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Cross-Post: A Night in the Life of a Busy Neurosurgical Resident

By Career, Cross PostNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will interest our readers. Today’s post originally appeared on Medicine @ Brown Magazine. Abdul-Kareem Ahmed, MD, provides a poignant depiction of one night as a neurosurgical resident at the University of Maryland. Every patient’s worst moment is Dr. Ahmed’s every day. Read More

Cross-Post: Why Is It Hard for Grandma To See Her Doctor?

By Cross Post, MedicareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that may be of interest to our readers. Today’s post originally appeared on AL.com on Nov. 1, titled “Why is it hard for grandma to see her doctor?” In the op-ed, Richard Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala., discusses how steep Medicare physician payment cuts scheduled to go into effect on Jan. 1, 2023, are not a good prescription for a healthy physician workforce.

The average physician will receive 8.5% less for providing the same services they did last year. While adjusting for inflation, Medicare payments to physicians have declined 22% from 2001-2021. According to Dr. Menger, “The people most impacted by these cuts will be our Medicare patients. In the backdrop of inflation, practices will not be able to sustain themselves by treating Medicare patients.” Dr. Menger concludes by stating that this puts seniors at risk for reduced access to care.

Click here to read the full article.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery.

Cross-Post: It’s Never Too Late to Pivot From N.F.L. Safety to Neurosurgeon

By Career, Cross PostNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in the New York Times on Oct. 11 as part of the “It’s Never Too Late” series. The article discusses how Myron Rolle, MD, a PGY-6 neurosurgery resident at Massachusetts General Hospital in Boston, Mass., transitioned from playing in the NFL to neurosurgery.

Dr. Rolle notes that he was inspired to become a neurosurgeon by the book “Gifted Hands” by Benjamin S. Carson, MD, FAANS (L) — a memoir that detailed how Dr. Carson went from being an inner-city youth with poor grades to the director of pediatric neurosurgery at Johns Hopkins University Hospital. Dr. Rolle’s long-term goal is to practice neurosurgery in the U.S. and spend a portion of the year in the Caribbean, developing neurosurgical services in the Bahamas and member states of CARICOM, an organization of Caribbean countries.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and @MyronRolle and using the hashtag #Neurosurgery.

Cross-Post: Neurosurgery Announces Global Neurosurgery ‘Moon Shot’ with New Editorial Board Section

By CNS Spotlight, Cross Post, Guest PostNo Comments

From time to time on Neurosurgery Blog, you will see us highlighting items from other places when we believe they hit the mark on an issue. To this end, we want to bring attention to the new Neurosurgery Editorial Board Section, “Global Neurosurgery,” highlighted by Section Editor Gail L. Rosseau, MD, FAANS, FACS, in the October issue of Neurosurgery.

As highlighted in a recent announcement about the new feature, “Despite rapid advancements in neurosurgical techniques and capabilities, much of the world’s population has limited or no access to modern care for brain and spinal trauma, stroke, tumors, and other neurological conditions.” To remedy this inequity, the Editor-in-Chief of Neurosurgery, Douglas S. Kondziolka, MD, FAANS, introduced this new section to help advance timely, safe and affordable neurosurgical care to all who need it. Comprised of experts from every generation and continent where neurosurgery is practiced, this new Neurosurgery feature is working to attract the highest-quality global neurosurgery manuscripts, emphasizing policies to assure equity in authorship, access and use of local data.

Dr. Rosseau likens the Global Neurosurgery initiative to President John F. Kennedy’s commitment to land American astronauts on the moon, “no specialty and no nation which expects to be a leader can expect to stay behind in the quest for highest quality health care for all people.”

To read the full Editorial in Neurosurgery, click here.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and @NeurosurgeryCNS.

Cross-Post: If Our Politicians Could See What We See: A Pediatric Neurosurgeon on Gun Violence

By Cross Post, PediatricsNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be impactful for our readers. Today’s post originally appeared in Time on June 23. Pediatric neurosurgeon John “Jay” Wellons, III, MD, FAANS, recounts his experience treating a patient hit in the skull by a bullet fired into a crowded playground. “As surgeons, we find ourselves left trying to fix the ghastly results of so much of this gun violence that seems endemic in our country,” Dr. Wellons states.

Dr. Wellons recounts how a colleague stood in an emergency department close to Sandy Hook Elementary years ago as the calls began to come in, he and his surgical team in medical gowns ready for the waves of injured children — waiting until they realized that no one survived to make it there. He concludes the article by saying, “Let me be clear, the death of children from any injury or any reason is heartbreaking, and the fact that gun-related death is the number one killer of our children, more than motor vehicle collisions and childhood cancer what our medical journals have been telling us over the last few months is a failure of our society and needs to be changed.”

Editor’s Note: The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) have long promoted education programs designed to prevent firearm injuries by teaching and encouraging proper firearm use, safety, storage and ownership responsibility. The AANS and the CNS praised Congress for passing the Bipartisan Safer Communities Act. The neurosurgical groups believe that this gun safety legislation — which would expand background checks, restrict certain individuals from owning firearms and provide incentives for states to enact “red-flag” programs — is a crucial step in preventing tragic and senseless firearm deaths.

We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery.

Cross-Post: Patient Advocacy in Neurosurgery

By Access to Care, Cross PostNo Comments

From time to time on Neurosurgery Blog, you will see us cross-post articles that we believe are of interest to our readers. Today’s post comes from a recent article in the AANS Neurosurgeon, the official socioeconomic publication of the American Association of Neurological Surgeons (AANS). In the article, Sarah I. Woodrow, MD, FAANS, outlines the importance of patient advocacy in neurosurgery and lists opportunities for neurosurgeons to get involved.

“Physician advocacy should be part of the daily practice of all neurosurgeons. Many of us advocate for our patients routinely as we participate in their care. It is important, however, to think beyond the needs of an individual patient and engage in system-level advocacy to promote a larger concept of societal well-being,” according to Dr. Woodrow. Opportunities include:

  • Working locally within one’s own health care system or organization to improve access and quality of care to patients, particularly those whose care has traditionally been neglected.
  • Interacting with local media to draw attention to issues faced by patients.
  • Engaging with local or national special interest groups (e.g., ThinkFirst, National Brain Tumor Society and Hydrocephalus Association) to promote ideas such as awareness or disease prevention.
  • Collaborating with colleagues at state neurosurgery medical societies and engaging with the Council of State Neurosurgical Societies — whose role in organized neurosurgery focuses on socioeconomic policy impacting neurosurgery practice and the quality of care delivered to our patients.
  • Engaging with state or federal lawmakers to advocate for legislation and policies that promote equitable health and safety for all.
  • Supporting the AANS/Congress of Neurological Surgeons Washington Committee and the Washington Office, the voice of organized neurosurgery at the national level. The committee, comprised of a cross-section of neurosurgeons, oversees neurosurgery’s health policy and advocacy efforts.
  • Donating to NeurosurgeryPAC, the non-partisan political action committee of the AANS that makes campaign contributions to political candidates that support issues important to neurosurgery.

For neurosurgeons interested in strengthening their role as physician advocates, starting small and local may seem like the best option. For others, organized neurosurgery has numerous opportunities to affect systemic change. Regardless of the approach, Dr. Woodrow notes that neurosurgeons must never underestimate the power of their voice to advocate for patients.

Click here to read the full article in the AANS Neurosurgeon.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and @AANSNeurosurg.

Cross-Post: Prior Authorization Is Hurting Our Patients

By Cross Post, Prior AuthorizationNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in MedPage Today on June 25. In the op-ed, neurosurgeon and chair of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Washington Committee John K. Ratliff, MD, FAANS, discusses how prior authorization is hurting patients and how bipartisan legislation in Congress can help address these problems in Medicare Advantage.

Dr. Ratliff points out that prior authorization, an administrative process requiring physicians to obtain pre-approval for medical treatments or tests before rendering this care to their patients, is becoming more common. Obtaining approval from insurers is burdensome and costly to physician practices. Without timely care, his patients often face permanent neurologic damage and sometimes death.

The Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018) would create an electronic prior authorization process and pave the way for immediate approvals for medical services that are routinely approved. This legislation would also improve transparency on the use of prior authorization, ensure that qualified medical personnel review prior authorization requests and protect beneficiaries from disruptions in care.

Click here to read the full article.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by using the hashtag #FixPriorAuth and following @Neurosurgery.

Cross-Post: ‘I’m a Neurosurgeon Who Can’t Move. Now What?’

By Cross Post, Spine CareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in MedPage Today on June 15. In the op-ed, David J. Langer, MD, FAANS, recounts a life-changing accident during a ski trip that resulted in a spinal cord injury and a feeling of powerlessness for the practicing neurosurgeon and star on the Netflix series Lenox Hill.

Moments after Dr. Langer fell while skiing in Colorado, he realized he couldn’t move his legs, “I’m a neurosurgeon who can’t move, I thought. Now what?” After being airlifted to a Denver hospital, he was diagnosed with central cord syndrome ⁠— his spinal cord was injured, but only temporarily. “Feeling valued and humbled, I returned home to my own team to repair my spine,” according to Dr. Langer. The excellent care he received in Colorado and at home in New York now reminds him to keep patients’ humanity front and center.

Click here to read the full article.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by using the hashtag #Neurosurgery and following @Neurosurgery and @DrDavidLanger.

Cross-Post: Perverse Health-Care Incentives Endanger Spine Patients

By Access to Care, Cross Post, Spine CareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in The American Spectator on May 21. In the op-ed, neurosurgeons Richard Menger, MD, MPA and Anthony M. DiGiorgio, DO, MHA voice their support of Louisiana HB 941, a bill in the Louisiana State Legislature that would allow only spine surgeons to perform spine surgery.

Non-surgeons have begun performing spine surgery at such a rate that it became necessary for the leading spine organizations — including the American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS) and AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves — to adopt a position statement on the issue. As pointed out by Drs. Menger and DiGiorgio, it is a fairly straightforward premise that a physician should be a spine surgeon to perform and bill for spine surgery.

Click here to read the full article.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by using the hashtag #SpineSurgery and following @Neurosurgery and @SpineSection.

Cross-Post: Physician Pay Cuts Are Another Threat to Independent Practices

By Cross Post, Health Reform, MedicareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue. Today’s post originally appeared in The Hill on Nov. 13, 2021. In the op-ed titled “Physician pay cuts are another threat to independent practices,” Richard Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala., discusses how the 9% Medicare physician pay cuts for medical services starting Jan. 1, 2022, will have enormous consequences for the entire health care system.

According to Dr. Menger, “Medicare physician pay has increased only 11 percent from 2001-2020. Meanwhile, the cost of running a medical practice increased 39 percent from 2001-2020.  Adjusting for inflation and the cost of running a practice, Medicare physician pay dropped 22 percent over the time period.” He continued, “Medicare payment to hospitals increased nearly 60 percent over the same time period.”

Medicare physician pay cuts place external pressure on physicians and drives them into more hospital-employed practices. Hospitals are merging and consolidating around regional health care markets on an astounding basis. Dr. Menger noted that a collection of the country’s leading surgical societies, the Alliance of Specialty Medicine and the Surgical Care Coalition, recognize this downward pressure as impossible to maintain.

Click here to read the full article in The Hill.

Editor’s Note: We encourage everyone to join the conversation online by following @Neurosurgery, @SpecialtyDocs and @SurgeonsCare and using the hashtag #Neurosurgery.