The AANS Board of Directors convened April 19-20 in Toronto during the 2001 Annual Meeting. The highlights are summarized here.
Finance Committee. AANS Treasurer Roberto Heros, MD, presented the 2002 operating budget. As submitted, the budget is balanced and gains significant ground over the 2000 deficit budget. The Board approved the budget as submitted.
Membership Committee. In anticipation of a change in the AANS Bylaws and upon recommendation of the Membership Committee, the Board approved the automatic promotion of Active (Provisional) members to Active membership upon notification of their successful ABNS certification. Previously, these members had to apply for a change in status. Accordingly, 114 individuals were transferred from Active (Provisional) to Active membership. Other membership approvals included 116 new Active (Provisional), 15 Associate, 34 International and 50 Active members. This brought total AANS membership to 6,459, representing an 18.2 percent increase over the 2000 total of 5,283 members.
Committee and Liaison Retirements. Motions were presented to eliminate organizational liaisons and committees now deemed redundant or unnecessary. Eliminated were: the Investment Subcommittee of the Finance Committee; the Annual Meeting Registration Committee (its functions are assumed by the Marshal’s Committee); the liaisons to the American Registry of Pathology; and the Healthcare Resources Advisory Committee. Also, the Electronic CME subcommittee of the Education and Professional Development Committee was changed to a subcommittee of the new Digital and Electronic Committee.
Policy Statements. The board approved two draft policy statements.
AANS/CNS supports AMA Policy on Treating patients with HIV and AIDS
A physician may not ethically refuse to treat a patient whose condition is within the physician’s current realm of competence solely because the patient is seropositive for HIV. Persons who are seropositive should not be subjected to discrimination based on fear or prejudice.
When physicians are unable to provide the services required by an HIV-infected patient, they should make appropriate referrals to those physicians or facilities equipped to provide such services.
A physician who knows that he or she is seropositive should not engage in any activity that creates a significant risk of transmission of the disease to others. A physician who has HIV disease or who is seropositive should consult colleagues as to which activities the physician can pursue without creating a risk to patients.
AANS/CNS Position on Improving Access to Emergency Neurosurgical Services
The Emergency Medical Services (EMS) system is in the midst of a growing crisis because of a recognized shortage of on-call specialists. This problem extends to the provision of emergency neurosurgical care. Since neurosurgeons are a vital component of the EMS system, their active participation is essential. Reimbursing neurosurgeons for serving on-call to hospital emergency departments is therefore appropriate.
- Within their capabilities, hospitals have a legal obligation under the Emergency Medical Treatment and Labor Act (EMTALA) to provide screening and stabilization services to patients who come to emergency departments. As part of this obligation, hospitals are required to maintain a list of physicians who are on-call to treat patients in the emergency room and to ensure that on-call physicians respond when called.
- Neurosurgeons have a variety of financial and contractual problems with managed care plans. In many instances, these contracts have no on-call arrangement, or require on-call availability without reimbursement, or have reimbursement rates that are extremely low. Because of these and other economic pressures, neurosurgeons are finding it increasingly difficult to subsidize emergency medical care through internal “cost-shifting,” thus limiting their ability to subsidize their own on-call activities.
- Neurosurgeons are faced with increased risks and liability when providing emergency care. Because of the seriousness of cases in the emergency medical setting and because of the lack of a pre-existing physician/patient relationship, neurosurgeons have a greater potential to be part of a medical malpractice action. In addition, neurosurgeons who provide on-call services must also comply with the mandates of EMTALA, subjecting them to potential fines of $50,000 for any violations of this complex law and regulations.
Position Statement: To facilitate the availability of neurosurgeons for on-call services to hospital emergency departments, hospitals may provide neurosurgeons with reasonable compensation for serving on the on-call panel. This compensation should supplement any reimbursement the neurosurgeon receives for services rendered while serving on-call.