title: The otolaryngologist's cost in treating facial trauma: American Academy of Otolaryngology--Head and Neck Surgery survey.
abstract: OBJECTIVE
  (1) To define practice patterns and perceptions of junior otolaryngologists treating maxillofacial/neck trauma. (2) To identify manners in which the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) can meet future trauma needs.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Academic and private otolaryngology practices.
  
  
  METHODS
  A 26-question survey was designed to identify demographics, practice patterns, perceptions, and areas for improvement in maxillofacial/neck trauma care. It was distributed anonymously to AAO-HNS members completing residency from 2005 to 2009. Analysis included descriptive statistics and χ(2) comparisons.
  
  
  RESULTS
  Of 1343 otolaryngologists, 444 (33%) responded. A total of 85% of responding physicians treat maxillofacial/neck trauma, and 64% identify trauma as an ideal part of their practice. Sense of duty (54%), institutional requirements (33%), and enjoyment (32%) are the most common reasons for treating trauma. Major deterrents include patient noncompliance (60%) and lifestyle limitations (47%). Five respondents (3.1%) have been involved in a trauma-related lawsuit. While insufficient reimbursement is a major deterrent to treating trauma (52%), only 36% would increase their volume if reimbursement improved. Increased educational opportunities represent the most common request to the AAO-HNS (59%), followed by AAO-HNS focus on improved reimbursement and tort reform (28%).
  
  
  CONCLUSIONS
  Most junior otolaryngologists treat maxillofacial/neck trauma on a monthly basis. A total of 64% identify trauma as a component of their ideal practice. They report being well to very well trained in all facets of trauma, with the exception of vascular and laryngotracheal injuries; but they desire additional education, such as courses and panels. Universal concerns include inadequate reimbursement, limited pool of treating physicians, and lack of practice guidelines.
authors.affiliation: Yokota Air Base, Japan.
authors.forename: Scott B
authors.initials: SB
authors.lastname: McCusker
authors.forename: Cecelia E
authors.initials: CE
authors.lastname: Schmalbach
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000191:economics* / Q000601:surgery*; D008505:Medical Staff, Hospital / Q000191:economics / Q000706:statistics & numerical data; D019838:Neck Injuries / Q000191:economics / Q000601:surgery; D010036:Otolaryngology / Q000191:economics* / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000191:economics / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States