Neurosurgery faces significant challenges to the professional status and livelihood of its members and the specialty. Buffeted as we are by the growing shifts in reimbursement patterns and encroachments by other specialties into our traditional scope of practice, the Joint Council of State Neurological Societies (JCSNS) planted the seed last year for a national effort by neurosurgeons to come forward and be heard. It is vital that we speak up and remind consumers, referring physicians, third-party payers, and even the media about the value and contributions of neurosurgical care to the well being of patients.
In this context, The American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS), and the JCSNS created an Ad Hoc Committee on Communications to consider and recommend a communications program that could address the challenges of today’s healthcare marketplace. This Committee consisted of myself, Edward R. Laws, Jr., MD, Bruce Kaufman, MD, Mitchel Berger, MD, Susan Nowicki, APR, AANS Director of Communications, and David Tabolt, an outside communications consultant based in Chicago.
Program Elements
We determined that such a program would be most effective if it was designed to build awareness of the specialty of neurosurgery incrementally, over time, rather than all at once on a grand scale. This is in keeping with guiding philosophy of the AANS Long-Range Plan that activities should be specific, measurable, attainable, relevant, and time-framed (SMART). The CNS concurs with these defined activities as well.
The Committee decided that each phase of the program should place emphasis on a common condition where neurosurgery should be the provider of choice, but currently does not enjoy an exclusive position. We also felt the program should educate as well as inform. Finally, and most importantly, we felt strong member involvement was needed in order to ensure its success. In summary, the overall goals of the program are to:
- Increase awareness of the scope and quality of neurosurgery.
- Engage members in a program of public and professional education about the specialty.
- Promote the timely, appropriate application of neurosurgical solutions to health needs.
- Help neurosurgery enhance and expand its role as a valued provider of health care.
The topic we chose for the first phase of our Getting SMART program is lumbar spinal stenosis (LSS). Once our communications process has proven its effectiveness, the Committee, with input from our Sections, will develop other topics to be given similar support.
Guiding Position
In broad terms, the position guiding development of the LSS communications initiative is that tens of thousands of older Americans are suffering severe, unnecessary pain and are being forced to give up active lives prematurely because an increasingly common affliction — lumbar spinal stenosis — is not diagnosed and treated soon enough with successful neurosurgery.
Neurosurgery can restore most of these patients to vital, active lives in a matter of weeks or months, but, unfortunately, managed care and the lack of information on the part of patients and the general public are keeping a growing number of patients from being referred to neurosurgeons for spinal problems. Primary doctors must be made aware of this disease and when it is appropriate to refer patients. Further, patients should ask to see a neurosurgeon if they have symptoms of lumbar stenosis.
Recruiting Volunteers to Lead the Way
To be effective, the program must be linked to the hundreds of practices that make up our specialty. This will not be easy. Neurosurgeons are busy. Some of you may feel ill-equipped or uncomfortable about promoting neurosurgery and its services. But we are asking members of the AANS and CNS to “raise your hands” to volunteer as local-market Ambassadors for the program.
Each volunteer will be asked to identify (with the help of prepared media listings) the local media outlets to whom information kits should be sent in his/her name. Any neurosurgeon may voluntarily become an Ambassador for this special initiative. Each Ambassador will receive a kit containing program materials and guides to using them. Materials will include the following:
- A backgrounder and Q&A on lumbar stenosis and treatment options.
- Press releases and guides to working with local print and electronic media.
- Patient and referring-physician brochures that can be customized to their practices.
- Educational slide presentation and teaching syllabus on lumbar stenosis.
- Sample letters to media, referring practitioners, and hospital CME directors.
The aim is not to make our volunteers public relations experts, rather it is to equip them with the tools necessary to tell our story in a comprehensive and coordinated way.
Media Outreach
In addition to the Ambassadors’ efforts, the National Office will coordinate a program to alert national and special-interest publications about the issue of LSS and neurosurgery. Target audiences will include national news publications, as well as other general, senior citizen, women’s, health, and healthy living magazines and newsletters, and national and syndicated broadcasting and editorial outlets and heath care trade publications.
The program will be supplemented by a special edition of Neurosurgical Focus in August 1997.
Incorporate Messages That Advance Neurosurgery
All materials and key media messages focus on both the specific patient benefits of the services offered and why neurosurgery is the “provider of choice.” Ambassadors are encouraged to represent the specialty as a whole, and to advocate neurosurgery’s capabilities.
Ambassadors will be asked to forward news clips and their success stories to the National Office, who will prepare regular reports to notify members of the program’s progress and to provide Ambassadors with tips and ideas for making the program more effective.
Referral Program
A separate package of materials is being developed for referring physicians. These materials can be used as leave-behinds at presentations and in mailings to primary care providers and other referral sources. The package will include:
- Referral guidelines
- Background on LSS
- Frequently asked questions
- Copies of patient and professional brochures
- Sample letters to referral sources
Program Ambassadors will be encouraged to disseminate the LSS background information as broadly as possible. Copies of the referral materials also will be available for purchase by members who choose not to participate in the broader Ambassador program.
Gatekeeper Advocacy
In addition to its outreach to referral sources, it is the intent of this program to develop a case for neurosurgery as the “practitioner of choice” for presentation to HMO and other managed care decision makers. We believe that making these gatekeepers aware that neurosurgeons provide spinal surgery services and are the leading providers of LSS services will be beneficial.
Joining the Program
Members who wish to take full advantage of this public education and professional outreach communications program as Ambassadors will receive 200 copies of the patient LSS brochure, 100 copies of the referring practitioner brochure, slide presentation, personalized press kits mailed to up to five local media outlets, and training.
If you volunteer to be an Ambassador, you will be asked to commit to making at least two public/professional presentations, mailing referral source brochures to at least 50 persons, and to cooperate with media interviews. You will also be asked to contribute $195 to support the program.
At the same time, all active AANS and CNS members who are not Ambassadors will be eligible to separately purchase sets of 100 patient brochures and 50 referral source brochures for $100. Reorder sets of public-only brochures will be available for $50 per hundred. We will be conducting a volunteer recruitment effort for the next 60 days to establish our network of Ambassadors. Then we will distribute our materials to participants and begin our media outreach.
I hope that all of you will consider joining the program as an Ambassador. If you cannot do so, I hope that you will utilize the physician referral materials in your community. More than at any time in our history, it is important that we educate our patients, colleagues, and policymakers about the valued role that neurosurgeons play in the health care continuum. And who better to teach that lesson than you.
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BECOME AN AMBASSADOR FOR NEUROSURGERY!
If you would like to enroll as an Ambassador for the Lumbar Spinal Stenosis Communications Program, please contact the Communications Department at the AANS National Office for an enrollment form. Call (847)692-9500 and direct your inquiry to Susan Nowicki, APR, Director of Communications. If you are interested only in ordering sets of patient and/or physician referral materials, contact Laura Weiss in the Order Services Department for an order form.