I think that regardless of what basic specialty you look at, there is a wide curve on who knows what. I was seen by a general ENT, who with really obvious oral cancer symptoms put me on antibiotics for two weeks to no avail, and when that didn't get my neck lump to go down, he just wanted to switch antibiotics. I didn't know much about the ENT world in those days, and had never even heard of oral cancer, and I went to a second one (also a generalist). However this was an older guy that had practiced for a couple of decades, and obviously had seen a lot more. He got what was going on right away and on my first visit the fine needle biopsy of the node was done. Both generalist ENT's, two very different levels of knowledge.

Having said all that, I think that what people would prefer here (and me too), is that general MD's are not people's sole source of information when they have a problem, and they get the most first look opportunities. They seem to be the group most behind the curve, and take the longest to refer and get it right. Dental people are really getting pushed to get this right, but there is still a huge number of them disengaged from the oral cancer issue. I won't go on a rant here as to why I believe this is, but it is a fact. They know the basics, and certainly see a ton of oral lesions of all types. However peer reviewed published data shows that most oral cancers are found/diagnosed outside the world of dentistry. That just means that they are not looking to me, since referring suspicious tissue out to someone further up the food chain is so easy to do. I think that non surgically oriented ENT's are still a good call, but no more so than an oral surgeon. (Who is asked to biopsy lots of things by his referring generalists).

We have a problem in the US with enough people being up to speed about the OC problem, HPV, what oral lesions are dangerous, and not enough people referring suspicious things out instead of watching and waiting for the obvious to heal when it isn't going to. I lay blame across all specialties, because here on these forums we have been hearing it for more than a decade - people come and they have the same issues, misdiagnosis, lack of diagnosis, failure to refer when something does not resolve, and every doctor type except oral medicine specialists in dentistry, and head and neck surgeons, make these mistakes with too great a frequency and have dropped the ball.

So I guess you would call me an equal opportunity layer of blame, and ENT's are just one of many that could get this better.