Morris raises many concerns in his letter and, although I understand and even share some of the concerns, I am not at all as cynical as he is about the management of otitis media, nor am I as pessimistic about the future for otolaryngology. Let us look at the issues that have been raised.
"The otolaryngologist is taken out of the loop Here Morris apparently is expressing concern that the Agency for Health Care Policy and Research (AHCPR) guideline suggests that a child younger than 3 years with persistent middleear effusion can be followed for 3 months before having a hearing evaluation, and the child might be followed for up to 4 months before having tubes inserted in the ears. We do need to remember that the AHCPR panel is not the first or only group to advocate waiting for several months before recommending insertion of tubes in the
Grundfast KM. Otitis Media-Reply. Arch Otolaryngol Head Neck Surg. 1995;121(12):1434–1436. doi:10.1001/archotol.1995.01890120090021