Letters to the editor.

Editor:

I have never hesitated to compliment you on a good editorial; similarly, I must tell you that your June editorial is terrible! You didn't adequately expand on your paragraph as to why the American Neurotology Society (ANS) voted against Certificates of Added Qualifications (CAQs) in neurotology and why the readers should vote similarly on the Academy ballot. You demonstrated an unconnected flight of ideas and stated wrong information.

By way of introduction, let me tell you that I still chair the Secretary's Liaison Committee (SLC). I was there; Dr. Nielsen did not say the American Academy of Otolaryngology--Head and Neck Surgery (AAO--HNS) would not administer (administrate) the Combined Otolaryngological Spring Meetings (COSM). He said the Academy's board of directors insists that they account for and recover all costs, and figured tiffs way if they did the meeting next year, it would cost the societies $106,000 more.

The SLC then went into executive session and, by prior arrangement, heard a presentation from the American College of Surgeons on how they could administrate the COSM meeting. The secretaries asked for a written proposal that they could discuss with their society's board of directors/council as to how to proceed with COSM management. The SLC will discuss this soon.

It is a multifaceted problem. The Triological Society announced they would pull out of COSM in 4 years. A lot of their dissatisfaction came from the condensation of the meeting with simultaneous scientific sessions all day, and no time for socialization like in the old Breaker days, etc.

Please accept this criticism as constructive.

Jerry Goldstein, MD

EAR, NOSE R. THROAT JOURNAL Board Member

Lake Worth, Florida 

Response:

Thank you for your informative letter concerning my June 2003 editorial, "Implications of subcertification in neurotology." I value your comments as an editor and friend and appreciate your taking the time to write to me.

You are in a position to know all of the details about the discussions between the AAO--HNS and COSM, and our readers will benefit from your explanation. I was present at the business meeting of the ANS; the reason Dr. Moises Ariana gave for making his motion that the official position of the ANS was against subspecialty certification by the American Board of Otolaryngology (ABOto) and that the president of the ANS be directed to officially transmit that information to the ABOto was that the ANS membership had voted overwhelmingly against subcertification in a poll taken by the president, but the results had not been officially conveyed to the ABOto. Members speaking in favor of his motion gave similar reasons.

The reason I included in my editorial the comments about the unrelated business between the AAO--HNS and COSM was to inform our readers who were not at the meeting of the announcement of the Triological Society's president and to stress the point I wished to make in the following paragraph of how rapidly medical practice is dramatically changing.

Jack L. Pulec, MD

Editor:

I appreciated your June 2003 editorial. I support your stand on the issue of subcertification. It is ill timed and only will make matters worse for each of the members of our medical specialty. We can assume that the reasoning behind subcertification is to give the certified a competitive edge in the marketplace. However, we face more competition from outside the specialty than from within.

It is my opinion that every effort should be made to expand the specialty and recapture lost areas of expertise than to further divide the specialty into ever-smaller bits. I think an example of a subspecialty that needs to be recovered is esophagology. This is now possible via flexible transnasal endoscopy. ENT is no longer the expert on this part of the body.

Garett D. Herzon, MD, FACS 

EAR, NOSE R, THROAT JOURNAL Board Member

Los Angeles, California

Editor:

I applaud your position.

Louis W. Welsh, MD

Huntingdon Valley, Pennsylvania 

Editor:

Your editorial in the recent issue of EAR, NOSE & THROAT JOURNAL was superb. You said it exactly the way it needed to be said. I commend you, as usual. The problem is that the hierarchy just doesn't want to hear all this.

Wallace Rubin, MD

Metairie, Louisiana

Response:

Thank you for your comments about my June editorial. There are times when we must all speak up about important issues.

Jack L. Pulec, MD