A Conversation with Valley ENT
Arizona Physician took the opportunity to discuss multi-faceted and statewide otolaryngology practice, Valley ENT’s success with its physician President, Jordan Weiner, MD. As one of the leading ear, nose, throat, and allergy specialists in Arizona, Valley ENT prides itself for being patient-centric and helping their patients improve their quality of life.
AZP: Dr. Weiner, briefly share with us your medical background.
DR. WEINER: After graduation from Albany Medical College in 1994, I went on to train in otolaryngology at the Mayo Clinic in Rochester, MN. I then entered private practice in Scottsdale where I have practiced since 1999. My practice has encompassed all aspects of ENT, but I now specialize in surgery for obstructive sleep apnea.
AZP: Your focus at Valley ENT is obstructive sleep apnea. Tell us its importance and why early detection is critical for people.
DR. WEINER: Obstructive sleep apnea (OSA) is unfortunately, much more than noisy breathing or snoring during sleep. With sleep apnea, there is reduced airflow into the body. This occurs intermittently throughout the night. While most people with sleep apnea don’t wake up during sleep apnea events, the quality and depth of sleep are reduced leading to patients feeling unrefreshed in the morning and often sleepy during the day. Even memory and cognitive function are reduced. During these episodes of reduced airflow/breathing, tremendous stress is placed on the cardiovascular system and brain health is compromised as well. Over many years, this leads to marked increases in the risk of high blood pressure, heart attack, heart arrhythmias, heart failure, stroke and dementia.
It is for all of these reasons why treatment is vital both to help patients feel and function better but also to maintain health.
AZP: You are the President of Valley ENT and a practicing physician; how do you juggle your clinical and administrative duties?
DR. WEINER: Most of my time is still spent on patient care. While I do have occasional administrative tasks during business hours, most of my administrative work is after hours. I simply lose some free time…
AZP: Dr. Weiner, you are one the original founders of Valley ENT, share with us a brief history of Valley ENT.
DR. WEINER: After I entered practice following completion of my residency in 1999, I quickly began to observe the imbalances between physicians and the large entities that physicians deal with. This included principally insurance companies but also increasingly hospital systems. While these entities do legitimately serve the interests of their stakeholders, physicians’ interests are not considered. For insurance plans, this generally means reducing compensation for services to whatever degree their market clout allows. In some cases, they will pay physicians below the cost of providing care. For hospital systems, this can mean bringing in employed physicians to complete directly with the established physicians already in the community or in other cases cutting off physicians
from patients enrolled in the hospital system’s closed provider network.
Around 2005, I began efforts to bring together high-quality otolaryngologists into the newly formed Valley ENT group. We formed the group in 2007 with 13 physicians. We have grown over time to 38 physicians, 22 audiologists and 4 physician assistants. We are now one of the largest ENT groups in the country. However, we do not grow at the expense of quality and reputation. If a potential physician or group doesn’t meet our requirements, they are not considered.
Valley ENT by the Numbers:
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Founded in 2007
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38 Physicians
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4 Physician Assistants
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1 Physical Therapist
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22 Audiologists
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230 Total employees
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Facial Cosmetic Surgical Procedures
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Blepharoplasty, BOTOX – Fillers and Chemical Peels, Deviated Septum, Chin – Neck Liposuction, Ear Surgery, Eyebrow Lift, Facelift & Neck Lift, Rhinoplasty, Nose – Sinus – Facial Fractures
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Conditions Treated
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Ear – Dizziness, Ear Drainage, Ear Fullness – Plugged
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Ear, Ear Infections, Ear Noise – Tinnitus, Ear Pain, Hearing
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Loss – Chronic & Sudden Onset
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Nose – Facial Pain – Pressure, Nasal Allergies, Nasal
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Mass – Growth, Nasal Obstruction, Nosebleeds, Runny
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Nose, Sinus Infections, Deviated Septum
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Throat – Hoarseness, Neck Mass/Growth, Tonsilitis,
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Throat Mucus, Difficulty Swallowing, Mouth Growths,
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Noisy Breathing,
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Immunology – Asthma, Hives
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18 Locations
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Phoenix, Scottsdale, Glendale, Mesa, Chandler, Flagstaff, Sierra Vista, Green Valley, and Tucson
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Connect with Valley ENT: (602) 258-9859 or visit azvent.com​
AZP: What services and programs do Valley ENT provide to patients? Which are the most popular.
DR. WEINER: At Valley ENT, we provide care for the full breadth and scope of otolaryngology. This encompasses patients from newborns to geriatric adults. As a specialty, otolaryngologists take care of disorders of the ear including all forms of hearing loss, nasal and sinus disorders, throat problems ranging from tonsil problems, throat cancer and voice disorders. We also manage breathing problems including nasal obstruction but also sleep apnea. Tumors of the glands of the face and neck including the salivary glands as well as the thyroid gland are managed by us too.
If hearing loss is significant, most of our locations also provide hearing aid services under the direction of our doctorate-level audiologist, not technicians as might be found in big-box stores. It’s hard to say what is most popular because each physician and each site is a little different.
In some locations, pediatrics might be a very large part of the practice, and they deal a great deal with tonsil problems and ear infections. Another site may specialize entirely in sinus and nasal disorders or ear conditions.
AZP: You have physicians working alongside audiologists, physician assistants, and nurse practitioners, how has that helped your practice?
DR. WEINER: The practice of medicine is complex and challenging. Working together with our other medical team members makes our practice stronger. We could not take care of ear disorders
without the expertise provided by our many audiologists. These professionals have doctorate degrees in audiology to allow the most accurate diagnosis of ear conditions given the complexity of the auditory (hearing) system.
They also provide our hearing aid services so that the patient has continuity of care with the same provider that helped diagnose the hearing loss. Our physician assistants and nurse practitioners can take care of many of the less complex problems common in ENT allowing the physicians to focus on cases of higher complexity requiring surgical management.
AZP: Share with us changes you have seen in otolaryngology in the past 10-15 years?
DR. WEINER: Like many other fields in medicine, otolaryngology has experienced some game-changing advances in recent years. For hearing disorders, the advances in hearing aid technology have been tremendous. Devices are small and far more sophisticated than ever before. This allows for far better
hearing results for the patient. In the world of nasal disorders, the development of a group of medications we call “biologics” has revolutionized the care of patients with inflammatory conditions of the nose and sinuses.
These drugs in many cases have eliminated the recurrence of nasal polyps after surgery and thus reduced the need for multiple sinus surgeries. For throat cancer, there have been two very significant developments. One is the emergence of human papilloma virus (HPV) as the leading cause of most throat cancers, replacing cigarette smoking in 2017.
This is significant because studies have shown that cancers caused by HPV are less likely to be lethal than similar cancers caused by smoking. Most patients now survive their throat cancer, a wonderful development we have witnessed. This better prognosis is leading to trials of reduced doses of radiation so that patients will not only survive their cancer but have fewer long term side effects from their treatment. We have also seen the development of “immunotherapy” for cancer with drugs that help the immune system destroy the cancer. This has dramatically helped patients with melanoma for example.
Finally, for sleep apnea surgeons, we now have the ability to treat sleep apnea with an implanted nerve stimulator that stimulates tongue muscles to keep the airway open during sleep. This has in many cases replaced older, more painful surgeries. Many more people are now getting treatment for their sleep apnea than ever before.
AZP: Valley ENT is a truly statewide otolaryngology practice, how were you able to achieve that? Do you see a need for expansion or are you the right size as a practice?
DR. WEINER: We have grown into a statewide practice because of the benefits we provide to practices as a result of joining our group. We have developed and honed all aspects of the business side of medicine. This includes electronic medical records, a professional billing department, internal accounting, IT and human resources and most importantly, the professional management of these areas and the group as a whole. We can do this more efficiently due to our size and do so with a much greater degree of sophistication than possible for a small practice with a few providers. This is eminently scalable, which allows us to bring in a group in another part of the state with relative ease to the benefit of both parties.
I don’t think there is necessarily a “right size” for a practice. Clearly, growth at the expense of quality is undesirable. However, by continuing to grow, we continue to improve the scale of our practice, which reduces costs and allows even greater sophistication and professional management. I do predict that we will continue to grow in the coming years.
AZP: As your organization grows, what obstacles do you see in your path forward?
DR. WEINER: The biggest is by far the government. We have seen huge increases in reporting requirements to the federal government in the name of increasing quality and decreasing cost. The metrics that we report to satisfy the demands of the government are practically irrelevant to the practice of otolaryngology, but it is time-consuming and expensive to do so.
AZP: What, if any, government intervention do you believe is needed to help practices like yours remain successful?
DR. WEINER: The question implies that government intervention is needed or helpful. Generally,
the opposite is true. Thus, the expression laissez- faire or “let go”. If left alone, medicine can flourish. For example, it was the federal government that pushed people’s health insurance into their employment by making this a non-taxable benefit when provided by employers but not when paid for individually during the 1930s. Thus, people’s healthcare insurance became both tied to employment and dictated by the employer, not something an individual would generally choose. On the other hand, when the government restricts trade or harms one’s competition, it does for a time benefit the
favored business. However, this is harmful to the consumer and industry at large, and I would never ask for this type of favor (“intervention”) from government.
AZP: What does the future hold for Valley ENT?
DR. WEINER: The future for Valley ENT is very bright. We have developed into a large, sophisticated practice serving the ENT needs for much of the state of Arizona. We have a strong brand. Our size and scope should position us to be able to deal with both large insurers as well as hospital systems on a fair basis while maintaining our core values. â–