Chapter 16: Accrediting Head and Neck Services
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Description
In this segment Dr. Goepfert talks about his service on the Joint Council, a combined effort of two societies of Head and Neck surgeons to regularize accrediting of surgical services. He first describes how the two societies came to work together, then notes how rigorous their parameters were for accreditation and the process of making site visits and making reports. (Dr. Goepfert also notes his discovery that some hospitals do not care about accreditation.) He was interested in the training of fellows who assist faculty members and observes that MD Anderson has a very well-organized training program: often fellows who come into the program have to be retrained to meet MD Anderson standards.
Identifier
GeopfertH_02_20120828_C16
Publication Date
8-28-2012
City
Houston, Texas
Interview Session
Helmuth Goepfert, MD, Oral History Interview, August 28, 2012
Topics Covered
The Interview Subject's Story - Professional Service beyond MD Anderson; Institutional Processes; Understanding Cancer, the History of Science, Cancer Research; Activities Outside Institution; Contributions; Education
Transcript
Helmuth Goepfert, MD:
As I mentioned to you, there were two head and neck societies. On two things they sort of worked together rather than against each other. One of them was education and training of head and neck surgeons, and the other one was in their annual meetings. So those were the two things that sort of got them together first. Both of them were interested in accrediting programs for the training of advanced head and neck surgery. So this committee, or this council, so to speak, would supervise that activity and keep up the credentialing of these programs. In addition to that, it eventually ventured into offering the selection of candidates. It was basically through this activity that I remained in touch with the two societies and sort of helped organize the accreditation process.
Tacey Ann Rosolowski, PhD:
And how did that work? What kinds of parameters did you decide to look at for accreditation?
Helmuth Goepfert, MD:
We looked at the— Basically what we looked at is what is the composition of the program as far as faculty is concerned, and it gave us an idea of what has been your patient caseload in the last year or two. What is the educational program that you have for your fellows? Are they lecturers? Is there laboratory experience? Is there requirement for publishing a paper at the end of their training? Issues of that nature. It was a pretty rigorous— There were assigned members of the two societies that would go and visit the programs and fill out a report. And according to that, we would grant them accreditation to train one, two, or even as high as three fellows per year.
Tacey Ann Rosolowski, PhD:
What is the effect of all of that? What effect did you see after creating that program?
Helmuth Goepfert, MD:
That there were hospitals that didn’t care about accreditation and sort of ran their own training program and still had people on board, but what I wanted to emphasize through this was that the fellow, which is one that comes out of a residency, needed additional training, and that this training be given by a structured program in a department, not by the fellow being the junior faculty. In many of the programs, the fellow was the junior faculty, which ended up the blind guiding the one or the one eye guiding the blind, because they really, as fellows, did not acquire any additional management skills except through practicing themselves. They didn’t have a mentor that would tell them this is the way it’s done. Our fellowship was very much geared towards training the surgeon how to examine the patient, evaluate the patient, the principles of multidisciplinary care, and how to operate in the operating room. Many fellows, we basically had to train them to operate from scratch. So, yes, that is a reality.
Tacey Ann Rosolowski, PhD:
Why was that?
Helmuth Goepfert, MD:
Because many a program in otolaryngology, from where these fellows came, really didn’t practice much head and neck surgery itself.
Tacey Ann Rosolowski, PhD:
And you were emphasizing yesterday the need for repetition in all of these.
Helmuth Goepfert, MD:
In some of these, yes. So, the group is more homogeneous today, where they get a little bit more exposure to surgery, but in those days, it was very heterogeneous. You often had people that, had they seen a laryngectomy? Yes, maybe one or two. Have they done one? No, they hadn’t. How many neck dissections had they been exposed to, or had they done or participated in? Maybe five to eight. What all of them had a lot of were tracheostomies, but tracheostomies were basically based on the need for an airway in patients that were in the intensive care unit. So, as I say, it was the heterogeneity of treatment—of training in the different programs—is what we wanted to diminish—make it more homogenous, more structured. So, we created documents that had to be filled and certain principles that had to be abided by.
Tacey Ann Rosolowski, PhD:
As you are kind of finishing up this section on your work as head of the department, is there anything that I’m missing? Are there other places where you felt you left your mark that we have not covered so far?
Helmuth Goepfert, MD:
(laughs) No. (laughs)
Tacey Ann Rosolowski, PhD:
You know, I never know how to ask that question because if I say, “What were your contributions?” people will say, “Oh, well, I was just part of a team.” Everybody is very—
Recommended Citation
Goepfert, Helmuth MD and Rosolowski, Tacey A. PhD, "Chapter 16: Accrediting Head and Neck Services" (2012). Interview Chapters. 1015.
https://openworks.mdanderson.org/mchv_interviewchapters/1015
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