BackTable ENT & Allergy

Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation.

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SYNPOSIS

Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis.

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TIMESTAMPS

00:00 - Introduction

06:00 - How ScribeMD AI Works

14:14 - Integration with EMR

20:31 - Legal Considerations with AI Technology

26:34 - Cost Implications of AI Scribes

38:46 - Future of AI in Medical Diagnosis

41:45 - Conclusion and Final Thoughts

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RESOURCES

ScribeMD.ai

https://www.scribemd.ai/

While the mantra “see one, do one, teach one” once guided surgical education, nowadays, technologies like 3D printed models and realistic surgical videos allow trainees to safely gain hands-on experience. In this episode of the BackTable ENT podcast, Dr. François Simon, pediatric otolaryngologist at Necker Hospital for Sick Children (Paris, France) joins host Dr. Gopi Shah to discuss technological innovations in surgical education.

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SYNPOSIS

First, Dr. Simon explains how 3D printing technology expands trainees’ anatomical knowledge. He speaks to his experience working alongside a 3D printing engineer to develop models used to teach otoscopy and ear surgery. Then, Dr. Simon tackles the role of videos in surgical education. His conversation with Dr. Shah focuses on the composition, ethics, and distribution of effective educational videos. Finally, Dr. Simon discusses how attending surgeons can leverage technology to maximize trainee learning in the operating room.

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TIMESTAMPS

00:00 - Introduction

02:36 - Embracing 3D Printing in Surgical Education

14:32 - Collaborating with Engineers to Produce High-Fidelity Anatomic Models

17:59 - The Future of 3D Printing in Medicine

20:44 - The Role of Video in Surgical Education

24:59 - Creating Effective Educational Videos

34:49 - How to Distribute Your Video to its Target Audience

36:23 - Ethical Considerations: Patient Consent & Privacy

44:56 - Final Thoughts & Resources for Educators

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RESOURCES

3D Printed Model to Teach Otoscopy:

https://www.m3d-print.com/en/products/otoscopic-simulator-tympano/

Dr. Simon’s Guide to Making an Effective Surgical Video:

https://videos-chirurgicales.u-paris.fr/en/

IVORY (Instructional Videos in Otorhinolaryngology by YO-IFOS): A Consensus on Surgical Videos in Ear, Nose, and Throat: https://onlinelibrary.wiley.com/doi/full/10.1002/lary.29020

In this episode, laryngologist Dr. Inna Husain joins host Dr. Ashley Agan for a deep dive into laryngopharyngeal reflux (LPR) to illuminate patient presentation, diagnostic tests, and future directions in LPR research.

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CHECK OUT OUR SPONSOR

Medtronic ENT

https://www.medtronic.com/en-us/healthcare-professionals/specialties/ear-nose-throat.html

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SYNPOSIS

The episode begins with a recap of Episode 83, in which Dr. Husain explained LPR fundamentals. Continuing from where they left off, the surgeons discuss various presentations of LPR, emphasizing the distinctions between acidic/non-acidic and direct/indirect reflux. Then, they review tests used to diagnose LPR and role of collaboration with gastroenterology colleagues. Dr. Husain shares her therapeutic approach to LPR, which includes lifestyle modifications for all patients, alginates for those with mechanical reflux, and nerve blocks for those with neurally mediated symptoms. The podcast wraps with a discussion of hot topics in LPR research.

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TIMESTAMPS

00:00 - Introduction

01:01 - Sponsor Spotlight: Medtronic ENT Innovations

04:37 - Summary of BackTable Episode 83 on Laryngopharyngeal Reflux (LPR)

08:34 - Typical vs. Atypical Presentations of LPR

23:36 - Dr. Husain’s Personal Experience with LPR

38:27 - Diagnosing LPR

46:43 - Lifestyle & Dietary Changes for LPR

50:53 - Hot Topics in Contemporary LPR Research

53:17 - The Brain-Gut Connection & LPR

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RESOURCES

BackTable ENT Episode 83: “Laryngopharyngeal Reflux with Dr. Inna Hussain:” https://www.backtable.com/shows/ent/podcasts/83/laryngopharyngeal-reflux

Medtronic ENT

www.medtronicent.com

Dr. Inna Husain’s Community Healthcare System profile: https://www.comhs.org/find-a-doctor/h/husain-inna

Dr. Inna Husain’s X:

https://x.com/drinnahusain

Dr. Inna Husain’s Instagram:

https://www.instagram.com/innahusainmd/

Dr. Inna Husain’s TikTok:

https://www.tiktok.com/@throatdoc

In this episode, Dr. Raj Sindwani, rhinologist at the Cleveland Clinic, joins host Dr. Gopi Shah to discuss advanced navigation systems, such as virtual reality (VR), to improve functional endoscopic sinus surgery (FESS).

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CHECK OUT OUR SPONSOR

Stryker ENT

https://ent.stryker.com

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SYNPOSIS

First, Dr. Sindwani shares how he combines pre-operative imaging data and navigation to plan successful surgeries. Then, he delves into features available in newer navigation systems, including target/anti-target technology, which notifies surgeons as their instruments approach critical structures. He covers topics relevant to navigation in clinical practice, including reimbursement, patient counseling, and troubleshooting in the OR. The episode concludes with a short conversation on the future of navigation-assisted FESS.

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TIMESTAMPS

00:00 - When to Use Navigation

10:42 - Harnessing Augmented Reality for Better Surgical Planning

20:43 - Registering Landmarks with Navigation

22:27 - How Navigation Systems Enhance Surgical Education

27:53 - Navigation in Office-Based Procedures

35:05 - Troubleshooting Problems with Navigation Systems

42:25 - The Future of Navigation-Assisted FESS

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RESOURCES

Stryker ENT Products:

https://www.stryker.com/us/en/ent.html

Dr. Sindwani’s Cleveland Clinic Profile:

https://my.clevelandclinic.org/staff/14102-raj-sindwani

In this episode of the BackTable ENT Podcast, thyroid expert Dr. Dana Gibbs speaks with host Dr. Ashley Agan about Hashimoto’s Thyroiditis and hypothyroidism. Despite the high prevalence of Hashimoto’s Thyroiditis (1-2%), the condition is often misunderstood. Otolaryngologists and internists alike will benefit from Dr. Gibbs’ insight into Hashimoto’s presentation, diagnosis, and treatment.

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SYNPOSIS

First, Dr. Gibbs explains how she shifted her clinical focus from comprehensive otolaryngology to thyroid disease. Recounting her decades-long, personal experience with hypothyroidism, she describes how nonspecific symptoms of fatigue, hair loss, and weight gain can lead clinicians astray. Then, she reviews the pathophysiology and diagnosis of Hashimoto’s Thyroiditis. Using labs and questionnaires, she interrogates the patient’s overall endocrine health, which she addresses using a combination of levothyroxine (T4), liothyronine (T3), and select supplements. She demonstrates how lessons learned treating Hashimoto’s extend to hypothyroidism management more broadly. Finally, the use of integrative medicine strategies to treat thyroid disorders is discussed.

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TIMESTAMPS

00:00 - Introduction

02:33 - Dr. Gibbs’ Personal Experience with Hypothyroidism

11:32 - Understanding Hashimoto’s Thyroiditis

18:26 - Hashimoto’s: A Challenging Diagnosis

33:17 - The Role of Stress in Thyroid Disease

35:04 - Thyroid Medications

51:21 - The Role of Surgery in Managing Hypothyroidism

55:01 - An Integrative Medicine Perspective on Hypothyroidism

59:27 - Final Thoughts on Hashimoto’s & Hypothyroidism

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RESOURCES

Dr. Gibbs’ Consultants in Metabolism Profile:

https://www.danagibbsmd.com/

Dr. Gibbs’ Instagram:

https://www.instagram.com/danagibbsmd/

In this episode, Dr. Mihir Patel, Professor of Otolaryngology at Emory University and expert in Transoral Robotic Surgery (TORS), discusses HPV-positive head and neck cancer with host Dr. Ashley Agan.

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CHECK OUT OUR SPONSOR

Medtronic ENT

https://www.medtronic.com/en-us/healthcare-professionals/specialties/ear-nose-throat.html

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SYNPOSIS

Dr. Patel opens by briefly sharing his journey to head & neck surgery, and, more specifically, expertise in TORS. After, Dr. Patel explains the epidemiology and pathophysiology of HPV-caused cancers, which frequently present as painless neck masses. Then, Dr. Patel describes workup and treatment of these cancers. He shares surgical strategies, paying special attention to cases of unknown primary lesions. He underscores the importance of collaboration with medical and radiation oncologists, particularly given the rapid pace of treatment innovation. Finally, Dr. Agan and Dr. Patel examine how increased HPV vaccine uptake could drastically lower the burden of this disease in the coming decades.

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TIMESTAMPS

00:00 - Introduction

05:26 - The Evolution of HPV-Related Oropharyngeal Cancer Treatment

17:26 - Contemporary Diagnostics for Head & Neck Cancer

24:39 - Surgical Strategies for Unknown Primary Lesions

38:15 - The Role of ctDNA in Cancer Management

46:10 - Advancements in HPV-Driven Cancer Treatment

53:30 - The Future of Cancer Screening and Vaccination

01:01:54 - Vaccination: A Tool for Cancer Prevention

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RESOURCES

Medtronic ENT:

https://www.medtronic.com/us-en/healthcare-professionals/products/ear-nose-throat.html

Dr. Mihir Patel’s Emory University Profile:

https://winshipcancer.emory.edu/bios/faculty/patel-mihir-r.html

AVOID Trial:

https://pubmed.ncbi.nlm.nih.gov/31785337/

In this episode, hosts Dr. Ashley Agan and Dr. Gopi Shah discuss the ENT workforce with Dr. Andrew (“AJ”) Tompkins, an Ohio-based comprehensive otolaryngologist and member of the American Academy of Otolaryngology-Head and Neck Surgery’s socioeconomic task force.

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SYNPOSIS

First, Dr. Tompkins provides an overview of the ENT workforce from trainee to retiree stages. He describes his work with the Academy’s socioeconomic task force, which provides important feedback on the number, location and work environments of practicing otolaryngologists. He emphasizes participation in the Academy’s workforce survey as the source of this data. Offering a sneak preview of 2023 survey results, Dr. Tompkins underscores the need to increase resident exposure to private practice settings and to plan for how treatment breakthroughs (such as the HPV vaccine) might affect future workforce needs. The surgeons finish by discussing necessary improvements in resident selection and continuing education.

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TIMESTAMPS

00:00 - Introduction

03:09 - Exploring the ENT Workforce: A Provocative Topic

08:09 - Unpacking the Challenges of ENT Workforce Data

22:16 - The Impact of Fellowship Training & Practice Shifts

31:59 - Previewing 2023 Data Insights

37:09 - Addressing Workforce Distribution and Access Issues

43:30 - How Technology & Training Influence the ENT Workforce

56:20 - Collaborations & Future Directions

01:01:24 - Concluding Thoughts on Workforce Dynamics

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RESOURCES

Dr. Andrew Tompkins’ Ohio ENT & Allergy Profile:

https://www.ohioentandallergy.com/physicians/andrew-tompkins-md-mba/

Triological Society Otolaryngology Workforce Analysis from 2016: https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.26238

“The 2022 Otolaryngology Workforce” Report from AAO-HNS:

https://www.entnet.org/wp-content/uploads/2023/07/2022-Otolaryngology-Workforce.pdf

Tompkins AJ. The Otolaryngology Workforce, Part I: Supply. ENTtoday. May 2022.

https://www.enttoday.org/article/some-studies-predict-a-shortage-of-otolaryngologists-do-the-numbers-support-them/

Tompkins AJ. The Otolaryngology Workforce, Part II: Structure & Rethinking Supply. ENTtoday. June 2022.

https://www.enttoday.org/article/transparent-regular-data-vital-to-reworking-how-we-think-about-workforce-supply/

Tompkins AJ. The Otolaryngology Workforce, Part III: Competition & Future Design. ENTtoday. July 2022.

https://www.enttoday.org/article/tips-for-creating-a-dynamic-otolaryngology-workforce/

In this episode of the BackTable ENT podcast, Dr. Pete Manes, associate professor of rhinology at Yale, discusses political advocacy with host Dr. Ashley Agan.

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SYNPOSIS

Dr. Manes begins by explaining how a life-long interest in government underlies his work as a physician-advocate with the American Academy of Otolaryngology-Head & Neck Surgery. Currently, he serves as the Academy’s Coordinator of Health Policy, where he contributes to private payer advocacy and Academy position statements. Drawing on this experience, he explains political challenges associated with being a smaller specialty, roles played by of Action Committees (PACs), and steps in legislative advocacy. Then, he shifts focus to cover how the Academy works with private payers to ensure fair reimbursement. The podcast concludes with resources to connect otolaryngologists with advocacy work.

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TIMESTAMPS

00:00 - Introduction

01:02 - Dr. Pete Manes’s Advocacy Role

08:04 - The Importance of Advocacy in Medicine

20:24 - Scope of Practice and Physician Payment Reform

30:02 - Building Relationships for Healthcare Advocacy

37:12 - Navigating Insurance Companies for Patient Advocacy

42:33 - Utilizing Position Statements in Healthcare Advocacy

48:29 - Accessing Academy Resources for Healthcare Advocacy

50:43 - Exploring Opportunities for Engagement and Advocacy

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RESOURCES

Dr. Pete Manes’s Yale University Profile:

https://medicine.yale.edu/surgery/otolaryngology/profile/rpeter-manes/

American Academy of Head & Neck Surgery (AAO-HNS) Position Statements:

https://www.entnet.org/business-of-medicine/position-statements/

AAO-HNS Health Policy Contact:

[email protected]

In this episode, Dr. Hamdy El-Hakim, pediatric airway surgeon and Associate Professor at the University of Alberta, joins host Dr. Gopi Shah to review laryngeal clefts in children.

First, Dr. El-Hakim describes the presentation of laryngeal clefts. Affected children have coughing fits bad enough to cause watery eyes and “blue spells.” These fits are sometimes misattributed to other airway abnormalities or GERD. Then, discussion shifts to the workup of laryngeal clefts. All patients with a suspected laryngeal cleft need a comprehensive physical exam, a risk factor assessment and a swallow assessment, most commonly a FEES. Many patients will also require a diagnostic laryngoscopy with bronchoscopy (DLB). Dr. El-Hakim advises listeners on performing this test in children. Treatment of laryngeal clefts include thickened feeds, injection laryngoplasty, or surgical repair. Finally, Dr. El-Hakim advises listeners on compassionate care for families living with this condition.

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SHOW NOTES

00:00 - Introduction

03:39 - Laryngeal Clefts in Children: Diagnosis & Classification

06:36 - Presentation of Laryngeal Cleft

12:07 - Risk Factors & Associated Conditions

21:38 - Physical Examination Insights and Diagnostic Approaches

30:15 - The Role of FEES and Modified Barium Swallow in Diagnosis

37:37 - Navigating Pediatric Swallowing Disorders: Strategies and Challenges

41:12 - The Complexities of Diagnosing & Treating Laryngeal Cleft

45:28 - Surgical Techniques & Postoperative Care

01:03:13 - Evaluating Success Post-Surgery

01:09:20 - Final Thoughts: The Impact of Pediatric Dysphagia on Families

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RESOURCES

Dr. Hamdy El-Hakim’s University of Alberta Profile:

https://www.ualberta.ca/airway-research/iarc-team/hamdy-el-hakim.html

Article demonstrating superiority of cold steel relative to laser in type I laryngeal cleft repair:

https://pubmed.ncbi.nlm.nih.gov/34184769/

In this episode, Dr. Mark Royer, private practice otolaryngologist and medical director of ENTLocums.com, joins BackTable to discuss salary negotiation for physicians.

Dr. Royer begins by using his personal career journey to highlight the importance of negotiation skills. Then, he describes how to develop these skills. Throughout the episode, Dr. Royer emphasizes the importance of knowing one’s value as a surgical subspecialist and tailoring your strategy to best suit your employer’s perspective and your needs. Relevant topics covered include selecting a practice, starting salaries, RVUs, locums, and non-compete agreements. Dr. Royer concludes by encouraging otolaryngologists to reflect on what they truly want out of their careers as they approach the negotiation table.

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SHOW NOTES

00:00 - Introduction

01:22 - Salary Negotiation

05:24 - Dr. Royer’s Journey from Residency to Entrepreneurship

10:16 - Negotiating Your Salary: Essential Tips and Strategies

26:27 - Different Approaches to Negotiation: Hospital vs. Private Practice

28:40 - Exploring the World of Locum Tenens

31:59 - Mid-Career Physician Negotiations and Raises

41:26 - Mastering Negotiation Tactics and Strategies: Tips from “Never Split the Difference”

47:38 - Navigating Non-Compete Clauses & Final Thoughts

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RESOURCES

ENT Surgery Solutions, LLC:

https://www.entlocums.com/

BackTable ENT Episode 57, “Locums Opportunities in ENT with Dr. Allison Royer:”

https://www.backtable.com/shows/ent/podcasts/57/locums-opportunities-in-ent

BackTable ENT Episode 107, “How Do I Negotiate My Physician Contract? Part I with Michael Johnson Jr., Esq:”

https://www.backtable.com/shows/ent/podcasts/107/how-do-i-negotiate-my-physician-contract-part-i

BackTable ENT Episode 108, “How Do I Negotiate My Physician Contract? Part II with Michael Johnson Jr., Esq:”

https://www.backtable.com/shows/ent/podcasts/108/how-do-i-negotiate-my-physician-contract-part-ii

“Never Split the Difference” by Chris Voss:

https://www.amazon.com/Never-Split-Difference-Negotiating-Depended/dp/0062407805