Otorhinolaryngology

I think in the past, everyone stayed like audiology did their own thing.

ENT did their own thing, right? It required a team to get it here.

Do you agree?

It was all about the team and now we're even expanding into collaborating with people that are experts in motor milestone development and not necessarily the vestibular system, but they understand motor milestones.

And I've sort of got a different take on it now, as I've learned over the last few years.

And so what we're really doing is pursuing what we refer to as a learning health system.

It's a little more comprehensive than just, say, classifier models, like something that, you know, an algorithm that says, hey, you need to see an ENT or hey, you need to see a psychiatrist.

What we're trying to really build is a little more comprehensive system.

So a woman called up.

She'd been operated on by an ENT doctor the day before and she's coughing up blood.

But she needed to come in.

The ENT doctors were standing right next to me.

And I said, Stan, Do you want to see Ms. So-and-so? She's coughing up blood.

And it was like Superman and Kryptonite, like with a phone.

So I would, Phil, if I were you, first, welcome to the program.

Second of all, I would consult an ENT.

What's an ENT, Jess?

An ENT? Yes, a doctor, a specialty.

You

have a child.

What would an ENT

be? I thought it was like an EMT.

So I saw an endocrinologist is what, who the gynecologist sent me to.

And then when I had thyroid issues, they sent me to an ENT.

And then when I had food allergies, they sent me to an allergist.

And like there, there's all these, like we've, we've, the medical community has divided us up into so many parts and nobody talks to each other.

So my doctor was like, I don't know anymore.

Something is not right.

And after I had a really bad sinus infection that lasted for about four to six weeks, she's like, I need you to go to an ENT.

So she sent me to the ENT.

They may already be on some antidepressant.

So those are the kids, even if it's mild, I would treat them more aggressively in the sense I would, you know, at least have them try, especially if they have big tonsils, big adenoids, get them an ENT evaluation.

and seek their opinion to see if they're a good surgical candidate or not.

And if not, sometimes we have to have a trial of CPAP, especially when the sleep apnea is pretty bad because, you know, surgery is not just going to happen, you know, within two weeks or so.

It may take several months to... get in with an ENT clinic, and then eventually get the surgery done.

It could be pretty much a process that itself could take six months or longer.

So then what do I do in the meantime? So I've had children where sleep apnea number was so high that we didn't really feel comfortable with just leaving them untreated.

So we actually put them on CPAP therapy because it's non-invasive while we're waiting for The ENT evaluation while we're waiting for surgery to happen so that at least, you know, their brains, their growth is not getting impacted by untreated sleep apnea.

to oculofacial surgery.

Interestingly, there was a similar larger survey study in ENT surgeons about eight years prior to our survey, and they also found that 72% of ENT surgeons had either back or neck pain.

So these risks aren't new.

and they're real.

It's gotten a lot better.

And the other point I love that both of you made is about the screen height.

I guess we're diverging now back into the OR very briefly, but I had an ENT friend of mine walk in while I was doing a DCR maybe a year ago or so, and my screen was just directly straight across at eye level.

And he said, you really should drop it down a tiny bit.

And then as I started refining my collection and really focusing on the best stuff I could afford and I could find, I started saying, "Well, let me have a little section for urology.

Let me have a section for ENT.

Let me have a section for ophthalmology.

Let me have a section for general surgery, Civil War," et cetera, et cetera.