The One Neurosurgery Group and the Real One Neurosurgery
I first became aware of the One Neurosurgery Advocacy Group (ONAG) in 2013, while serving as President-Elect of the American Association of Neurological Surgeons (AANS). ONAG called for the AANS and the Congress of Neurological Surgeons (CNS) to merge into a single membership organization. A good deal of information, much of it incomplete and misleading, was sent to the AANS and CNS members, with a request that they contact the leadership of both organizations to force the issue of merger. The AANS and CNS leadership discussed this extensively and agreed to meet with the leadership of ONAG – this offer was rejected.
The AANS and CNS responded to member concerns that had been raised, but there was a consensus among the leaders of both organizations that a merger was neither possible nor desirable. A resolution calling for a merger was brought to the floor at the Council of State Neurosurgical Societies (CSNS) Plenary Session in New Orleans that year. This resolution was thoroughly discussed, debated, rejected and finally withdrawn by the plenary session delegates. Despite this, the calls for merger from what is now the One Neurosurgery Group continue unabated.
In 2003, the AANS and CNS engaged a third-party mediator to explore merger models and assess the advantages and disadvantages of each for neurosurgeon members. After more than six months of meetings, attorneys’ fees and other expenses, it was determined that our two organizations, each with a successful journal and annual meeting, had such significant differences in mission, culture and governance structure that a true merger was impossible. The AANS, the CNS or both could cease to exist, but there was no reasonable pathway for a merger. If both organizations dissolved, a new organization could be created, which would have to assume/inherit the contract obligations of both parent organizations. In the end, it was clear that continuing as two separate organizations made the most sense. This held true in 2013 and it holds true today. Another attempt at forcing a merger would yield the same result, while consuming valuable resources that could otherwise be used to support members.
Neurosurgeons are social animals. Between 1920 and 1972, eight national neurosurgical organizations were founded: the Society of Neurological Surgeons (SNS), the AANS (originally the Harvey Cushing Society), the American Academy of Neurological Surgery (AAcNS), the American Board of Neurological Surgery (ABNS), the Neurosurgical Society of America, the CNS, the Society of University Neurosurgeons and the Council of State Neurosurgical Societies. Supplementing this are the Joint Sections, more than 40 state or regional neurosurgical organizations and approximately 10 multidisciplinary organizations with neurosurgical members. With the exception of the ABNS, membership is not required in any of these organizations to practice neurosurgery. Membership in all of these is voluntary. Any neurosurgeon desiring membership in only one organization is now, and has always been, free to do so.
I would like to close with a plea for the real One Neurosurgery – the collaboration of the AANS, AAcNS, ABNS, CNS, SNS, the review committee (RC) for neurosurgery of the Accreditation Council for Graduate Medical Education and the Washington Committee for Neurosurgery (WC) in order to advance the specialty of neurosurgery in patient care, research, education, public service and advocacy. For many years, the SNS had convened meetings of the leadership of the AANS, ABNS, CNS, RC and WC. Initially, these summit meetings were held once a year in conjunction with the AANS Annual Scientific Meeting, then twice a year in conjunction with the CNS annual meeting as well.
As I said once before in this journal, “Although neurosurgery is a small specialty, it is blessed with many organizations that bring unique perspectives, talents and resources to the table. The effective collaboration of these organizations is essential in making sure that neurosurgery continues to lead American medicine in patient care, education, research and public service.”1
1. Harbaugh, R. E., Boop, F. A., Shaffrey, C. I., Lonser, R. R., Burchiel, K. J. & Timmons, S. D. “One Neurosurgery.” AANS Neurosurgeon, American Association of Neurological Surgeons, June 2016, aansneurosurgeon.org/features/one-neurosurgery/.
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