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J Otolaryngol Head Neck Surg. 2018 Jul 20;47(1):47. doi: 10.1186/s40463-018-0293-8.

Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology - head & neck surgery in Ontario, Canada.

Author information

1
Department of Otolaryngology - Head & Neck Surgery, Surgical Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, ON, Canada. antoine.eskander@utoronto.ca.
2
Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada. antoine.eskander@utoronto.ca.
3
Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, Michael Garron Hospital, Endocrine Surgery, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada. antoine.eskander@utoronto.ca.
4
Department of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada.
5
Department of Otolaryngology - Head & Neck Surgery, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.
6
Department of Otolaryngology - Head & Neck Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.

Abstract

BACKGROUND:

An analysis of the scope of practice of recent Otolaryngology - Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates.

METHODS:

Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded.

RESULTS:

There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as 'otology' (42%), 'general otolaryngology' (35%), 'rhinology' (17%) and 'head and neck' (4%). The most common procedure codes were categorized as 'general otolaryngology' (45%), 'otology' (23%), 'head and neck' (13%) and 'rhinology' (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon.

CONCLUSION:

This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. The findings demonstrated a prominent representation of 'otology', 'general' and 'rhinology' based consultation diagnoses and procedures. The data derived from the study needs to be considered as residency curricula are modified to satisfy competency-based requirements.

KEYWORDS:

Consultation; Diagnoses; Medical education; Otolaryngology; Procedures; Recent graduates; Volume

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