The George W. Bush era is in full swing, ending a period of seeming calculated political hostility toward medicine and the specialty of neurosurgery. As touched upon in our cover story about the election and neurosurgery, the Clinton years saw a series of skirmishes between organized medicine and the federal bureaucracy. During this time we battled legislation and regulation that threatened the well being of our patients, our hospitals, our training programs and ourselves. While the stakes and passions have soared, organized neurosurgery has used educational tactics and skillful negotiation with great effectiveness. In this highly charged environment neurosurgery’s Washington Committee has served as the focal point of these efforts to present the perspective of our specialty to those that develop public policy.
While the look of the Bush White House will certainly be different than that of his predecessor, we cannot be sure that the forces inimical to the delivery of excellent neurosurgical care will suddenly become friendly. Anyone dealing regularly with the political scene in Washington is aware that change occurs slowly, victory is rarely complete and vigilance is essential.
It is my personal perspective that organized neurosurgery must continue to strengthen and refine the activities of its Washington Committee. The cost is relatively small and the potential benefit is enormous. This process has already begun, thanks to the unvarying support of the AANS and CNS officers and their Boards of Directors.
One important development has been the enlargement of the Washington Office staff-a step necessitated by the expansion of the scope of activities carried out by the Washington Committee. Organized neurosurgery is fortunate to have skilled personnel at the Washington Office, staffed by Cherie McNett, Lori Shoaf and Cynthia Spriggs and led by Katie Orrico, JD. Having worked with this team for two years, I can attest that the ability of neurosurgery to leverage the political process is extremely favorable because of our staff. Not only are they knowledgeable but they are excellent coalition builders and maintain strong working relations with many legislators and their staff.
A Valuable Reorganization
Recently, the Washington Committee has become part of a matrix structure with formal links to the AANS/CNS Drugs and Devices Committee, the AANS/CNS Outcomes Committee, the AANS/CNS Sections, the Council of State Neurosurgical Societies and the AANS/CNS Coding and Reimbursement Committee. This internal reorganization has allowed the Washington Committee and its matrixed partners to rapidly collect information and respond to external initiatives more quickly and cohesively than in the past.
This internal reorganization also reflects the expansion of the external initiatives by organized neurosurgery. Led by Rick Fessler, MD, neurosurgery has regularized its interaction with the FDA. New coding and reimbursement strategies have been coordinated by Jim Bean, MD, Bob Florin, MD, Lyal Leibrock, MD, Sam Hassenbusch, MD, Richard Roski, MD, and Greg Przybylski, MD. Through Buz Hoff, MD, Past President, and Howard Eisenberg, MD, President, the Society of Neurological Surgeons brings an important perspective to our initiatives in GME and at NIH. Our relationship with the AMA has been tightened thanks to Troy Tippett, MD, and neurosurgery’s other representatives to the AMA House of Delegates.
Wholly unrelated to these organizational developments by the Washington Committee has been the development of an independent neurosurgical Political Action Committee (ANS PAC). Support of such political action groups strengthens our voice in the political process.
Tough Challenges Ahead
Drawing an organizational chart for these interrelationships is daunting, yet such a complex approach is essential if we are to be successful. What will occur in Washington during the next four years as it pertains to neurosurgery is difficult to foresee.However, difficult challenges that require a concerted, collaborative effort to overcome will most certainly arise in the future. To counteract these developments, we’ve improved our organizational structures and are positioned to effectively represent the interests of our specialty and enhance the delivery of care, whether it be by coalition, education or political means.
As Chair of the Washington Committee for the past year, I am indebted to the AANS/CNS, their leaders and the many people mentioned in this column who have committed their time and talents to the betterment of our specialty and the patients we serve.
A. John Popp, MD, is Editor of the AANS Bulletin, Chair of the Washington Committee, and Henry and Sally Schaffer Chair of Surgery at Albany Medical College.