A recurring theme of this column is the many ways that the American Association of Neurological Surgeons works for its members. At a time when the medical environment is rife with new challenges to physician reimbursement and delivery of care to patients, members of the AANS have a right to expect good value for the dues they pay. The topic of the cover story in this issue, professional physician conduct, is but one example-albeit an important one-of a unique service that the AANS provides to its membership.
Maintaining a High Moral Plane
Ensuring accurate testimony, whether for the plaintiff or defendant, is not about an association “policing” its membership; rather it is one timely, tangible example of our association’s quest to maintain our specialty on a high moral plane. In many ways this quest mirrors our daily activities as neurosurgeons as we strive to deliver excellent patient care. Should not our patients be able to trust what we say whether we are talking with them about surgery or testifying in court?
Yet, is there more that we should do as an organization? At a recent board meeting our president-elect, Roberto Heros, MD, asked if the current activities of our Professional Conduct Committee represented the optimal amount of activity by an organization in our commitment to ethical behavior. This is a thought-provoking question particularly in the wake of the 1999 Institute of Medicine report on preventable medical errors, as well as ongoing government audits of physicians’ billing for Medicare services. What more might we do through our professional association to ensure high standards in our specialty and enhance public confidence in neurosurgeons specifically and the healthcare profession in general?
It is my personal perspective that presently the AANS does help neurosurgeons in multiple areas that impact the delivery of high quality and ethical neurosurgical care. For example, the association engages in outcome studies to analyze the appropriateness and results of our surgical procedures. It participates in continuing medical education through scientific meetings and the Journal of Neurosurgery to enhance the knowledge base of the membership and assist with our specialty’s commitment to lifetime learning. Furthermore the AANS sponsors courses in correct billing procedures to educate practicing neurosurgeons about the complexities of evaluation and management codes, helping them successfully navigate the reimbursement minefield and avoid even the appearance of impropriety in the process. When ethical issues do arise that affect the field of neurosurgery, the AANS Ethics Committee is charged with the responsibility of contemplating the complexities of the topic in question and advising the AANS Board of Directors, which in turn considers the issue at hand and decides upon an appropriate course of action.
Quest Requires Call and Response
Are the present efforts of the AANS in the pursuit of accuracy, excellence and ethics enough? Never! One of the fundamental tenets of pursuing ideals is the recognition that such a quest is never completed. The next step in this particular quest is the important task force led by our president-elect. I invite you to heed Dr. Heros’ sincere call for suggestions from the membership with regard to the future scope of the Professional Conduct Committee. A considered response is the obligation of all who would seek to make our specialty better.
The AANS Bulletin, itself, is intended to be a vital component of this quest for neurosurgical excellence by its focus on education of the practitioner about such topics as malpractice avoidance, coding, practice efficiency and outcomes. Further, it is meant to serve as a vital organ of discourse among neurosurgical professionals, providing information, provoking thought, and inviting comment. To this end your feedback on topics covered or opinions expressed in these pages, and your ideas for stories that should be covered are sincerely invited.
A. John Popp, MD, is editor of the Bulletin, chair of the AANS/CNS Washington Committee, and Henry and Sally Schaffer Chair of Surgery at Albany Medical College