The 69th Annual Meeting of the AANS in Toronto offered in just six days in April innumerable opportunities to improve professional talents and patient care for years to come. Neurosurgeons honed their skills at clinics and seminars, advanced their scientific knowledge, enhanced their understanding of socioeconomic issues, honored their peers and renewed old friendships.
Here are some other numbers that show the scope and quality of the meeting:
- The meeting drew 2,466 medical attendees and 5,896 attendees altogether. The majority hailed from the United States and Canada but neurosurgeons from as far away as Germany, Brazil, Turkey and Australia also attended.
- The scientific program included 35 practical clinics, 21 scientific sessions, 126 oral abstract presentations and 500 poster presentations.
- Nearly 200 companies displayed more than 660 technical and institutional exhibits. The latest neurosurgical equipment was featured.
The meeting showcased neurosurgery to millions of people in the United States and Canada through outreach to the media. Fifty neurosurgeons took part in hometown radio interviews and three neurosurgeons participated in a live Web chat on WebMD. Additionally, dozens of reporters were on hand to file stories for their newspaper, radio station or Web site.
Presidential Address
In his presidential address, Stewart B. Dunsker, MD, sharply criticized the regulatory burdens imposed on physicians by government and the insurance industry. “Each president of the AANS thinks they have seen the pinnacle of senseless destruction to patient care,” said Dr. Dunsker wryly. The primary purpose of the AANS remains educational, yet the ever increasing regulatory repression has forced neurosurgeons to protect and preserve not only the nervous system but the healthcare system itself.,/p>
The current healthcare system is based on a false premise, said Dr. Dunsker. “Cost controls have never succeeded in providing long-term solutions to economic problems,” he said. The cause of rising healthcare costs is not physician compensation but an aging population, increased demand for healthcare, especially for the sophisticated technology shown by the media, and increased labor costs. Yet the Healthcare Financing Administration, notorious for inappropriately evaluating reimbursement, has targeted physicians and hired former FBI agents who are mistaking “minor accounting errors” for fraud, said Dr. Dunsker.
Dr. Dunsker called on neurosurgeons to be more active in county medical societies, the American Medical Association and other such groups to leverage their influence. “Five thousand levers can move the government and insurance companies,” he said. “We need to take part in the debate not in the halls of hospitals but in the halls of legislatures.,
“It’s easy to sit back and let other physicians do the work. The more we work … the more likely we are to change the future.”
Canadian Healthcare
The future of medicine in Canada was the subject of a special lecture by Alan R. Hudson, MD, retired president and CEO of the University Heath Network in Toronto. Dr. Hudson compared the health systems of Canada and the United States and implicitly offered some advice for his beleaguered U.S. colleagues.
Canada’s universal healthcare system outperforms the U.S. system in infant mortality, longevity and other statistical categories even while spending considerably less, said Dr. Hudson. Canadians proudly cherish their system and derisively compare it with the “dreadful American system.” Moreover, physicians in Canada get to decide what is medically necessary treatment and the bills they submit are paid in full. Also, regulatory paperwork both for physicians and patients is much less burdensome than in the United States.
Yet the Canadian system is inadequate in some important respects and is facing a financial crisis, said Dr. Hudson. The system, ostensibly a one-tier system, actually has several tiers. Nearly one-third of healthcare spending in Canada is from private funds because some services such as the costs of drugs outside hospitals are not covered by the government. Accessibility is also an issue. Canadians in certain regions are much less likely to receive certain procedures such as cataract surgery. Another problem is the relative lack of high-end technology. The entire country does not have a single Gamma Knife.
Adding to these woes are rapidly rising costs in healthcare. “To put it succinctly, we can’t afford it. Spending is going up,” said Dr. Hudson. Further fueling the troubles are a nursing shortage and a brain drain among physicians, as healthcare professionals head to the more lucrative United States.
Dr. Hudson said the sage advice of New England poet Robert Frost can help Canada emerge from its predicament: “Originality and initiative are what I ask for from my country.”
Cushing Orator
Tom Brokaw, the 2001 Cushing Orator, praised the U.S. men and women of the World War II era for saving the world from tyranny and fashioning an affluent modern world whose chief virtue is the abundance of political and individual freedom. Yet, said Brokaw, the anchor of NBC Nightly News, the United States today appears to have lost its way. Business, education, healthcare and the media are bogged down by narrow self-interest and mean-spiritedness.
Brokaw asked neurosurgeons to act patriotically. “I hope during the course of this meeting you advance your understanding of an exacting profession. That alone is a great contribution,” he said. “I would hope you would ask from time to time, ‘Is it enough? What else can I do not just as a physician but as a citizen?’ “
Neurosurgeons Honored
The exemplary “citizens” of neurosurgery were honored. Julian T. Hoff, MD, a longtime leader in research and education and an AANS Past President, received the 2001 Cushing Medal, the highest honor bestowed by the AANS. Gary VanderArk, MD, who organized a coalition in Colorado to help those without health insurance, received the 2001 Humanitarian Award. Co-recipients of the Distinguished Service Award were Frank P. Smith, MD, and Donald H. Stewart, MD, both longtime leaders in organized neurosurgery. Shekar N. Kurpad, MD, received the 2001 Van Wagenen Fellowship. Dr. Kurpad’s research interest is using stem cell transplants to protect and restore cerebral circuitry after high-dose intra-arterial chemotherapy.
New Leaders
The Annual Meeting also saw the changing of the guard. Stan Pelofsky, MD, was elected the 2001-2002 President of the AANS. Roberto Heros, MD, was elected President-Elect; Volker Sonntag, MD, Vice President; Robert Allan Ratcheson, MD, Secretary; Arthur L. Day, MD, Treasurer; and Dr. Dunsker, Past President. Joining the Board as Directors at Large were Steven L. Giannotta, MD, L.N. Hopkins, MD, and Richard Roski, MD. Joining as Ex-Officio members were Ross Bullock, MD (Neurotrauma Section), David F. Jimenez, MD (CSNS), T. Glenn Pait, MD (History Section), John G. Golfinos, MD (Young Neurosurgeons), and Thomas G. Luerssen, MD (Pediatric Section).
Lynn Martin Offers Advice on Advancement for Women Neurosurgeons
Women neurosurgeons who want to advance the status of women in neurosurgery must be more assertive and emulate the tough-minded negotiating strategies of men, said former U.S. Secretary of Labor Lynn Martin, who spoke at the WINS reception at the Annual Meeting.
“Women think they should mediate,” said Martin. “Why not just say, ‘These are the four things [we want.]’ “
“I’m the biggest fan of lists,” said Martin. “There is no argument, no fighting, no nothing. ‘Here is the list.’ “
Martin, who gave the 8th Annual Ruth Kerr Jakoby Lecture, said that, unfortunately, neurosurgery is a particularly tough field for women to gain advancement in. “The tenure and research tracks to a great extent lay upon the exact times of child rearing,” she said. “Women want to have ways to come in and out of the profession.”
Not helping matters is the attitudes of some men. “It’s still my belief that there is an undercurrent of sexism in all the surgical disciplines. It’s hard to hit because it’s subtle-and that’s a sign of progress,” she said.
Women need to learn how to negotiate contracts and handle other business-related matters if they want to get ahead. “Like most women, I had no ability to negotiate contracts [after I left government]. Men do it better. Men do not emotionalize contracts and women still do,” she said.
Martin said furthering women in medicine is not so much a gender issue as it is a human rights matter. She talked about how women in Afghanistan are not allowed to see a doctor, let alone become one. Equity in the workplace is “what America is about. If we do this right, we will all be better off.”