The practice of medicine has changed significantly over the past decade-culturally, technologically and strategically. Neurosurgery faces significant challenges to the professional status of the specialty and livelihood of its practitioners. Managed care has limited neurosurgeons’ ability to charge appropriate fees, while competing specialties have expanded the scope of their practices to include many procedures and services once “owned” by the neurosurgeon.
This can be seen very clearly, for example, in the areas of spine, cerebrovascular and peripheral nerve disorders. These trends have been accelerated, to some degree, by advances in technology and a growing tendency toward subspecialization. Most significantly, referral patterns have undergone a dramatic change. This is largely due to the fact that a large portion of referring physicians, third party payers and the general public are unclear as to the role neurosurgery plays in treating common medical conditions. Consequently, growing numbers of patients who would ordinarily have seen a neurosurgeon have been directed to other specialists, such as orthopedic surgeons, for treatment.
Given this environment, it is more important than ever that Neurosurgery communicate with and educate referring physicians, third-party payers, potential patients and government decision-makers about the quality and scope of neurosurgical care. Traditionally, neurosurgeons have not had to be aggressive in the market place, but competition dictates that Neurosurgery take a more proactive approach (see previous article on media coverage).
A Brief History
The AANS Public Relations Committee was first organized approximately seven years ago with relatively modest goals, focusing initially on publicizing the Annual Meeting. However, as the health care environment began to change, the committee became more aggressive in its outreach efforts to the media. Under the leadership of then-chairman Bruce Kaufman, MD, the committee tripled media coverage of the Annual Meeting and began to build a reputation for AANS as a source of credible information about neurosurgery.
The committee also began to serve as a primary resource for several new communications initiatives developed in partnership with the Congress of Neurological Surgeons, including the neurosurgical marketing exhibit project that targets family physicians and internists and the two Getting SMART About Surgery marketing communications programs. It also assisted in development of public education content for NEUROSURGERY://ON-CALL®.
In 1999, in his role as chair of the PR Committee, Dr. Kaufman was asked to serve on the editorial board for a new AANS public outreach project, a neurosurgical insert to USA Today. “When we first developed the concept for the Getting SMART programs,” noted Dr. Kaufman, “we identified a communications gap with the public and media about neurosurgery: America thinks we are strictly brain surgeons. It was readily apparent that we were going to have to do more marketing and public relations to change this perception if neurosurgeons were going to expand their practices in the future.”
Changing Role of PR Committee
Neurosurgery Today: It’s Not Just Brain Surgery, the USA Today insert, was a major national effort by the AANS to change the erroneous perceptions many hold about neurosurgery. The AANS published the insert not as a one-time effort, but rather as the first step in an ongoing process to raise public awareness of neurosurgery. To accomplish this mission, the membership of the Public Relations Committee was expanded and its charges broadened. The committee, led by its new chairman Ronald Warnick, MD, of Cincinnati, Ohio, has as its main charge to educate the public, media, legislators, managed care organizations, referring physicians, related medical specialties and other groups about neurosurgery. Its membership has been expanded to 12 AANS members representing each of the six neurosurgical sub-specialties. In addition to Dr. Warnick, committee members include Robert Heary, MD, vice chair; Bruce Kaufman, MD, past chair; Ghassan Bejjani, MD; Kim Burchiel, MD; Robert Harbaugh, MD; Peter David Le Roux, MD; Karin Muraszko, MD; Sherry Taylor, MD; Alex Valadka, MD; Howard Weiner, MD, and Edie Zusman, MD.
“Unfortunately, the media has presented a very skewed image of what neurosurgeons do,” said Dr. Warnick. “In addition, competition is growing among various board-certified physicians within the medical community to stake out their piece of the ‘treatment’ pie. The number of professional medical societies promoting their specialties is on the rise. While it is beneficial for the public to better understand how specific medical disorders should be treated, in many cases they are receiving confusing messages about who should be treating them. The job of the Public Relations Committee is to cut through that confusion and tell our target audiences exactly what neurosurgeons can and should do.”
New Projects
To accomplish its goals, the PR Committee has developed a series of strategies to address the key constituencies with which neurosurgeons need to communicate. During the next several years, AANS members will begin to see an array of public relations projects unfold that are aimed at raising the visibility of neurosurgery. Some of the projects to be implemented in the new few months are:
National Spokespersons Network. The network is comprised of a specially trained group of neurosurgeons who are experts in various aspects of neurosurgery including stroke, Parkinson’s disease, epilepsy, spinal cord injuries, back pain, sports-related injuries, lumbar spinal stenosis, brain tumors, neurotrauma, pain management and pediatric neurosurgery. These experts will serve as spokespersons for AANS and will be available to assist media representatives with their stories, provide additional background materials and offer knowledge about the everyday practice of neurosurgery. The PR Committee will provide information to spokespersons that will work proactively with the media to maintain and enhance the image of neurosurgery and the AANS. Each member of the PR Committee and the Board of Directors will serve on the Spokespersons Network.
Procedural Statistics Survey. For the first time the AANS is compiling data on neurosurgical procedures, which will then be published in a special report. This invaluable data will be used to inform the media, third-party payers, vendor companies and various committees developing public and physician education programs about the scope of neurosurgery and to bring better focus to AANS public outreach, education, research activities and fund-raising activities. Approximately 1,500 active members have received a questionnaire asking for their annual operative figures including the number of patients being treated in each procedural category. The report will be published in late September.
Scientific Press Releases. Press releases highlighting selected articles in the Journal of Neurosurgery, Journal of Neurosurgery: Spine and Neurosurgical Focus will be distributed to science reporters nationwide beginning with the September 2000 issue.
Public Education Brochures. A new line of patient education brochures for members’ use in their practices is planned. The first, to be available in late fall, will be “A Patient’s Guide to Neurosurgery.”
Collaborative Projects. The AANS continues to work on collaborative communications efforts with other medical organizations including the Brain Attack Coalition, the National Institutes of Health and the National Stroke Association.
Internet Initiatives. AANS is reaching out to health-related sites such as WebMD and drkoop.com to develop collaborative public outreach projects.
Getting Involved “We are continually working to expand the public’s perception of neurosurgeons across the country, but this is something that can also be done effectively on the local level,” noted Dr. Warnick. Neurosurgeons need to actively engage in marketing and public relations within their communities.
“I urge all of you to build upon what the PR Committee is doing at the national level,” Dr. Warnick said. “Volunteer to speak before civic groups, make yourself available to local media as an informational resource, use the Getting SMART materials to promote awareness of neurosurgical practice with referring physicians and the public, distribute Neurosurgery Today within your community . . . just spread the word. Neurosurgery is not just brain surgery.”
With continued focus on public outreach efforts for the AANS, look for new initiatives from the AANS Public Relations Committee in the months to come.
AANS Public Relations Committee Charges
- Create and implement proactive neurosurgical public education programs for national media coverage including consumer and trade publications, newspapers and radio stations and make recommendations for special projects such as implementation of a national neurosurgical education campaign
- Serve as the primary neurosurgical scientific resource for all AANS media, public education and referring-physician communications programs and evaluate new practice/technology developments in the field for possible communications/PR opportunities
- Oversee coordination of all public relations activities in support of the Association’s Annual Meeting
- Develop concepts and materials for the neurosurgery/marketing booth for the American Academy of Family Physicians and American College of Physicians Annual Scientific meetings
- Oversee development and production of AANS public education brochures, videotapes, slides and any additional support materials as required
- Help to organize and implement the grassroots AANS Spokes-persons’ Network dedicated to promoting the neurological surgery specialty and viewpoints/programs and members of the AANS
- Assist in collection and publication of procedural statistics for the specialty of neurological surgery for use with nationwide media relations efforts
- Coordinate communication outreach efforts with other medical specialties including neurology, stroke medicine, rheumatology, internal medicine, pediatrics, emergency medicine, radiology, etc.
- Help develop and implement public awareness programs that build upon nationally recognized campaigns and programs relating to neurosurgery
- Serve as communications liaison to both the AANS Washington office and the Coding & Reimbursement Committee for development of socioeconomic programs and projects and participate in identification and dissemination of leading-edge neurosurgical research.