Neurosurgeons Must Invest in Future – Please Support the Neurosurgery Research and Education Foundation

Neurosurgeons historically have been pioneers. We have described disease entities (such as Cushing’s disease and Dandy-Walker malformation), developed surgical techniques (such as microsurgery and deep brain stimulation), and invented new technologies (such as stereotactic radiosurgery and spinal instrumentation). Our specialty has grown as these advances have improved the lives of our patients. Future improvements in the lives of our patients and the future growth of our specialty are critically dependent on our continuing to discover and innovate.

Our specialty remains small and highly selective. We are a very capable and successful group, but our continued success is threatened. We must compete for patients with other specialties much larger than our own. Our rates of discovery and innovation depend on our willingness to invest in research and education. The goal of the NREF, the Neurosurgery and Research Foundation of the American Association of Neurosurgeons, is to augment discovery and innovation by neurosurgeons by supporting promising young neurosurgeon clinician scientists at critical points in their careers.

Believing that neurosurgeons, through proximity to our patients, are best able to recognize opportunities for clinically relevant innovation, the NREF directs support of research to neurosurgeon clinical scientists. This support is most highly leveraged when given at key decision points in a young neurosurgeon’s career: the elective years of a residency and the first few years of an academic appointment. By providing salary support, the NREF grants to NREF Research Fellows and Young Clinician Investigators encourage research in three ways: they diminish the financial imperative for clinical activity, they facilitate acquisition of research training, and they validate the recipient’s commitment to research. As a result, neurosurgeons with high potential for research receive opportunity, training, and encouragement.

This targeted support of neurosurgical research is particularly important given the current decline in government support for research, especially research by surgeons. Hypotheses or techniques that we neurosurgeons believe to have high potential for clinical significance might go unexplored if we defer to governmental agencies that have little neurosurgical input. If we want to foster neurosurgical research with the greatest potential for helping our patients, we must identify it and we must fund it.

Toward these aims, the NREF has the superb Scientific Advisory Committee, led by Robert Grossman, MD; the Annual Fundraising Campaign and appeals directed by Michele Gregory; and the resourceful Executive Council, composed of 20 knowledgeable, committed neurosurgeons from all neurosurgical disciplines and regions of the country. The Scientific Advisory Committee annually evaluates more than 50 proposals from candidate Research Fellows and Young Clinical Investigators, and nearly half of the proposals typically are judged to be of high quality and deserving of funding. Under the terrific leadership of Marty Weiss, MD, FACS, the NREF has increased the number receiving funding from nine to 15 annually. We hope to increase that to 20 annually over the next three years.

Our fundraising efforts focus on three groups: patients, partners, and practitioners. Firstly, our patients: As the direct beneficiaries of prior neurosurgical research, patients should be keenly aware of its importance, grateful for past discoveries, and eager to support future investigation. The NREF will approach patients through patient advocacy groups and foundations focused on neurosurgical diseases.

Secondly, our partners: As agents of translation of discovery into treatment, companies fully appreciate the importance of investing in research and development. Much of the recent increase in NREF funding has come from corporate partners interested in enhancing ties with neurosurgeon clinician scientists. We will seek further increases in this support.

And thirdly, practitioners: We neurosurgeons should support neurosurgical research and education out of both self-interest and altruism. Many of the projects funded by the NREF pursue discoveries and innovations that will expand the bounds of neurosurgical practice to the benefit of both patients and practitioners. Support of the NREF is thus a commitment to the future of neurosurgery as well as a way to give back to a profession that has been so good to us.

As beneficiaries of NREF efforts, past awardees will be asked both to donate financially and to explain to others the impact of an NREF grant on their commitment to research. The NREF also will appeal to sister organizations, such as the Congress of Neurological Surgeons and the American College of Surgeons, to join us. Most critical, however, is the support of individual neurosurgeons. We know better than anyone else how important to our patients and to the future of our profession are continued discovery and innovation. I hope that each of us will give wisely and generously.

Griffith R. Harsh IV, MD, FACS, MBA, NREF chair and 1986 NREF Research Fellow, is professor, program director, and vice-chair of neurosurgery at Stanford University.