The AANS will celebrate its 70th anniversary in Toronto. That marks 70 years of education of neurosurgeons and the public and a long history of advocacy for neurosurgeons and for our patients. The AANS has carried its heritage of the past into the present and the AANS will carry that heritage into the future. Our tradition is treasured, but we look upon that as not something to be preserved and maintained AT ALL COSTS but as a way to be innovative and to serve our members and our patients.
We have built on the best from our history and that scaffold gives us a better base to take us into the future. Indeed, the AANS has always used the strength of its staff and its infrastructure to not only support activities but also, most importantly, to develop programs that advance all of neurosurgery.
Board Is More Responsive, More Democratic
To meet demands and to enhance communication with various segments of the neurosurgical community, the AANS changed the selection process for membership on the Board of Directors (BOD) several times in the past 25 years. Those changes made the AANS more representative of American neurosurgery and more democratic. Quadrant representatives of the Council of State Neurosurgical Societies (CSNS) sit not only on the nominating committee of the AANS but also on the BOD itself.
Officer and BOD nominations are solicited from every component of neurosurgery so that members can be selected from the widest range of individuals. The BOD consists of neurosurgeons from all walks of practice. Approximately half are individuals from private practice and half are from academia. To enhance the outreach of the AANS BOD and communication with the specialty areas within neurosurgery, each specialty section has a representative as an ex officio member on the BOD.
To augment communication, the AANS launched a leadership conference six years ago in which it invited representatives from all the Sections and the CNS to participate so that we could exchange ideas and eliminate areas of misunderstanding. Subsequently, that became a joint project with the CNS and AANS hosting the Sections. That process of expanding communication grew and now we have ex officio representatives from all Sections on the BOD, which enables the AANS to hear and respond to the concerns of American neurosurgery.
Primacy of Education
The AANS Annual Meeting continues to be the educational highlight of the year. Clinical practice and clinical ideas are the cornerstones of the program. Concentrating on clinical material alone, however, is not enough. What we have learned from both our own research studies, as well as from the non-medical industry at large, is that Research and Development (R&D) are necessary for the advancement of the specialty. Consequently, interspersed throughout the entire meeting will be R&D reports. Also, this year we will have the first endowed lecture, the Hunt Wilson Lecture. Renowned scientist Dennis W. Choi, MD, will educate all of us at the meeting.
Attending the Annual Meeting is the most efficient and effective way of learning. However, it is not always the most convenient way. The AANS will continue to experiment with ways to make learning more convenient. We are developing more courses to take on the road. These types of courses were successful in training 3,000 neurosurgeons to become proficient in spinal instrumentation. These programs require financial resources. But these are not just expenses-they are financial investments for the benefit of all of neurosurgery.
Support for Research and Education
This past year the AANS Research Foundation changed its name and expanded its mission. It became the Neurosurgery Research and Education Foundation (NREF). The new name reflects its enhanced emphasis on increasing education of neurosurgeons in research as well as funding research.
The NREF continues to spur new areas of R & D. These endeavors will undoubtedly lead to the expanded neurosurgery of tthe future. Whether that expansion develops into new forms of intra-operative treatment of gliomas, into refined treatment of movement disorders, into enhanced stabilization of the spine or into innovations in any other area of neurosurgery cannot be known. We do know, however, that investing in these new areas will expand the envelope of treatment for our patients and will expand the sphere within which neurosurgeons work.
Journal of Neurosurgery
The Journal of Neurosurgery remains the world’s premier source for neurosurgical education and research. The quality of the research it publishes and the quality of its artwork continue to merit awards. Not being content to bask in their laurels, John Jane, MD, the Editor, and the prestigious Editorial Board, have launched two new journals: Neurosurgical Focus, an award winning online journal, and the Journal of Neurosurgery: Spine, which is quickly gaining increased readership.
Working for the Family of Neurosurgery
The AANS has been at the forefront of Continuing Medical Education accreditation. When the Accrediting Council for Continuing Education (ACCME) changed the rules for giving CME credits, the AANS trained staff to become experts in the accreditation process. By investing resources to codify the new rules, the AANS saved money and time for the other neurosurgical organizations. We will continue to record CME credits so that members will have an easier time documenting credits for membership and licensure.
Recently the AANS started programs to publicize articles in the Journal of Neurosurgery and to inform the public of conditions commonly treated by neurosurgeons. We sent press releases to newspapers around the country. Much like we did with the USA Today insert, we inform the public that in addition to treating problems of the brain we are involved with the treatment of back pain, Parkinson’s disease, stroke, sports injuries and other areas. This message has been printed in 130 newspapers and reached more than 1.6 million people.
AANS also showed its leadership in launching the Cost Containment and Physician Reimbursement committees. For a number of years these activities were managed and funded solely by the AANS. Finally, others recognized these projects’ importance and they became joint projects. The CSNS even asked that we increase the money allocated to study reimbursement.
NEUROSURGERY://ON-CALL®
The AANS launched NEUROSURGERY://ON-CALL® thanks to the innovation and drive of Sidney Tolchin, MD, former President of the AANS. This successful online initiative required an investment of resources by the AANS that has benefited all neurosurgeons. The wisdom of introducing N://OC* has been born out by the fruit of the endeavor, but this required staff and infrastructure resources that we are told are not needed.
Publication of ‘Orphan Books’
The AANS has been at the forefront of publishing books on neurological surgery. Indeed, the AANS is the largest producer of neurosurgical books in the world. Some of the topics presented have been called “medical orphans.” Other publishers would not produce them because the market was not big enough to ensure a profit. Even though those publications have required financial support from the AANS, we produced them because the educational benefits far outweighed any monetary considerations. These publications represent another area of investment by the AANS for the benefit of all neurosurgeons. They are an investment with a return in education, not dollars-an investment well worth the effort.
Professional Conduct Committee
The AANS Professional Conduct Committee is not only the most active neurosurgical professional conduct committee, but it is also a model for professional conduct committees in the United States. The AANS has been asked to share the details of its model with other medical organizations because our model guarantees due process for all the individuals involved. This costlly activity (more than $50,000 per year) benefits all neurosurgeons because it helps protect all of us from physicians who might testify inappropriately in depositions or in court. The AANS has even gone to the U.S. Supreme Court to uphold neurosurgery. Maintaining professional conduct activities is an infrastructure we need and it serves American neurosurgery well.
AANS National Office
More than two decades ago the physician leaders of the AANS recognized that the demands on them were being stretched to the limit. They realized that some goals of the association would be sacrificed if only volunteer physicians were used to manage and direct the organization. Consequently, they hired Carl Hauber, CAE, as the first Executive Director and bought a building to house the various activities of the association. Over time the AANS carefully blended the work of volunteer physicians with that of a professional staff to enhance its effectiveness. Of course, neurosurgeons could handle the responsibilities such as negotiating with hotels and signing contracts with publishers, but we scrupulously avoided imposing a burden on neurosurgeons when professional staff could perform these tasks. Over time we have developed and built an efficient administration to manage the association’s activities and we are proud of that AANS machine.
We all know these are difficult times in the house of medicine. Even though the storm clouds of interference from government and third-party carriers gather, the AANS shall continue its activities of education of neurosurgeons, education of the public, and of advocacy for the profession.
The 2001 Annual Meeting from April 21-26 promises to be outstanding. Paul McCormick, MD, Annual Meeting Chair, has gone to extraordinary lengths to make this program work effectively and efficiently. Our Scientific Program Chair, William Friedman, MD, has put forth an excellent array of papers and presentations. One of the highlights will be the Cushing Oration by Tom Brokaw, world famous journalist. With this superb menu of education I am sure you will want to attend the meeting.
I hope to see you all in Toronto.
Stewart B. Dunsker, MD, is a practicing neurosurgeon at The Mayfield Clinic, Professor of Clinical Neurosurgery, Vice Chairman of the Department of Neurosurgery and Director of the Division of Spine Surgery at the University of Cincinnati.