In “A Tale of Two Cities,” Charles Dickens described “the best of times, the worst of times.” Neither applies today, but we are clearly in “strange times.” The United States is more prosperous than it has ever been. Governmental budgets are reaching all-time highs, including allocations for the National Institutes of Health (NIH), our primary biomedical research agency, which will exceed $20 billion in 2001. At present, technological discoveries are occurring at warp speed and research discoveries make the news everyday.
Are these the best of times? Many would argue no, in part due to the growing number of academic health centers approaching bankruptcy. While there has been a progressive reduction in reimbursement for patient care, particularly for the “non-cognitive” specialties such as cardiac surgery and neurosurgery, our administrative burdens associated with patient care, insurance requirements and administrative regulation have all steadily increased. Are these the worst of times?
The Role of Research
Our lives as neurosurgeons revolve around four or five basic areas: patient care, administration (including office management), family, teaching and research. Given that there is only so much time in a day, certain priorities have to be established and something has to give. For some, family time suffers; for others, teaching. Ironically, administration rarely comes up short, and patient care can’t be budgeted. Research is often last on the list of practicing neurosurgeons and is, thus, a vulnerable target.
What does it take to do research? The “essentials” are a good idea, time, money, space and mentoring. The practicing neurosurgeon intending to do research must have each. However, time is certainly the most precious, given the current climate that requires neurosurgeons to work harder for less.
What Does it Take?
While discoveries are being made everyday by full-time researchers, there still remains a cadre of surgeons who are serious investigators, each requiring the “essentials” of research. Most neurosurgery residency programs require research training for at least one year, some do not because they lack time, money, mentoring and space. Those requiring resident exposure to investigation commit the essentials to sustain the effort. While the federal government has been the “deep pocket” for research funding, other corporate and philanthropic organizations also have provided financial support for research.
In fact, substantial grant support and nearly 40 achievement awards are available within our neurosurgical community. Most of the awards come from the American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS) or their subspecialty Sections, and range in cash awards from $250 to $35,000.
In addition, 13 research grants are available for neurosurgeons in training or soon out of their residency. The AANS/CNS Sections award seven of those grants and the remaining six are provided on a competitive basis by the Neurosurgery Research and Education Foundation (NREF).
This past year, NREF awarded six new grants, three of which are two-year commitments for $35,000-$40,000 each, and the remaining three are one-year awards. NREF has committed itself to supporting 10 investigators per year. NREF’s ability to support researchers comes from the generous contributions of neurosurgeons, corporations or individual donors. In addition, the foundation has a $5.5 million endowment.
Can Neurosurgeons Improve NREF’s Efforts?
Most neurosurgeons cannot provide the time, space or mentoring to those in need of research training. However, many can provide financial support. It takes approximately $700,000 of NREFs endowment to fund one research award ($30,000-$40,000 per year). Thus, major donors are the lifeblood of our annual fund-raising program. Bequests, gifts, and “staggered” giving over several years are just a few of the mechanisms available for those who wish to support NREF’s endowment.
Smalller gifts also are welcome. A gift in honor or memory of a loved one is an ideal way to show your gratitude to someone important to you and your career. While smaller gifts can be named and the purpose of the gift directed toward a fellowship, the continuity of the award disappears unless the donation adds to the endowment. For example, a donation of $40,000 for a fellowship in honor of a former instructor can last no more than one year, since the money is spent by the investigator or fellow during that year. Establishing a fellowship “in perpetuity” requires a major gift of at least $700,000 to sustain its continuity.
NREF must increase its endowment in order to ensure the continuity of research funding and to maintain a long-term commitment to investigations that will improve our specialty. To that end, neurosurgeons must support research and development in our specialty – make your tax deductible contribution today!
To learn more about NREF, or to make a donation, please call Barbara Schwarz, NREF Director of Development, at (888)566-AANS.