The American Academy of Otolaryngology-Head and Neck Surgery fully supports access to emergency otolaryngologic care for all members of our communities, but there are serious issues of surgical manpower and resource allocation which represent a threat to timely patient access. While hospitals bear a legal mandate to furnish screening and stabilization services to all individuals presenting themselves for emergency medical attention, there must also be a balanced and reciprocal consideration to ensure community demands for emergency specialty services can be met. The chasm between expectations for access to emergency otolaryngologic care and surgeon workforce availability to provide such care continues to widen.
Otolaryngologists have special expertise in the management of an array of emergent medical conditions specific to the specialty. The on-call services provided by otolaryngologists are critical to the delivery of high-quality emergency medical care. Many of these emergencies are time-sensitive and potentially life-threatening, making otolaryngology call uniquely challenging.
Otolaryngologists have accepted unpaid call coverage of hospital otolaryngologic emergencies as an obligation that was necessary as a member of a hospital’s medical staff. In recent decades there has been a shift away from formal affiliations between otolaryngologists and hospitals. This shift, along with retirement in an aging otolaryngologic workforce, has led to a decreased number of otolaryngologists who are available to provide coverage for emergency hospital-based otolaryngology call. This has resulted in an increasing burden of on-call responsibility for the diminishing number of otolaryngologists in the workforce.
The provision of uncompensated hospital-based emergency otolaryngologic services has numerous negative consequences including impeding the delivery of timely care to patients, negatively impacting physician quality of life, and increasing otolaryngologist burnout. The provision of emergency hospital-based call coverage without adequate compensation threatens the provision of sustainable quality otolaryngologic care and makes it difficult to maintain fiscally viable otolaryngologic practices that can attract and retain providers.
It is the position of the American Academy of Otolaryngology–Head and Neck Surgery that hospitals which include otolaryngology services through their emergency department and/or hospital consulting service should compensate otolaryngologist-head and neck surgeons at fair market value for providing on-call services. This compensation should be in addition to any reimbursement received for patient care provided. This position is in alignment with the position of the American Medical Association that “Physicians should be provided adequate compensation for being available and providing on-call and emergency services.” (On-Call Physicians H-130.948)
Approved March 2024
Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology–Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.
