Practice Management Pearls: NERVES – Summarizing the Benefits of Society Membership and Socio-Economic Survey Participation

Some brief history. Neurosurgery Executive’s Resource, Value and Education Society (NERVES). This acronym, born on an actual envelope, breathed life into the beginning of organized neurosurgery’s quest to gather national neurosurgery-based practice benchmarking data and provide a platform for sharing best practices amongst its administrative leadership. NERVES was officially formed by the Council of State Neurosurgical Societies (CSNS) in 2002. 

NERVES’ mission is to connect neurosurgery executives to resources, education and data to enhance value for the business of neurosurgery. Membership in NERVES is defined as being actively employed, engaged or contracted in the leadership, management or executive administration of an entity organized to provide or facilitate the provision of neurosurgical services in one of two capacities:

• Administrator, executive or practice manager of a private, academic or hospital-based neurosurgery practice, or a combination thereof.
• Administrator, executive or manager of a hospital neuroscience service line at a hospital that has neurosurgeons with active staff privileges.

The evolution of practice types has required NERVES to review and update its by-laws to keep the membership definition relevant to current practices. NERVES has a typical Board of Directors and Committee structure, including Membership Directors from across the country representing various regions and practice types. There are two liaison positions: Washington Committee Liaison and the CSNS/AANS Liaison.

The practical benefits of NERVES membership include networking with neurosurgical colleagues each year at the NERVES Annual Meeting, sharing best practices across the country on the NERVES email listserv platform, sharing ideas and networking during the annual conference and by completing the annual NERVES Survey; receiving a copy free of charge once published. The annual cost of membership is kept nominal to remove barriers of entry to the society. NERVES membership provides opportunities in neurosurgery administrator leadership development, relevant education, business development sharing, advocacy and personal growth. 

Colleague networking is often cited as the single most beneficial factor of membership. The new member mentorship program is a key component to “plugging in” with NERVES by frequent communication with a trusted colleague.  Strong friendships have been formed during the society’s existence, a testament to the importance of membership participation and annual meeting attendance.

How do these items benefit a neurosurgeon or group of neurosurgeons?  Access to information at a moment’s notice on the listserv. This is an active community of colleagues willing to answer questions, provide feedback, highlight online resources and share ideas. During the time I’ve been in my practice in Indianapolis, I have travelled around the country to other practices to learn from their best practices. We have hosted neurosurgery leaders and physicians to our practice many times during my NERVES membership.

The NERVES Annual Meeting is a two-and-a-half-day event preceding the AANS Annual Scientific Meeting. During the first afternoon of the meeting, practice roundtables are held by practice type and size, moderated by a NERVES member. Often, this is the place where a practice administrator will make connections and hear best practices that eventually are implemented in their own group. Ideas are generated for future meetings, member webinars, NERVES survey enhancements, etc. The roundtables are always one of the highpoints of the meeting.

A new member reception is held in the early evening before the opening reception. Current and past board members are present to welcome new members and first-time attendees to the meeting. Often, this is where a mentor/mentee relationship will form. 

Days two and three feature the keynote speaker and 4-6 general session speakers. Both days have more detailed breakout sessions often moderated by NERVES members. The meeting includes a sponsor exhibitor hall with vendors that NERVES members may find helpful in their practices. Another benefit of membership is making these vendor connections to help with practice efficiency and cost containment.

The NERVES Socio-Economic Survey is perhaps the most appreciated benefit by many neurosurgeons and neurosurgery groups. The 2024 NERVES Survey was the 20^th edition of the survey which incorporates data provided by practice members on a per full-time equivalent (FTE) physician basis for physician data points. Other questions are answered at the group level, such as staffing FTEs and overhead. The data is organized by geography, practice type, population, ownership type, group size, sub-specialty (peds, functional, spine, cranial, vascular/endovascular), and statistically by mean, median, 25^th, 75^th and 90^th percentiles. Productivity and compensation data is collected on neurosurgeons, advanced practice providers, pain management, neurology and neuro-interventional radiology. Call pay data is reported by call agreement type and by impact on per FTE physician compensation. 

A sampling of data points is listed here:

• Total compensation and components of compensation
• Physician benefits, malpractice costs, and coverage limits
• Productivity: charges, payments, WRVUs, cases, and new patients
• Call pay
• Academic support categories
• Relevant issues questionnaire

Groups that complete the survey receive survey results free of charge. On average, 4-8 hours are needed to complete the NERVES Survey. Surveys can also be purchased by anyone, including fair market value consulting firms. Survey data is collected and distributed by a third party and is governed by Federal Trade Commission (FTC) rules and regulations. NERVES cannot access discreet data provided by survey responders. The survey is generally completed in the latter half of the calendar year with results being published in January of the following year. Participation of the greatest number of neurosurgeons yields more data points for analysis! The data prepared is the most detailed and relevant available for individual neurosurgeons to benchmark their practice and use for negotiating compensation, call pay and determining value.

Regardless of practice type, NERVES provides a forum to improve practice efficiency and the bottom line. NERVES highlights ways to grow practice leaders and prepare them for the ever-changing landscape of the practice of medicine. For a little more than an annual Costco membership, your practice can gain data, knowledge and insights to help it thrive in today’s environment.