Colleagues Hail Dr. Florin for Contributions
For years a small core of neurosurgeons have worked behind the scenes on reimbursement issues, representing the interests of neurosurgery. One of the most effective and knowledgeable experts on coding is Robert E. Florin, MD, whose tenure with the AANS RUC Advisory Committee ends next spring. Dr. Florin will remain an important resource for these issues, but his colleagues want to take the opportunity to salute him for his tireless efforts.
“Dr. Florin is probably one of the most knowledgeable physicians in the United States about the CPT system and RBRVS [Resource-Based Relative Value System],” says John A. Kusske, MD, AANS Vice President and former Chair of the AANS Managed Care Advisory Committee. “He has developed a detailed knowledge of the fundamental workings of the system and has developed original techniques to analyze the RBRVS. He is sought after by all medical specialties for his knowledge.”
Dr. Florin participated in the AMA’s five-year review of Medicare’s RBRVS, playing a crucial role in the recommendations submitted to the Health Care Financing Administration. For this service and other roles, he received the 1996 Distinguished Service Award from the AANS.
The AANS/CNS Joint Officers recently sent Dr. Florin a letter saluting him for his service to neurosurgery.
“Dr. Florin became a world-class expert in coding, reimbursement and in the workings of HCFA,” says Stewart B. Dunsker, MD, AANS President. “He understood the process and the people. By sheer volume of work and by displaying dedication that is unrivaled, he mastered the entire scene and all the databases.”
ABC Documentary Showcases Neurosurgeon
A network prime-time TV audience watched a neurosurgeon in action when he performed a hemispherectomy on a three-year-old girl at Johns Hopkins Children Center in Baltimore. The gripping drama was part of ABC’s Hopkins 24/7, a six-part documentary series that aired in the late summer and fall. The show highlighted neurosurgery, allowing millions of Americans to see a delicate, life-altering procedure performed by a neurosurgeon.
This was not the first time Benjamin Carson, MD, chief of Pediatric Neurosurgery at Johns Hopkins, drew attention. In 1987, he was the primary neurosurgeon among a 70-member team that successfully separated seven-month-old German twins joined at the brain. The 22-hour operation to separate the Siamese twins was believed to be the first time hypothermia was coupled with circulatory bypass and deliberate cardiac arrest to spare brain tissue. In 1997, he led a team of doctors in South Africa in the first completely successful separation of vertical craniopagus twins from Zambia.
But it’s not the headlines that motivate him. “The most satisfying part of the job is being able to walk out to those extraordinarily anxious parents who never believed that anything good was going to happen and to be able to tell them that their kid is doing great,” he said in a live chat on ABCNews.com after the show.
Dr. Carson has performed 80 hemispherectomies. Johns Hopkins is a leading center of the procedure, performing one to two of the surgeries every month. The first hemispherectomy was performed by neurosurgeon Walter Dandy, MD, at Johns Hopkins in the 1920s.
Dr. Carson said he saw Alex in July along with other children he has operated on at a hemispherectomy reunion. “Alex has done extraordinarily well-no more seizures and rapidly progressive development. The vast majority of the patients are just doing spectacularly,” he said.
The TV program showed Alex’s parents anxiously asking Dr. Carson basic questions the morning of the surgery. Dr. Carson said those questions had been answered for the parents before.
“Frequently, during periods of great anxiety, people will forget and we always say we have to tell them the same thing three times before it sinks in,” he said. “I think it is very important for physicians to educate patients. I think the days of the doctor dictating should be gone, hopefully, because the most important thing that a person has is their life and their health and they should be fully informed so that they can be an active participant in their own health care.”