Otolaryngology Referral Policy Changes Begin This Month

Otolaryngology has experienced a sharp rise in referrals, which has increased wait times for new patients to two to three months. New referral policies will go into effect May 3, 2023, to help ensure those patients who most need specialty care from Otolaryngology have timely access to our specialists. We will reevaluate our capacity and referral policies every three months.

Effective May 3, we will not see patients with the following conditions:

1. Allergic rhinitis
2. Ankyloglossia for children 3 years old and older
   • For concerns about ankyloglossia impacting speech, we recommend submitting a referral to our Childhood Communication Center (CCC) with subspecialty VPD Clinic for a Speech Language Pathology evaluation focused on the impact of oral structure on speech function. Our Speech Language Pathology team will collaborate with Otolaryngology if any concerns are identified that would benefit from our intervention.
3. Chronic cough
4. Globus sensation
5. Hyperacusis
6. Speech delay
   • For concerns about general oral anatomy impacting speech, we recommend submitting a referral to our Childhood Communication Center (CCC) with subspecialty VPD Clinic for a Speech Language Pathology evaluation focused on the impact of oral structure on speech function. Our Speech Language Pathology team will collaborate with Otolaryngology if any concerns are identified that would benefit from our intervention.
   • For concerns about hearing loss impacting speech, we recommend submitting a referral to Audiology for a hearing evaluation.
7. Throat clearing

We will schedule patients with the following conditions if they have already received first-line treatment and not shown the expected improvement:

• Epistaxis
• Recurrent pharyngitis or tonsillitis
• Rhinitis
• Tonsillar hypertrophy/snoring
• Otitis media and eustachian tube dysfunction

Helpful resources for PCPs

Resources to support PCPs in managing the above conditions may be found on the Otolaryngology website. They include:

Allergic rhinitis

• Patient education handout for Nasal Allergies
• Patient education handout for Nasal Saline
• Clinical Practice Guideline for Allergic Rhinitis (AAO-HNS)

Chronic cough

• See resources for Allergic Rhinitis, above
• GERD Parent Take Home Guide_11-13-13.pdf (gikids.org)

Epistaxis

• Patient education handout for Nosebleeds
• Patient education handout for Nasal Allergies
• Patient education handout for Nasal Saline

Globus sensation

• See resources for Allergic Rhinitis, above
• GERD Parent Take Home Guide_11-13-13.pdf (gikids.org)

Otitis media

• Algorithm: Acute Otitis Media
• Algorithm: Acute Otitis Media With Treatment Failure
• Algorithm: Recurrent Acute Otitis Media
• Algorithm: Chronic Otitis Media
• The Diagnosis and Management of Acute Otitis Media (AAP)
• Clinical Practice Guideline for Tympanostomy Tubes in Children (AAO-HNS)

Pharyngitis

• Algorithm: Acute Pharyngitis
• Algorithm: Recurrent Pharyngitis
• Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America | Clinical Infectious Diseases | Oxford Academic
• Clinical Practice Guideline for Tonsillectomy in Children – Update (AAO-HNS)

Sinusitis

• Algorithm: Chronic Sinusitis (Chronic Rhinitis/Chronic Nasal Drainage)
• Algorithm: Acute Sinusitis

Throat clearing

• See resources for Allergic Rhinitis, above
• GERD Parent Take Home Guide_11-13-13.pdf (gikids.org)

Tonsillar hypertrophy

• Algorithm: Tonsillar Hypertrophy
• Clinical Practice Guideline for Tonsillectomy in Children (Update) (AAO-HNS)

If there are additional resources you would find helpful to your practice, please email physician.relations@seattlechildrens.org. We value your input.

Learn more

Find complete referral guidelines on the Otolaryngology “Refer a Patient” website.