In 1999, Drs Robbins and Shaha 1 delivered the inaugural presidential lectures, which highlighted the traditions and history of our 2 founding societies. Last year, President Medina 2 drew our attention to some formidablechallenges with respect to workforce, the direct consequences of poor reimbursement, and the potential that we might lose our impact on head and neck disease if we fall prey to tragic optimism. These concerns were recently echoed by Academy President Jack Gluckman, 3 who identified head and neck surgery as a specialty in crisis.