Becoming president of the AANS is an honor that was beyond my wildest dreams when I began to practice and teach neurosurgery 25 years ago. This honor bestows a responsibility that I eagerly accept: in simple terms, to do my best to ensure that the AANS serves neurosurgery as effectively and efficiently as it could. To this end, I have set some “internal” and “external” priorities.
Unification, the Highest Priority
Internally, my highest priority is to continue to strengthen the “house” of neurosurgery so that it can serve our needs in the most effective and efficient manner. We at the AANS believe firmly, as has been emphasized by our two most recent presidents, that neurosurgery best can be served by a merger of our two national organizations that would result in one single infrastructure to serve all the needs of neurosurgery.
We emphasize that the merger we envision is not a takeover of one organization by the other. On the contrary, what makes this merger eminently sensible and attractive is precisely the fact that the Congress of Neurological Surgeons has been so successful as an organization.
The CNS was founded to meet the needs, mostly educational at that time, of the many neurosurgeons who were excluded from the AANS because of its early restrictive membership requirements. Over the years the AANS, by adding different membership categories to accommodate different stages of a neurosurgical career, has become all-inclusive, while at the same time the CNS has grown as an extraordinarily successful organization fully capable of providing its membership, which is now practically indistinguishable from the AANS’s membership, with a full range of services that go beyond the original educational mission.
In other words, now we have two mature, successful organizations providing similar and in some cases, competitive services to an almost identical membership. This is what makes it possible for the AANS to talk to our colleagues at the CNS entirely as equals working together to unify neurosurgery to better serve the needs of our membership. We want to incorporate those attributes that have made each organization successful into the culture and governance of a unified house that blends the best of each organization.
A Vision for Unification
The unification that I envision is entirely compatible with the continuation of the two greatest sources of pride for each organization: the journal and the annual meeting. Each meeting might maintain its current flavor and format and each journal, its own independent editorial process. Both journals and both annual meetings could be served by the single infrastructure of a unified house for neurosurgery.
Unification is what our current challenges demand, it is what our membership has clearly stated it wants, and the timing for it is propitious; after all, four of the six current officers of the AANS are either former presidents or vice-presidents of the CNS.
This is why, with the conviction that each organization wants to do what is best for neurosurgery, I am optimistic that the ongoing discussions on unification that both organizations are undertaking in earnest will succeed.
Strengthening AANS
While working with unshakable commitment toward unification, we will continue to strengthen the AANS. I am fortunate that, in no small part due to the wisdom and hard work of my predecessors, I am taking the helm of a much stronger organization than we ever had.
We now have an outstanding, though leaner, home office in Chicago ably led by Thomas A. Marshall, our executive director, who in a little over a year has stabilized and energized our staff.
Our financial situation-thanks to the efforts of Arthur L. Day, MD, our treasurer, and Ronald W. Engelbreit, CPA, our most capable deputy executive director-has been turned around so that the AANS is again a healthy organization. This success allows us to engage in other “internal prioritiies.”
We have appointed a task force, led by Robert A. Ratcheson, MD, our secretary, to find innovative, effective ways to enhance our educational mission, especially in the increasingly important area of “maintenance of competency,” which is such an important component of our modern neurosurgical horizon.
Another task force was developed to improve and enhance the educational value and the attractiveness of our already very successful annual meeting. A third task force has been studying ways of enhancing the scope of our Professional Conduct Committee, which is a source of great pride for us and a model of professionalism in this activity that has been widely praised and is beginning to be emulated by other medical professional associations.
Finally, Dr. Day is leading an effort to find new sources of revenue, within the core of our mission, that will make it possible to fund these activities and to reduce the dependence of the organization on membership dues; in other words, to reduce your annual dues.
Unified Front Faces Formidable Challenges
Externally, we face formidable challenges. Fortunately, years ago the AANS and the CNS-working together synergistically in a model of how we could serve all the needs of neurosurgery-developed the Washington Committee. It would take too much space to describe the impact that this unified activity of our national organizations has had; this impact, though perhaps hard to perceive by the membership, has transcended by far what could be expected for a specialty of our size.
We are very fortunate to have Katie Orrico, JD, as the able and effective director of our Washington office. I share with her the view that our greatest “external” challenges are the professional liability crisis, the continuing decrease in Medicare reimbursement, and the crisis in neurosurgical coverage in emergency medical services brought about in no small part by the modifications and amplification of EMTALA regulations.
Another major threat that is very much on our radar screen is the threat to our patients and our livelihood posed by the SPORT (Spine Patient Outcomes Research Trial) study underway at the National Institutes of Health that, because of major flaws in design, could lead to the conclusion that surgery is no better than conservative treatment for lumbar disc herniations and lumbar spondylosis.
These are some of the “hot topics” that will continue to be covered in the Bulletin. The AANS and the CNS, through our Washington Committee, are ferociously engaged in each of these battles … and we will redouble our efforts!
I look forward to the honor and the challenge or serving you as the 72nd president of the American Association of Neurological Surgeons.
Roberto C. Heros, MD, is the 2002-2003 AANS president. He is professor, co-chairman and program director of the Department of Neurosurgery at the University of Miami.