Truth or Consequences – Neurosurgeons Need to correct Their Image or Lose Potential Patients

A the cliché goes … image is everything. If true, how exactly does the American public perceive neurosurgeons? According to the news media, they are perceived primarily as doctors who remove brain tumors, of course. We know that neurosurgery is not “just brain surgery.” But how can the profession change that perception?

Before embarking on the Neurosurgery Today project (a neurosurgical insert published April 7 in USA Today), the American Association of Neurological Surgeons performed a media analysis to determine exactly what consumers were hearing about neurosurgery. Media analysis is one way to measure public perception. How the media portrays a certain issue or group often sets the mold for the public’s stereotypes, perceptions and opinions. That explains the millions of dollars poured into advertising and public relations campaigns each year.

The AANS media analysis searched through more than 3,000 newspaper and magazine articles, and radio and television reports and transcripts published in the United States during 1998. The search looked for the terms and concepts related to neurosurgery. The image that emerged paints an unrepresentative, yet not surprising, picture of neurosurgery:

• References containing “neurosurgeon and brain” outnumbered references with “neurosurgeon and spine” almost five to one.
• A quarter of all the articles that reference “neurosurgeon and brain or spine” also include the word tumor.
• The words “pediatrics” and “head injury” appeared with “neurosurgeon” more often than “spine.”

What Do These Numbers Mean?
The logical conclusion from the media analysis is that neurosurgeons are primarily brain surgeons because it appears that almost 80 percent of what they do is brain related. Further, the numbers imply that the most common disorder neurosurgeons treat is brain tumors. The reality is that according to the last Comprehensive Practice Survey conducted by the AANS in 1995, almost 70 percent of all neurosurgical procedures are performed on the spine, while brain tumors make up less than 10 percent of neurosurgical cases.

In addition, the analysis seems to indicate that pediatric patients and head injuries make up a larger portion of neurosurgical patients than spine disorders. The reality is neurosurgical spine procedures far outnumber pediatric and head injury-related procedures.

“This is the same problem we identified before we started development of the first Getting SMART About Neurosurgery project. America thinks we are strictly brain surgeons,” says Bruce Kaufman, MD, former chairman of the AANS Public Relations Committee. “It’s clear we have to do more marketing and public relations to change this perception if neurosurgeons are going to expand their practices in the future.”

While the media analysis presents a very unrepresentative profile of the profession, side-by-side comparisons with other specialties in competitive treatment areas are even more revealing:

• The term “back pain” was analyzed separately with the words “neurosurgeon,” “orthopedic surgeon” and “chiropractor.” “Back pain and orthopedic surgeon” outnumber “back pain and neurosurgeon” more than five to one and “back pain and chiropractor” outnumber “back pain and neurosurgery” four to one.
• When the terms “back pain and surgery” appear, the word “neurosurgeon” is only mentioned 6 percent of the time.
• Articles mentioning “carotid endarterectomy” also mention “vascular surgeon” (22 percent) or “cardiologist” (18 percent) more than twice as much as “neurosurgeon” (8 percent).
• The term “herniated disc” is 40 percent more likely to appear with “orthopedic surgeon” versus “neurosurgeon.”
• In articles focusing on stroke, 43 percent of the time cardiology is mentioned, 38 percent neurology and 19 percent neurosurgery.
• Fewer than two percent of the articles mentioning Parkinson’s Disease include a reference to “neurosurgeon.”

Polishing Neurosurgery’s Image
Ronald Warnick, MD, current chairman of the AANS Public Relations Committee, says, “If the public, which includes patients, the media, general public and primary care physicians, doesn’t know we treat these disorders, we are going to lose referrals to other specialties. With the Internet, patients are getting smarter and more sophisticated everyday and know what they want when they walk in to a doctor’s office.”

“We must continue to work on expanding the perceptions of neurosurgeons across the country and throughout our target audiences. The image of neurosurgery needs to be polished.”

Public Relations Statistics

The public is not aware that neurosurgeons operate on more than just the brain. Public Relations Statistics: What Do Neurosurgeons Do?

Neurosurgery in the Media

Nearly 3,000 newspaper and magazine articles, as well as radio and television reports and transcripts published in the United States, were searched for the terms and concepts related to neurosurgery during 1998.

The Story of “Back Pain”
Nearly 4,000 newspaper and magazine articles, as well as radio and television reports and transcripts published in the United States, were searched for the term “back pain” during 1998.

• Neurosurgery is mentioned in less than one percent of the hits for “back pain.”
• Even though surgery is mentioned 1,506 times, neurosurgery is only mentioned in 6 percent of those hits.
• “Surgery” is 75 percent as likely to be mentioned as “treatment.”
• “Back pain and orthopaedic” hits outnumber “back pain and neurosurgery” more than five to one.
• “Back pain and chiropractor” hits outnumber “back pain and neurosurgery” almost four to one.