Feature Article: Toward a More Effective Collaboration

Toward a More Effective Collaboration by Aaron Fletcher, MD

2doctorsAs a discipline Otolaryngology has long recognized the benefits and virtues of a collaborative model of healthcare delivery. In fact, I believe that few other medical specialties collaborate as frequently and as effectively as Otolaryngologists—it is an integral part of our culture. On a daily basis, we are called to collaborate with specialists of diverse expertise (Audiologists, Speech and Language Pathologists, Neurosurgeons, Radiologists, Radiation Oncologist, Medical Oncologists and so on). In consulting these experts, we recognize the knowledge of these specialists as complimentary to our own and no less valuable. In fact, we frequently congregate in multi-disciplinary conferences where everyone has a say, and everyone’s opinion counts.

As our specialty embarks upon a changing healthcare landscape, we are constantly challenged to evolve our collaborative process in order to keep pace with the expanding application of technology across healthcare.This collaborative spirit is one of the major reasons that I enjoy this specialty. One of the things I appreciate most about Otolaryngology is the opportunity to learn the subtle nuances of a diagnostic finding, condition or technique that are afforded by colleagues and other members of the treatment team.  Throughout my very young career, I’ve found that better collaboration invariably leads to better care and that to be successful; collaboration requires shared vision, values, risks, resources, and rewards regardless of function, occupation or level of training. This is truly what collaborative care is all about.

communicationThe ubiquity of internet access via mobile devices and smartphones, along with the rise of social media has changed the way in which health care information is distributed and consumed. This factor has allowed patients ample access to information about their health conditions and associated treatment options. A recent Pew Internet research study found that one in three adults have turned to online sources to figure out a medical condition that they or someone else they know might have1. Combining these internet resources with expanded mobile network technology means that patients are increasingly capable of seeking answers to their healthcare questions instantaneously. This means that patients are now empowered to become more active participants in their care, and this is certainly a good thing.

On the other hand, these factors also exert pressure upon caregivers to keep pace with these changes in health related information consumption by increasing technological sophistication and improving their own access to medical knowledge. By doing so, we are better suited to meet the demands of a patient population that is better equipped to make important healthcare

As the application of technology across the healthcare landscape has led to a greater sense of empowerment among patients, advancements in health IT, (including electronic health records, cloud computing and health information exchange platforms), also hold great promise for clinicians. The advent of these tools has empowered clinicians to mobilize and share clinical information with members of the treatment team at any time and from any location with internet access. Given the intrinsic collaborative nature of our field, it makes perfect sense that we leverage these technologies to expand our approach to coordinating collaborative care. HIPPA compliant hosting and file sharing networks are now working to mitigate the risk of exchanging protected health information (PHI) via the web and mobile devices. These networks work to encrypt PHI both in storage and in-transit, thereby providing a layer of protection against breaches in security. While these platforms should be used with caution to ensure compliance with HIPPA regulations, as these tools continue to evolve, they will create new opportunities for collaboration and partnership across traditional institutional and geographic boundaries.

Naturally, I believe that Otolaryngologists should be at the forefront of integrating these tools into clinical practice, as we continue to seek new ways of perfecting collaborative care.  I believe ubiquitous data accessibility and sharing (cloud computing) coupled with HIPPA-compliant hosting platforms have the ability not only to facilitate, but to enhance the way we collaborate. Using these tools we can share best practices and treatment protocols, coordinate video conferences with colleagues outside our geographic area, and obtain outside expertise about challenging cases. These tools also allow us to interface with patients about their care, and to provide them a portal to share relevant updates on their condition from the comfort of their home. All of these efforts are critical to the long-term success of our collaborative efforts as a specialty, and familiarity with the tools by which we accomplish these aims is imperative.

So as we embark upon a continually evolving paradigm of healthcare consumption and delivery, we must continue in the spirit of collaboration, and seek out the new tools of our trade.  By doing so, we can continue to demonstrate that better collaboration leads to better care.


1.            Fox, Susannah, Duggan, Maeve: Health Online 2013. Accessed online via http://  pewinternet.org/Reports/2013/Health-online.aspx


Dr. Fletcher is the author of the just-published Comprehensive Otolaryngology Review: A Case-Based Approach Fletcher_COR

New year, new Plural blog

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If you’ve been following our blog the last few months— or trying to— you may have noticed we’ve been a bit quiet lately. Well, we are back at it so you can look forward to fresh posts on topics you care about. Whether you are a Plural author (or would like to be one) or you are a student or professional in Speech-Language Pathology, Audiology or Otolaryngology looking for information on your field, we promise to post on topics of interest to you. You can look forward to monthly guest posts from experts across these disciplines. This month’s guest post is a great article by Devin McCaslin, author of Electronystagmography/Videonystagmography (ENG/VNG)  that will be up on January 7. We will also be featuring publishing and self-marketing tips for authors, information and updates on professional meetings, and newsworthy items on our authors or their fields.
We are looking forward to a great year in 2013 with an exciting list of new books and other products due to publish, including many new editions of some of our best-known and treasured books. Be sure to check back with us for regular updates or to let us know what you think! You can also stay social with Plural on  Facebook  and Twitter.

Practical HNO References

We take pleasure in sending you details of three outstanding, practical references for your Cancer team. Check them out here!

First up is Biel’s book on PDT. Increasingly, PDT is moving from the domain of the dermatology team and onto your caseload. This practical book offers hints and tips as well as a solid grounding in successful technique. Also detailed are Weber and Moore’s outstanding new work on cutaneous malignancies and Guy Petruzzelli’s bestselling practical reference for all head and neck surgeons. Order your copies today!

Best-Selling Pediatric Craniofacial Reference

Charles Moore’s multi-disciplinary reference offers you a range of perspectives in diagnosing, assessing and successfully treating pediatric facial trauma.

This practical reference offers the viewpoints of a team of clinicians distills the wisdom and expertise of an oral surgeon, neurosurgeon, dentist, ophthalmologist, otolaryngologist, radiologist, plastic surgeon, and craniomaxillofacial surgeon. Order your copy today!

Resource books for the ear, nose, and throat

Take advantage of three pocket-sized references that certainly punch above their weight – from KJ Lee’s outstanding manual of best practice, through Raza Pasha’s famed guide for the Boards (now in its third successful edition), to a great 10-minute assessment guide that your ER, nursing and allied health teams should have at their fingertips.

All three ready references will help save your time, as well as offering valuable hints, tips and guidance in your daily clinical practice. Click here for more info and to order your copies today! 




Pocket references for ENTs on the move!

Plural has the perfect pocket resources for ENTs – like the newly released Otolaryngology Surgical Instrument Guide by Justin S. Golub, MD, and Nicole C. Schmitt, MD.

The definitive guide to more than 200 of the most frequently used surgical instruments in otolaryngology-head and neck surgery! Each chapter features professional photographs of instruments followed by detailed descriptions and tips for use. Conveniently organized by specialty, this book will be prove highly useful for residents, fellows, attendings, scrub nurses/technicians as well as advanced students.

Click here for more information and to order your copy today!


New Surgical Instrument Guide Coming Soon!

The pocket partner to Pasha’s Otolaryngology-Head and Neck Surgery is coming soon! Releasing this Fall, Otolaryngology Surgical Instrument Guide serves as a handy reference of more than 200 of the most frequently used surgical instruments in otolaryngology. Organized by surgical subspecialty, this pocket guide features professional photographs of the instruments, their formal name, their aliases and details on how to set up equipment. Order your copy here.

Welcome to the June 2011 issue of Plural Community, the free newsletter by your community, for your community.

In advance of the publication of his new book Cutaneous Malignancy of the Head and Neck : A Multidisciplinary Approach, co-author Brian Moore writes our feature article on the subject of skin cancer—a condition that he now ranks as not far short of epidemic.

Congratulations are extended to our winners! Gina Palma from Bronx, NY, was the winner of our Plural Community May competition and received free copy of Communication and Swallowing in Parkinson Disease. Michael Wadie won a copy of the forthcoming Cutaneous Malignancy of the Head and Neck: A Multidisciplinary Approach and Alan Chu received Health Care Reform Through Practical Clinical Guidelines, both at the annual COSM conference. Lastly, congratulations to Clarissa Rider, who won a free copy of What Every Singer Needs to Know About the Body at May’s Classical Singer convention. For details on June’s competition, see below!

We hope you enjoy!

Plural is headed to COSM!

We are excited to be preparing for the COSM meeting in Chicago.  We have amazing discounts on our favorite books, including some titles that are 50% off!  We will also be having a drawing for two free books.  We will be at booth #618; please stop by and say hello!

Excellent Review of Sleep Medicine in JAMA

The new book Sleep Medicine  received a wonderful review in the Journal of the American Medical Association (JAMA).

Here’s an excerpt:

“…Because Sleep Medicine provides such a good overview of the field as a whole, it will be useful for family and pediatric physicians as well as nurse practitioners. And because of the exceptionally detailed and well-presented overview of the structural and mechanical aspects of the upper air-way, how these aspects contribute to the development of OSA, and the thoroughness with which the different treatment options are discussed, this text will likewise prove to be an excellent resource for trainees as well as practicing specialists in sleep medicine.”

Read the full review and order your copy here!