In neurosurgery, every action we take is deliberate — one patient, one operation, one outcome at a time. Yet beyond the operating room, our collective actions carry an impact just as vital: advocating for the policies and systems that shape how we care for our patients.
This issue of AANS Neurosurgeon focuses on advocacy — not as a political exercise, but as an extension of our professional responsibility. Advocacy is, at its core, about education and engagement. It is about ensuring that lawmakers, regulators and the public understand the realities of neurosurgical care and the needs of the patients we serve.
Recent developments highlight why this work matters. The CY 2026 Medicare Physician Fee Schedule includes significant practice-expense reductions and a new “efficiency adjustment” to work RVUs that could affect surgical access nationwide. At the same time, strong, coordinated advocacy from Washington helped secure important wins — including the restoration of RUC-passed values for key CPT codes, progress in pausing the WISeR Model and bipartisan support for lifting restrictions on physician-owned hospitals.
None of these outcomes are about partisanship. They are about preserving access to high-quality care and protecting the integrity of our profession and the patients we serve. In this way, advocacy becomes less about politics and more about partnership — between physicians, policymakers and patients — to make informed decisions grounded in evidence and experience.
Every neurosurgeon, whether in private practice, academia, or training, plays a role in this shared effort. Advocacy can take many forms: educating a patient about how policy affects their care, contributing to a professional comment letter, mentoring residents on health-policy literacy, or simply staying informed on issues that shape our field. Each action strengthens our collective understanding and our ability to lead.
Through this issue, we hope to broaden the definition of advocacy — to see it not as an agenda, but as awareness. The articles within will highlight how neurosurgeons engage constructively with evolving regulations, reimbursement models and workforce challenges. They share experiences, context and ideas — not to take sides, but to inform and inspire dialogue.
Our community’s strength lies in its unity of purpose: a commitment to advancing science, improving patient outcomes and safeguarding the practice of neurosurgery for future generations. As the landscape around us changes, so must our engagement — guided by facts, collaboration and a steady focus on patients.
In that sense, advocacy is not a separate duty from surgery, it is an extension of it. Both require clarity, precision and compassion. Both demand persistence in the face of complexity. And both, when done well, can profoundly change lives.
Aruna Ganju, MD, FAANS, FACS is an associate professor of neurological surgery at Northwestern University’s Feinberg School of Medicine in Chicago and the current editor of AANS Neurosurgeon. She is a past chair of the AANS/CNS Section of Women in Neurosurgery (WINS) and Residency Program Director in the Department of Neurological Surgery at Northwestern University Feinberg School of Medicine. Her clinical areas of interest are surgical treatment of disorders of the spinal column and cord.
