Trends in Otolaryngology Consultation Patterns at an Academic Quaternary Care Center

Abstract

Patients with diverse otorhinolaryngologic concerns often have conditions that can be appropriately triaged and medically managed by primary care professionals. However, recent database reviews demonstrate that individuals with poor access to health care services may be more likely to present to the emergency department (ED) for evaluation and treatment of routine conditions, such as uncomplicated acute rhinosinusitis.¹ Adult and pediatric patients with otologic symptoms also represent a significant care burden to the ED, presenting with acute otitis media, otitis externa, and cerumen impaction.² Although the ED is designed to serve patients with urgent medical needs, it has become a convenient access point for many patients with nonurgent conditions, despite the extended wait times and potentially inferior clinical outcomes.^3-6 Nonurgent conditions evaluated at the ED are also associated with higher hospital fees and costs owing to potentially unnecessary tests and treatments.^7-10 The influx of new patients into the health care system owing to the Affordable Care Act is likely to continue to add significant burden onto emergency care professionals and those in the consulting specialties, including otolaryngology, if current trends in medicine continue.