State otolaryngology society membership: an obligation for all of us.

Costs for annual dues and contributions seem awfully high to many physicians. Economic pressures generated by decreasing reimbursement and increasing overhead expenses have led many doctors to look for ways to cut costs. Dropping out of organizations that charge dues and eliminating voluntary contributions seem like easy, benign cost-reduction measures. However, state otolaryngology societies deserve our continued support.

These societies exist to serve the public good by advancing the highest ethical and professional standards for the practice of Otolaryngology--Head and Neck Surgery, and by serving the professional interests of otolaryngologists and our patients. Much of the work performed by state societies takes place "behind the scenes," and many otolaryngologists are not even aware of how much these societies do. Nevertheless, their work is of great benefit to all of us, and we are obligated ethically to contribute our fair share to help defray the expense of the benefits we receive.

So what do effective state societies actually do? This brief discussion will not provide a complete answer, but I will attempt to highlight a few of the important activities typical of most state otolaryngology societies.

State societies advance the interests of our profession through professional education, public education, public relations, establishing relationships with insurers and advocating for reasonable reimbursement, monitoring proposed legislation, advocating on our behalf with state regulatory agencies, identifying and supporting appropriate political candidates, and in many other ways. Moreover, the pursuit of such local activities enhances the contributions of our national associations by providing local insights and personal attention that national organizations cannot offer as easily.

For many residents and young practitioners, state society meetings provide not only practical education, but also our first opportunities to present papers in public. State society meetings have been educational proving grounds for generations. Many state societies supplement their annual meetings with periodic courses and with invaluable public education campaigns on topics such as smoking cessation, head and neck cancer, voice preservation, infant hearing screening, and many others. They also help the public to understand not only otolaryngologic disorders, but also who otolaryngologists are and what we do. These activities not only improve healthcare and public relations, but they also influence public opinion and establish the educational basis needed to generate public support for legislation that is of value to our patients and our profession.

State otolaryngology societies typically work closely with county and state medical societies to represent our interests with local payers and legislators. Having our interests represented by a large group of physicians enhances our chances of obtaining appropriate reimbursement, and of obtaining reimbursement at all for newer procedures and treatment methods.

There is a nearly endless list of legislative initiatives around the country that may have immediate, practical impact on otolaryngologists and our patients. They address issues such as insurance coverage, tort reform, scope of practice, licensure for physicians, licensure for allied health personnel, and many other vital topics. Just as the American Academy of Otolaryngology--Head and Neck Surgery (AAO--HNS) works closely with national organizations for audiologists and speech-language pathologists to ensure professional excellence and public safety by maintaining appropriate definitions of scope of practice, so too must local organizations.

State otolaryngology societies typically hire lobbyists who work on our behalf to identify and analyze bills of interest as soon as they are introduced, and sometimes even before they are introduced, so that our state otolaryngology and medical society leaders can review them, have effective input while there is still time to influence the outcome of proposed legislation, and so that we can have a voice in supporting or opposing proposed laws that affect our patients and our practices. The old adage that "all politics is local" holds true for medical politics as well as for politics in general. Without the diligence of the lobbyists paid for by our state societies and the dedication of our state society leaders, a variety of beneficial legislation (such as infant hearing screening programs and antismoking legislation) might never have been passed. Conversely, without their efforts, numerous potentially disastrous legislative efforts might have succeeded over the past two years.

Specialty and medical societies and their political action committees (PACs) are responsible for advances, and for protecting our specialty and our patients. They identify not only potential advances and problems, but also politicians who understand the difference between them. The societies and their PACs provide the support we need in order to ensure optimal care for otolaryngologic disorders. The amount of support they require as dues and PAC contributions is a pittance compared with our incomes and the value of the education and public relations they provide; and it is certainly paltry compared with the amounts that trial attorneys spend happily on similar efforts.

If we expect to maintain our standards of practice and patient care, then we need to help solve the many problems that confront us. While few of us would even consider dropping our membership in the AAO--HNS (nor should we), too many of us benefit from the work of our state societies without contributing. Our state societies need support from all of us. National change begins in our own neighborhoods, and every otolaryngologist should be involved.

ROBERT T. SATALOFF, MD, DMA 

Editor-in-Chief