Listen Up

Reducing referrals for ear wax – A study from England compared the use of a bulb syringe plus ear drops to ear drops and office follow-up for patients with problematic ear wax. Home use of a bulb syringe reduced the need for ENT referrals for wax removal.

• Observation – This is potentially a good way to reduce referrals and improve your economic profile. A couple years ago, I reviewed an evidence based guideline about ear wax removal and learned about everything we know – and don’t know – about this topic (who knew it was such a priority?) The Wall Street Journal web edition covered the release of this document and the resulting public commentary provided one of the funniest medical threads I have encountered to date. The highlights include the following list of items that should  not be used to clean earwax:
• toothpicks;
• pipe cleaners;
• lollipop sticks;
• car keys;
• pencils with too sharp a point;
• cocktail swizzle sticks;
• nail clippers;
• crayons;
• screwdriver longer than 4 inches;
• umbrella tips;
• 9 inch nails;
• uncooked strand of spaghetti;
• flame on tip of charcoal grill lighter;
• fish hooks; and
• shish kabob skewers. 

And the best comment: "How about the keys to a ’72 Ford Galaxy. That’s what my grandad always used. Worked for him. Plus it lubed the ignition."