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| Robert A. Ratcheson, MD |
The emergence of spring after a seemingly endless Midwestern winter rekindles thoughts of a humming stream and colorful trout under the vast Montana sky; while I have attempted to suspend such tempting thoughts until after my term as AANS president and the 2005 AANS Annual Meeting have concluded, the strategy Maclean describes so succinctly does have current application to our profession. Whether navigating a complicated neurosurgical procedure, managing the competing demands of a busy practice, or prioritizing the initiatives of your multifaceted professional association, “knowing where to put the power on” is perhaps more an art than a science.
What are the priorities of neurosurgery today? How can the American Association of Neurological Surgeons identify the right priorities and then set and achieve specific goals? These questions I have asked myself, particularly during the past year, and discussed with the Executive Committee and the Board of Directors with input from the 40 or so committee chairs and the more than 200 committee members who comprise the volunteer leadership of the AANS. We may not always agree with one another, but through ongoing deliberations among keen-witted colleagues, the better ideas tend to take hold. And it is those ideas, those initiatives, where we have tried to “put the power on” over the past year.
Furthering Neurosurgical Education
First and foremost, the AANS is an educational organization, and this year a preponderance of the AANS effort has been directed toward education and educational issues. The AANS itself grew out of the need of neurosurgery’s pioneers to learn more and to share their hard won information with one another, with the expectation that as a result, their patients’ outcomes would improve. This is no less true today, although contemporary neurosurgeons are asked to not only manage the tasks of care delivery and learning, but also navigate through multiple layers of documentation and regulations to support the requirements associated with licensure and certification. In the very near future, in addition to state licensure and initial board certification, they will be asked to fulfill the requirements of the American Board of Neurological Surgery’s Maintenance of Certification program and very likely Medicare’s “pay-for-performance” mandates.
Through the Washington Committee, the AANS stays apprised of federal agencies’ developing requirements.
The AANS has put its efforts toward helping AANS members manage the MOC process through the attainment and documentation of continuing medical education credits in fulfillment of these requirements. The American Board of Neurological Surgery has chosen the AANS as the single source to track, validate and store CME requirements for individuals in the MOC program. The AANS’ password-protected Web site, MyAANS.org, serves as the virtual center for CME credit tracking and management. The site, with its new design and continual updates, contains many unique features for managing CME credit, such as customized reports, personalized transcripts, subspecialty transcripts, certificates of credit from AANS-sponsored, jointly sponsored and endorsed meetings, and a new feature that allows members to select a delegate who can manage the entire online tracking process for them. The site provides convenient access to additional CME offerings; these include meetings and courses, as well as the opportunity to obtain CME credits online through Neurosurgical Focus and soon, through the Journal of Neurosurgery, as well as links to a wealth of pertinent online information, such as the new AANS CME policy for the three-year cycle that began Jan. 1. Members will find the site easier to navigate and responsive to members’ requests and suggestions.
Offering New Member Benefits and Opportunities
Our commitment to neurosurgical education must address the needs of neurosurgery’s next generation. This year the AANS made significant new additions to existing long-time benefits for residents and fellows, which include free AANS membership, the Bulletin, free attendance at selected resident-oriented practical clinics at the annual meetings, and access to the online journal Neurosurgical Focus and the Online Career Center. Beginning with the April 2005 meeting in New Orleans, residents and fellows now also receive free registration for the AANS annual meeting and free subscriptions to the world’s premier publications for neurosurgical education and research: the Journal of Neurosurgery, Journal of Neurosurgery: Spine and Journal of Neurosurgery: Pediatrics.
We have also instituted reduced rates for the courses on practice management and oral board preparation. The AANS has instituted a program which offers neurosurgical residents the opportunity to learn and fulfill the core competency requirements, mandated for all residents by the Accreditation Council for Graduate Medical Education, by viewing selected video lectures online. We have also remembered our more senior members and now offer lifetime members a 50 percent reduction on their annual meeting registration fee.
Two new AANS membership categories, International Residents and Allied members, were approved by the membership in a vote taken last summer. International residents and surgical technicians are now eligible to join the AANS ranks and enjoy the many benefits of membership.
Nurturing Neurosurgery’s Future
One of our most important activities is the Neurosurgery Research and Education Foundation. This year the AANS helped fuel neurosurgical research through two Neurosurgery Research and Education Foundation initiatives, the Creating Masters in Neurosurgery campaign, which by January had raised more than half of its annual goal, and the Celebrate a Life tribute and memorial campaign. In addition, NREF membership responded generously to our voluntary appeal which accompanied the AANS dues statement. This year, from a total of 53 applicants, NREF supported four Research Fellowships and five Young Clinician Investigator awards. We are pleased to recognize donors who generously gave during the second half of 2004 in this issue of the Bulletin. I know I speak for the entire neurosurgical community in expressing my heartfelt thanks for their generosity. There also has been a change in NREF leadership. We are grateful to Julian “Buz” Hoff, MD, for his seven years of superb leadership under which NREF has grown and contributed greatly to our profession’s research efforts. Martin Weiss, MD, assumed the chair of the NREF in October 2004.
The AANS places great value on its Pinnacle Partners who continue to help make it possible to produce educational meetings, courses, and related materials. The AANS has always approached interactions with corporate partners prudently and professionally, but in the light of increased regulatory demands, believe that formalizing these relationships is in the best interest of patient care and the delivery of unbiased information. This year, I appointed a task force which was headed by Jon Robertson, MD, AANS secretary, to develop AANS Guidelines for Corporate Relations. This report ensures an appropriate relationship between AANS educational offerings and our corporate sponsors. This document, which was approved by the Board of Directors last fall, is detailed in Governance in this issue of the Bulletin and is available in its entirety on the AANS Web site.
Tackling the Medical Liability Crisis
The medical liability crisis is one of the most serious issues facing neurosurgery. It threatens both practitioners and academicians. No issue has galvanized neurosurgery more thoroughly than this outrageous and inappropriate assault upon physicians. The ability to
| This year a preponderance of the AANS effort has been directored toward education and educational issues. |
The AANS Professional Conduct Committee remains an important part of our efforts to counter unjust and inaccurate testimony. Although the committee addresses unprofessional activities of members of any kind, unfortunately the bulk of its work has to do with inappropriate testimony. Each year, this activity has grown and currently 22 cases are pending. Our committee and its structure serve as a model for an increasing number of medical associations who have instituted similar programs.
Staying in Touch
Members should know that their participation in the biennial AANS Member Survey is more than just appreciated. AANS leadership and staff decide “where to put the power on” through knowledge of how members are practicing, what they indicate they are interested in learning about, and how they rate the importance and success of various AANS activities. Although the results of the 2004 survey, which was released in the Winter 2004 Bulletin, indicate that, in general, members are quite satisfied with the AANS, no one intends to rest upon these laurels. Clearly, much more can be done to serve the needs of our membership.
Along the same lines, AANS members will be asked to participate in the online AANS census this year. The census will augment the member information on which the AANS can base programming decisions. Further, beginning this year and moving forward, the census will be bolstered by improvements in survey design. These improvements will enable reliable point-to-point analysis of data and will result in the AANS gaining a powerful tool for identifying trends in neurosurgery and developing programs and policies accordingly.
Spotlighting the Annual Meeting
Every spring the AANS annual meeting concludes a year of intense activity and culminates the year with a celebration of science. This year’s meeting, April 16-21 in New Orleans, exemplifies all that the AANS does for members and for neurosurgery throughout the year with its theme of Education and Innovation in Neurosurgery. The annual meeting remains the premier educational event of the neurosurgeon’s year and is one of the largest meetings held. It is our most important source of clinical teaching and clinical ideas. Through our named lectures program, we have been able to enlist the skills of the world’s foremost neurosurgeons and scientists who offer their knowledge of the most advanced concepts, techniques and research advances.
So this is where we have “put it on.” While the AANS is proud to provide the physical infrastructure for organized neurosurgery, the AANS also remains a community of more than 7,000 real people: members and staff. It is through the efforts of many talented people that this 73rd AANS Annual Meeting is made possible, and I thank all those involved for this stellar effort. Special thanks must go, however, to Annual Meeting Chair Richard G. Fessler, MD, and Scientific Chair James T. Rutka, MD.
In New Orleans, when I hand the gavel over to AANS President-Elect Phil Wirth, MD, I will do so with the confidence that he is taking the leadership of a thriving organization that is well-positioned for growth and innovation and meeting the challenge of the coming years. And I’ll continue to wish him well. Part of the time, it will be from a stream in Montana, fly rod in hand, putting to use the bit of Norman Maclean’s wisdom which I have attempted to practice this year: “Power comes not from power everywhere, but from knowing where to put it on.”
Robert A. Ratcheson, MD, is the 2004-2005 AANS president. He is the Harvey Huntington Brown Jr. professor and chair of the Department of Neurological Surgery at Case Western Reserve University and at University Hospitals of Cleveland.
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