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Discussion in 'Otolaryngology' started by Stillmaticbeat, May 27, 2008.
How much collaboration is there between Oral Surgeons and ENTs?
In what regards? They do their thing, we do ours. Our specialties overlap in a few areas (Trauma most notably), but I haven't seen a combined case at my institution. Usually, they send over cancers that require a big whack for us to take out and reconstruct. OMFS do the TMJ surgeries, orthognathic surgeries, tooth extractions, etc while we do a variety of different cases (sinus, parotids, ears, thyroids, cancer).
There is very little to no collaboration in my experience in private practice--except when I have to take care of their post-extraction abscesses because they don't get privileges at hospitals. As a resident, I had lots on interactions with them, mostly on trauma, but sometimes for mandibular advancement procedures. I rarely did combined cases with them.
My experience is a little different.
We split trauma call with PRS but since we have no OMFS residents and only 1 attending they don't take trauma call. We solicit their input sometimes prior to cases.
We will do cancer whacks with them maybe once a month.
So not a ton of interaction but our OMF guy comes to tumor board and is always readily available to help out with anything. So maybe more interaction that some of the above folks have.
This is a question that will be specialty-dependent....The ENT's will say we take care of all the "tooth abscesses they can't handle" (which is untrue)...and the OMFS will say we take care of the "trauma that the ENT's screw up because they know nothing about occlusion".
I am indifferent on the subject. We also do a ton of parotids and submand. glands.....and cancer whacks....ENT loves that fact. It's always gonna be a pissing contest when 2 specialties do similar procedures...
It's like the Plastic surgeons and Orthopods that fight over hand surgeries. Whichever you ask....that specialty is gonna say they are better.
Moving on....in private practice, most OMFS guys stay out of the hospital because reimbursement is so low. Hence, ENT's and OMFS don't work together too much in the private world.
Just my 2 cents.....
Agree that there is a lot of overlap in certain areas. But we both do our separate specialty interests. As far as the overlap areas, if a surgeon is trained well and is meeting the standard of care, I see no problem with that surgeon doing the operation that historically falls into my specialty's realm. I can guarantee, however, that if the standard of care is not met and harm is done, there will likely be a long line of properly trained surgeons willing to serve as expert witnesses. This applies to ENTs who dabble in the other surgical realms, too.
On a side note, I find it difficult to accept any surgeon who is trained to take care of their own complications, but chooses not to and pass it on to someone else in order to maximize their own financial benefit. You can get privileges at a hospital and get it in the contract to not take call - especially if your volume at the institution is sufficiently low.
Completely agree. 100%. I didn't say there were tooth abscesses that the OMFS's couldn't handle--they just choose not to for financial reasons, even on their own patients.
To me, that's total BS and abandonment. If I ever get called to testify for one of the myriad patients I see and have to I&D because the OMFS didn't, I'll be happy to say that too.
Likewise, if I'm off cavorting around on a carotid body tumor and perf the bifurcation and have to call vascular to come in and save mine and the patietn's butt, I should get strung up. Works both ways.
Almost no combined cases with me. I have some good colleagues who I send some patients to and they send me patients as well. Good guys and guys that I would work with if a case presented that needed it (can only think of a few), but haven't needed it so far.
I appreciate what The Throat has said and agree there too (btw, I met your partner at an Acclarent thing on Saturday--very nice guy). I refer a lot of TMJ to OMFS and I get a reasonable number of adenoid hypertrophy and OSA pt's from them. Occ they'll also send sinus or septoplasty patients as well. One of my best friends in the world is an OMFS. However, I respect him all the more because he'll take care of his post-op complications. I stand by what I said in that if you decide to do procedures, you should be willing to handle the complications--at least the common ones and those that fall under your scope of practice.