquely well-versed in operating on all the structures of the head and neck. The number of surgeons who count themselves in this specialty area has grown to be in the tens of thousands in the US alone. So how is the uninformed patient to decide, from amidst that overwhelming surplus of options, which ear, nose, and throat surgeon is the best fit for him- or herself? Here are a few starting tips to get you on your way to walking into the operating room:
Safety in Specialties
Compared to structures such as the shoulder, hip, and spine, the ear, nose, and throat seem small. However, their size belies a level of complexity hidden within, and so it is that even this physically small area of the body is comprised of a dizzying assortment of tissues, nerves, airways, and blood vessels. The composition of the nose and that of the inner ear are nothing alike; you might shy away from choosing a surgeon who specializes in the former if the operation you need is for the latter. One of the best ways to go about searching for an ear, nose, or throat surgeon is to pick from among those who specialize specifically in the procedure that you need.
Look for a surgeon who has not only received degrees and accreditation in his or her specialty area but who has also continued to make use of the most up-to-date technology and techniques available. A perusal of his or her recent operation history should reveal numerous procedures similar too, or better yet, of the exact same type as, the one that interests you. Experience, more than almost anything else, is the best predictor of a surgeon’s abilities.
With the type of ear, nose, and throat surgeon that you want in mind, a great resource from which to begin your search is a directory. Look to well-established organizations like the American Academy of Otolaryngology to provide a member list that you can trust. Simply by virtue of being accepted as members, the surgeons you find listed in these kinds of directories already come with a mini-background check done for you. It’s a simple and painless way to get started.
If the process of sifting through long lists and ticking choices off without ever seeing a surgeon face-to-face seems to be missing something, then you may want to begin your search with some word-of-mouth recommendations instead. You might turn to friends and coworkers who have had ear, nose, or throat surgery, or ask your personal physician to drop some names. Another ever-more-common phenomenon is the use of internet boards and chats to collect personal accounts from a wider variety of people than you may have access to physically. Word-of-mouth can be a wonderful way to reap information from eclectic sources, but remember that the most enthusiastic recommendation doesn’t replace good, solid investigation on your
Choosing a Surgeon
While you will probably not be golfing with him or her anytime soon (nor would you likely want to!), you should learn a few things about the person that is about to perform surgery on you. When choosing a surgeon, you should ask the questions listed here. Some of them may seem personal or difficult, but remember, this person is going to have your life in their hands. You are permitted to respectfully ask some pointed questions.
- Are you board-certified in surgery? Are you board-certified in surgical subspecialty? Surgeons must go through years of training to become surgeons. After finishing four years of medical school there is anywhere from five to nine years or more of surgical residency that needs to be completed. When residencies and fellowships are completed, the surgeon is usually ready to take their boards. This is essentially a very challenging exam that tests the surgical resident on their ability to perform surgery and manage patients. The term “Board Eligible” means that the resident surgeon has completed all of the requirements of residency and/or fellowship and has not yet taken the final exam.
- If a surgeon is board eligible, ask when he or she is going to take the exam. It may be that he or she has not had the time to take the exam. The best answer to hear is that the exam has been scheduled. Other answers such as “I have not had time” may be very true, but they are not very comforting.
- How many surgeries of this type have you performed? You will want to know how many they have “scrubbed in on” as well as lead. Remember that medical students can “scrub in on” a surgery during medical school. That certainly does not mean that they are leading the case or even know everything that is going on during the case. Surgical residents get increasing responsibility as they progress through residency. The true number of completed cases is the ones that were performed, not just “opened and closed.”
- What is the average complication rate? What is your complication rate? This will let you know two things, one how tricky and complex the surgery is and two, how good your surgeon is. You can check complication rates for particular surgeries online. If it is very far different from the one quoted, consider that when choosing a surgeon. The surgeons individual complication rate should be at or below the one quoted.
- How is called shared among your practice partners? Will you be available or will someone else? Surgeons are busy and they are most happy in surgery. The “before and after stuff” is less interesting to them. Make sure they are available to you in case you do have a complication or if the surgery needs to be revised. A busy surgeon is usually a good surgeon. A surgeon that is too busy to see patients is not an ideal choice.
ENT Stands For Ear, Nose, and Throat
An otolaryngologist or simply ENT is a medical doctor that seems to straddle the fence between medicine and surgery. An Ear, Nose, and Throat Specialist or ENT surgeon specializes, perhaps obviously, in diseases affecting those three structures; however, ENT surgeons do quite a bit more. While much of their practice involves surgeries in an operating theater, a large portion of their work is done in a clinic setting. Procedures such as hearing tests and placing “tubes” in patient’s ears take place on an outpatient basis. The specialty is steeped in tradition and many otolaryngologists still use rather old fashioned instruments and supplies. This is not to say the ENT surgeons do not keep up with the latest medical and surgical science—they do! However, many of the tried and true devices still work perfectly well on patients of today. The surgical specialty has gone to great lengths to preserve this tradition and operates its own surgical residency program—unlike other surgery residencies that require general surgery training before specialization. Perhaps ENT surgeons evolved from a time when more family doctors performed limited surgical procedures right in the office. In any case, finding an ENT surgeon is unlike finding a general surgeon. They are almost a different breed of doctor.
More Than Just Three Letters
ENT surgeons really do it all when it comes to head and neck surgery. It is important to realize that the ears, nose, mouth, and throat are all connected in space. The nose and sinuses drain into the back of the throat and the ears are connected to the throat through the Eustachian tubes. Surgery in one area can have an impact on all of the areas. The scope of procedures can range from tonsillectomy after multiple infections to the placement of cochlear implants to bring hearing to those who are deaf. Despite operating in such a discrete area, there is subspecialization within the field. If you are in need of a more sophisticated procedure such as a cochlear implant, you should spend some time finding an ENT surgeon that has specialized training in neurotology and surgery of the inner ear. For more straightforward surgeries, any board-certified ENT surgeon should be able to help. ENT surgeons also diagnose and treat disorders related to balance and equilibrium which can be caused by disturbances of the structures of the inner ear. Speaking to your primary care physician is an important part of finding an ENT surgeon. Your doctor can help determine the scope of your issue, whether you need an ENT surgeon or ENT subspecialist, and may also be able to refer you to a good ENT surgeon in your area.