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Pediatric Advances Prove Instructive for the Specialty

Cotton-Fitton Endowed Lecture in Pediatric Otolaryngology
9:45 – 10:45 am
Room E450A

Most medical advances are explored and developed in adults and later applied to children. In otolaryngology, pediatric practice can lead the way.

“Robin Cotton and Cindy Fitton’s accomplishments have shown us that some pioneer pediatric advancements form the basis for adult care,” said Jennifer J. Shin, MD, SM, vice chair of academic affairs and associate professor of otolaryngology at Harvard Medical School. “Methods that advanced early in pediatric otolaryngology support our ability to demonstrate value-based care. These techniques have been incorporated into national and international programs, and it’s much of where medicine is going next.”

Jennifer J. Shin, MD, SM

Dr. Shin will explore recent advances in pediatrics that have affected the entire specialty during her lecture, “Pediatric Advances: Shaping Daily Practice for the Subspecialist and General Otolaryngologist.”

Pediatric researchers are reshaping daily practice for all ENT clinicians, she said. This includes guidelines on the management of otitis media, the appropriate use of validated instruments, and the development of a cascade of procedural advances.

“We’ve developed a system to help parents describe their children’s symptoms more efficiently and in a way we can track,” Dr. Shin said. “That leaves us more time to talk about management strategies and share decisions about potential interventions and the risks and benefits of surgery.”

On the purely practical side, pediatric care often requires more in-depth discussions with families, leading to a need for more efficiencies in clinic.

“It may be that those of us who see kids are not deterred by a detail-oriented approach,” Dr. Shin said. “Or it could be the need to explain treatment rationales in more detail to parents, but a substantial portion of us are highly interested in evidence and outcomes.”

There is increasing movement toward value-based care, which is a model that incentivizes providers with rewards for better outcomes and lower spending, she said. Some reimbursement structures already include payment based on demonstrated patient outcomes.

“It is important for us as otolaryngologists to learn to judge what is being proposed to assess our value proposition and our performance,” Dr. Shin said. “Outcomes that are patient-centered—what matters most to children and families—that’s what we need to focus on. We are learning to use pediatric data to guide us in making the soundest decisions for all of our patients.

“In the spirit of the Cotton-Fitton legacy, I will talk about ways that recent pediatric data can guide us in making the soundest decisions day to day in clinic. With the growing focus on value-based care and performance metrics, understanding national and international programs as well as important recent advancements can help otolaryngologists pick and judge ways to assess our own outcomes.”

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