To become the 70th President of the American Association of Neurological Surgeons (AANS) is an honor, and I pledge my utmost to merit that position. The individuals who have preceded me in office have set high standards, and I will do all that is in my power to not only uphold the traditions of excellence of the AANS, but to work feverishly to carry our organization into the 21st Century.
AANS: The Representative Body
AANS founders took the name of the preeminent neurosurgeon of the day, Harvey Cushing, as the name of their Association. When it was transformed into the AANS in 1965, it assumed a larger role, and became the medical specialty society representing the broadest spectrum of Board-certified neurosurgeons in the U.S. Over time, the AANS assumed an even greater representative role and began appointing quadrant representatives from the Council of State Neurosurgical Societies (CSNS) to represent and meet the needs of its grassroots members. Slowly, the AANS became the spokesorganization for organized neurosurgery.
A number of years ago, to enhance the nomination to the Board of Directors, the AANS Bylaws were revised to include more AANS members to serve on the Nominating Committee and to remove the AANS President from serving on that committee. This served not only to make the process more democratic, but to help avoid the possible undue influence of the President.
Last year, representatives from the AANS/CNS specialty Sections were seated as Ex-Officio members to the Board of Directors, along with the Chair of the CSNS, Chair of the Young Neurosurgeons Committee, and the Editor of NEUROSURGERY://ON-CALL®. In addition, the President of the Congress of Neurological Surgeons serves in a Liaison capacity to the Board of Directors, along with President of the Royal College of Physicians and Surgeons (Neurosurgery) of Canada, and the President of the Mexican Council of Neurological Surgery, A.C. This restructuring has enhanced the interchange of information and made the AANS even more democratic.
Advocating the Role of Neurosurgery
Like the AANS, the neurosurgical workforce is undergoing a transformation. Presently, neurosurgery represents less than 1 percent of the total physician workforce. However, despite being such a small specialty, neurosurgeons must undergo the most rigorous training, deal with the sickest patients and overcome the most difficult complications. Neurosurgeons also must make the time to deal with the political processes in hospitals and legislatures, and advocate the role neurosurgeons play in the medical community.
Likewise, the AANS has labored to educate third-party payors and decision-makers about the role of the neurosurgeon and the disorders that he or she treats, and recently published a special supplement in USA Today. The AANS will continue to expand its efforts through a variety of communication initiatives, including a grassroots spokespersons network and a series of prepared newspaper columns on neurosurgical topics.
Volunteers at the county and state medical society levels are needed if we are to advance the specialty and get the voice of neurosurgery heard.
Although we can work on national policies and carry the message to Capitol Hill, most of the work will be carried out on a grassroots level. In that arena, the effectiveness of a neurosurgeon at the local level cannot be overstated. Neurosurgeons are constantly asked for their opinions at the county and state society levels and that information is carried to the national level through both the American College of Surgeons and the American Medical Association, as well as into state legislatures. The ability to leverage our effectiveness is crucial, and that power rests in the hands of the individual practicing neurosurgeons – you and me.
To that end, I ask each and every one of you to join with me in representing the future of our specialty at the state and local level. Your involvement will help facilitate what we accomplish on Capitol Hiill. More important, your involvement will have a great influence in changing legislation and ultimately improving the state of neurosurgical practice. As Tip O’Neil, former Speaker of the House of Representatives, said, “all politics is local.” That statement applies to all of us – think about it.
Stewart B. Dunsker, MD, is the 2000-2001 AANS President.