Virtually all neurosurgeons will have to deal with a medicolegal issue by the end of their career. Neurosurgeons have the highest annualized rate of lawsuits at >19%. Perhaps shockingly, even by age 45, approximately 88% of surgeons in high-risk subspecialties will have been involved in a lawsuit. This number elevates to >99% by age 65. The concern about professional liability lawsuits is, without a doubt, the highest profile medicolegal issue for neurosurgeons — even though many more issues other than litigation affect our daily medical practices. Medicolegal and socioeconomic topics such as neurosurgical workforce, contracting and employment, and payor/insurance issues such as coverage policies, reimbursement and prior authorization regularly impact each neurosurgeon’s practice in multiple ways — even if it is not immediately apparent.

We are all trained in both the science and art of medicine throughout those seven long years of residency. Yet, historically, very little attention is paid to educating neurosurgeons about myriad medicolegal and socioeconomic issues. There is a relative dearth of information on socioeconomic topics compared to matters concerning the science and practice of medicine in the literature. As such, during our residency and in our daily practice, we learn precious little about issues related to the social, political or economic aspects of neurosurgery. However, these issues consume so much of our time and significantly impact our practices.

To this end, the November issue of Neurosurgical Focus is dedicated to medicolegal issues that can be useful to neurosurgeons at all stages of practice. We hope that this issue will serve as a primer on the subject so that neurosurgeons can develop an appetite for regular reading about and involvement with these critical issues.

Articles in the Neurosurgical Focus’ November issue include:

Lastly, please note the hard work in this area that the Council of State Neurosurgical Societies (CSNS) has done for decades. The CSNS is the group in organized neurosurgery that addresses the confluence of medicolegal and socioeconomic issues and neurosurgical practice as neurosurgeons. It is jointly supported by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons since its inception in 1972. It began as the Joint Socio-Economics Committee. It functions as a grassroots organization whose members are drawn from each state’s neurosurgical society. This structure allows it to be broadly representative of the whole of neurosurgery while at the same time being agile enough to deal with the rapidly changing landscape of these issues. In addition to delving into the November medicolegal issue of Neurosurgical Focus, neurosurgeons are encouraged to participate as active members in your state neurosurgical society to ensure that you remain an integral part of the CSNS.

Click here to read the press release and here for the complete issue of “Medicolegal Issues in Neurosurgery” in Neurosurgical Focus.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following @Neurosurgery and @CouncilSNS and using the hashtag #Medicolegal.

Jason D. Stacy, MD
North Mississippi Medical Center
Tupelo, Miss.

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