BackTable ENT BackTable

In this episode, Dr. Gavin Setzen of Albany ENT & Allergy Services addresses the current landscape of insurance reimbursement with host Dr. Ashley Agan.

The episode opens by reviewing the current state of healthcare financing, where climbing costs, declining reimbursement, and continued consolidation of medical groups confront physician-owned private practices. Mindful of this context, Dr. Setzen describes his experiences tackling reimbursement challenges. Recounting his successes, Dr. Setzen encourages physicians to base their claims in evidence-based medicine, enlist allies (such as patient unions), and develop relationships with insurers. He then provides strategies to efficiently manage Prior Authorizations, including Peer-to-Peer conversations. Finally, Dr. Setzen shares how coordinating one’s reimbursement strategy with colleagues and advocacy groups helps increase odds of success.

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CHECK OUT OUR SPONSOR

Stryker ENT
https://ent.stryker.com

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SHOW NOTES

00:00 - Introduction
01:55 - Dr. Gavin Setzen’s Journey and Practice Insights
05:30 - The Challenges of Healthcare Landscape and Insurance
10:06 - Innovations in ENT: Navigating New Technologies & Reimbursement Challenges
20:23 - Strategies for Overcoming Insurance Denials
52:30 - The Importance of Data and Collaboration in Patient Advocacy
55:19 - Closing Thoughts

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RESOURCES

Dr. Setzen’s Albany ENT & Allergy Services Profile:
https://albanyentandallergy.com/bio/gavin-setzen/

In this episode, pediatric otolaryngologist Dr. Julie Wei (Akron Children’s Hospital) and psychologist Dr. Herdley Paolini discuss surgeon burnout with guest host, pediatric otolaryngologist Dr. Anthony Sheyn (Le Bonheur Children’s Hospital).

First, Dr. Paolini reviews causes of surgeon burnout, drawing on three decades of experience working in physician wellness. Then, Dr. Sheyn and Dr. Wei discuss steps they’ve taken to combat burnout. Dr. Wei illuminates challenges unique to female surgeons, including higher levels of emotional exhaustion, fertility struggles, and ‘mom guilt.’ Then, the discussion shifts to address the roles that healthcare administration and medical education play in surgeon burnout. The podcast concludes with Dr. Wei’s experience advocating for needed changes in her hospital’s call policies.

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SHOW NOTES

00:00 - Introduction
03:18 - Operating Through Challenges: Dr. Wei’s Experience with Burnout
06:02 - Exploring Causes of Surgeon Burnout with Dr. Paolini
16:03 - Squashing the Stigma: Embracing Vulnerability in Surgery
25:37 - The Power of Advocacy and Building a Case for Wellness Programs
31:06 - Early Interventions and Transforming Medical Education
34:10 - Balancing Professional & Personal Life As A Surgeon
42:47 - Initiating System Changes for Physician Well-being

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RESOURCES

Dr. Anthony Sheyn’s Le Bonheur Children’s Hospital Profile:
https://www.lebonheur.org/doctors/anthony-sheyn

Dr. Julie Wei’s Akron Children’s Hospital Profile:
https://akronchildrens.org/people/Julie-Wei.html

About Dr. Herdley Paolini:
https://www.physicianintegration.org/about

“Safeguarding Physician Wellbeing” by Dr. Julie Wei:
https://www.routledge.com/Safeguarding-Physician-Wellbeing-Using-Checklists-for-Personal-Professional-and-Psychological-Safety/Wei/p/book/9781032589893

“Inside the Mind of a Physician: Illuminating the Mystery of How Doctors Think, What they Feel, and Why they Do the Things They Do” by Dr. Herdley Paolini:
https://www.amazon.com/Inside-Mind-Physician-Illuminating-Publishing/dp/0982040903

In this episode, Pediatric Speech Language Pathologist (SLP) Olivia Brooks (University of Florida Shands Hospital) shares her experience performing inpatient fiberoptic endoscopic evaluation of swallowing (FEES) with host Dr. Gopi Shah.

First, Olivia reviews the presentation of swallowing disorders in infants. She explains differences between the two most common swallowing tests: videofluoroscopic swallow study (VFSS) and (FEES). Then, she reviews how she uses patient comorbidities and the physical exam to select the appropriate test for each infant. Underscoring the importance of collaboration across care teams, she describes her role performing swallow studies in the NICU and pediatric CVICU. She then shares tips on equipment, ergonomics, and teamwork while performing bedside FEES. The podcast wraps with her advice about working on an interprofessional team to care for children with swallowing disorders.

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CHECK OUT OUR SPONSOR

Karl Storz Tele Pack
https://www.karlstorz.com/

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SHOW NOTES

00:00 - Introduction
06:26 - The Importance of a Comprehensive Evaluation
13:00 - Choosing Between VFSS & FEES
22:44 - The Evolution of Inpatient Bedside FEES
31:27 - The Role of Speech Pathologists in Swallow Assessment
33:23 - Collaboration between Speech Pathologists & Otolaryngologists
35:31 - Developing Safety Protocols for Bedside FEES
41:21 - Equipment for Bedside FEES
53:20 - Differences between the NICU and the CVICU
01:00:03 - Final Thoughts and Advice Regarding Swallow Studies

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RESOURCES

KARL STORZ ENT Products:
https://www.karlstorznetwork1.com/ent

Olivia Brooks CCC-SLP’s UF Profile
https://ufhealth.org/doctors/olivia-a-brooks/bio

In this episode, Dr. Ashleigh Halderman, Rhinologist and Associate Professor at the University of Texas Southwestern Medical Center, discusses chronic invasive fungal sinusitis with hosts Dr. Gopi Shah and Dr. Ashley Agan,

First, Dr. Halderman outlines her advocacy work as President of the Texas Association of Otolaryngology. Then, the discussion transitions to chronic invasive fungal sinusitis. Dr. Halderman defines the disease, describes typical patient presentation, and reviews concerning imaging findings. Until biopsy can clinch the diagnosis, she maintains a high index of suspicion in cases of bizarre clinical presentation or facial paresthesia. The surgeons then shift their attention to management, which consists of culture-directed antifungals and judicious surgical intervention. Dr. Halderman wraps up the episode by sharing her pearls for operative management and long-term surveillance.

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SHOW NOTES

00:00 - Introduction
02:10 - Exploring the Texas Association of Otolaryngology
05:58 - Understanding Chronic Invasive Fungal Sinusitis: Types & Treatments
20:25 - Diagnostic Challenges and Imaging Insights
27:07 - Navigating Diagnostic Challenges and Treatment Options
29:40 - The Role of Biopsy in Confirming Fungal Infections
30:52 - Surgical Considerations and Pre-Operative Strategies
40:29 - Surveillance Strategies: Managing Chronic Invasive Fungal Sinusitis
46:34 - The Future of Surgical & Antifungal Therapies for Chronic Invasive Fungal Sinusitis

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RESOURCES

Dr. Ashleigh Halderman’s UT Southwestern Profile:
https://utswmed.org/doctors/ashleigh-halderman/

BackTable ENT Episode 30, “Revision Endoscopic Sinus Surgery"
https://www.backtable.com/shows/ent/podcasts/30/revision-endoscopic-sinus-surgery

Texas Association of Otolarynogology:
https://www.taohns.org/

In this episode, Dr. Sohit Kanotra, director of UCLA’s Complex Pediatric Airway Program, discusses open airway surgery in children with host Dr. Gopi Shah.

First, the surgeons review the presentation of pediatric airway stenosis, which causes stridor in younger children and exercise intolerance in older ones. Drawing on his experience at UCLA, Dr. Kanotra addresses how to build a pediatric airway program, emphasizing the importance of relationships with the NICU and PICU. He advises airway surgeons to coordinate with these units to share protocols, organize conferences, and assist with bedside swallow assessments. Then, the discussion transitions to pre-operative evaluation of and contemporary strategies in pediatric airway reconstruction. Dr. Kanotra shares pearls for surgical planning, operative technique, and post-operative management. The episode concludes with Dr. Kanotra’s high-level advice to fellow pediatric airway surgeons.

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SHOW NOTES

00:00 - Introduction
03:03 - Building UCLA’s Complex Airway Program
09:37 - Decision-Making in Pediatric Open Airway Surgery
20:10 - Pediatric Airway Surgery: A Multidisciplinary Effort
32:24 - Preoperative Assessment for Open Airway Surgery
38:16 - Evaluating the Airway: Techniques & Tools
39:34 - Planning for Open Airway Surgery
40:15 - Understanding Expansion & Resection Procedures
56:58 - Using Release Maneuvers in Pediatric Open Airway Surgery
01:00:29 - Post-operative Management and Follow-up
01:06:33 - Concluding Thoughts & Pearls

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RESOURCES

Dr. Sohit Kanotra’s UCLA Profile
https://www.uclahealth.org/providers/sohit-kanotra