EMTALA, HIPAA and PLI have become as familiar to most neurosurgeons as SAH, GBM and AVM. They became part of my vocabulary during my recent tenure as chair of the AANS/CNS Washington Committee, where on the “front lines” I saw how legislation sometimes adversely affected neurosurgeons and, ironically, the patients that the legislation was intended to assist.
As neurosurgeons we cannot escape the fact that we have an obligation to both our profession and our patients to raise our voices and present our point of view, whether it be in Sacramento, Springfield, Albany, or Washington. That is not to say that all of us are completely comfortable with the idea of writing to senators, calling congressmen, or meeting with officials on Capitol Hill.
Now we are confronted by the fact that to achieve legislative reform, neurosurgery’s message must reach the public. Some medical societies are launching full-fledged public relations campaigns to inform citizens about how the professional liability insurance crisis is affecting their doctors and their own access to care. Chief among them is the American Medical Association, which allocated $15 million to its campaign for tort reform to combat the PLI crisis, with $12 million earmarked for the public relations effort.
In this issue of the Bulletin, the cover story provides an overview of the AMA’s PR campaign and details what the AANS and organized neurosurgery are doing to inform the public of these important issues. Complementary articles provide different points of view and tips on how neurosurgeons can work with the media to convey scientific information and effectively manage our message.
What About Neurosurgery?
From a personal perspective, I sometimes find it distressing that these seemingly extraneous issues intrude on my practice of neurosurgery. After all, I didnt apply to medical school because I wanted to be a politician. I didn’t train as a neurosurgeon because I wanted to have daily interaction with the media.
I did want to help patients. I did want to marshal whatever talents, intellect, skill, and understanding I possessed toward that end. From this viewpoint, advocacy is part and parcel of the profession of neurosurgery.
Those who know me know of my longtime interest in music. I have been struck by the similarities between careers in music and neurosurgery. Each requires the underpinning of knowledge, technical skill, intense concentration and a great deal of practice. Great musicians and neurosurgeons also share a passion for what they do and are able to appreciate the creativity necessary for success in their respective professions.
Both also devote themselves to careful listening: Musicians listen to other musicians and their audience; neurosurgeons listen to their colleagues, and most importantly, to their patients.
Both professions also are fraught with stereotypes. Musicians frequently are portrayed in television and movies as difficult and eccentric individuals. Neurosurgeons probably fare much worse. In fact, consider the last time a neurosurgeon-or even a “brain surgeon”-was favorably portrayed in a popular movie or on TV.
Yet as neurosurgeons, we are most familiar with the rigorous training we undertook, the on-call schedules, the long days in surgery, and our personal pain at less-than-perfect outcomes for our patients.
How can the public not know? The answer is, the general public’s perception of neurosurgery is shaped by the popular media. Most people don’t know what we do until they or a loved one needs our services. It is then that we have the opportunity to impact their view of neurosurgery by how we interact on a personal level.
But now, when neurosurgery must impact legislation and policy that directly affects us and our patients, we do need to reach out to the public with a consistent message. We need to view the media as our ally in informing the public about what we do, how we help our patients, and how our patientts are being hurt by policies that purportedly help them.
We begin with our patients. As professionals we know that effective communication underlies the physician-patient relationship. It is not a great a stretch to apply these familiar principles to working with our legislators and members of the media. With the understanding of the skills that are required and some practice formulating and managing a message, every neurosurgeon can be an effective advocate, starting with how we represent ourselves and our profession in our communities every day.
A. John Popp, MD, is editor of the Bulletin, president-elect of the AANS, and Henry and Sally Schaffer Chair of Surgery at Albany Medical College.