In this issue of the Bulletin, we explore the topic of neurosurgical workforce and the impact it has on the current practice and future of neurosurgery. While models for estimating the state of the medical workforce have been developed, problems still exist when attempting to accurately assess workforce needs. Workforce modeling is not a science, despite the mathematical formulae contained in most workforce projections that provide a semblance of science. Furthermore, trending to the future increases the uncertainty of our specialty’s needs, as unforeseen variables impacting on neurosurgery inevitably occur. These facts must be enumerated and disseminated if we are to prevent policy analysts from making substantial workforce decisions based on inexact data misperceived as being accurate.
Recognizing that the desire by legislators and policy analysts for data concerning workforce is unlikely to diminish and since no model exists that will, with certainty, predict future workforce needs, it is my personal perspective that we as individual neurosurgeons and AANS members, must take steps to ensure our specialty’s workforce remains well positioned in the future. To that end, I propose the following strategies:
- Participate in all activities pertaining to workforce analysis. Many would speak with conviction that ignoring the whole issue of workforce has worked in the past. However, letting market forces drive workforce is associated with such problems as oversupply, which results in an increase in health care costs and physician dissatisfaction, and undersupply that causes poor access to heath care. Participating in sanctioned studies that may lead to more accurate workforce rightsizing allows for important specialty concerns to be factored into the analyses.
- Increase every neurosurgeon’s competitiveness. To prosper, our specialty must continue to expand its horizons. The call by AANS president, Martin H. Weiss, MD, in the summer 1999 Bulletin, to support the research mission of our society was not the plea of an isolated academician, it was a call to the members of our organization to recognize that research performed by neurosurgeons will result in the discovery of new neurosurgical treatments that will expand our field. Included in research strategies is the use of outcome studies to demonstrate the quality of care provided by neurosurgeons compared to other specialties. Other means of enhancing neurosurgeons’ competitiveness include continuing medical education courses sponsored by the AANS, where neurosurgeons can learn about new techniques and new technologies to enhance their practice.
- Educate students and residents about workforce and socioeconomic issues. Program director and medical student advisors must counsel residents and medical students interested in a career in neurosurgery as to the prevailing climate of practice. While I believe that most students enter our specialty because of interest in the field, it is our responsibility as educators to apprise our students and trainees about the complexity of the economic environment so that they can make informed decisions about entering the specialty. For neurosurgical residents, it is crucial that training programs educate residents about ways to better prepare oneself for the complexities of the practice environment.
- Support the AANS . The AANS is more than an organization that has an annual meeting and collects dues. The AANS, as the spokesorganization for neurosurgery, has developed a long-range strategy that enhances neurosurgical practice, education, and research. Thus, the raison d’etre of our organization is to aid its members in maintaining their competitive edge in a highly competitive environment. While we ooften speak of the AANS as if it were a monolith, most know that the successful dynamics of the organization are a result of the hard work of our volunteer physiician members and the dedication of the AANS National Office staff, under the energetic direction of Dave Fellers, CAE. To maintain the integrity of our specialty in the current competitive socioeconomic environment, your involvement in and support of our organization is of paramount importance.