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Cross-post: As a Neurosurgeon, I See the Devastating Toll of the Raised Border Wall

By Cross Post, Spine Care, TraumaNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that may interest our readers. Today’s post originally appeared in the Los Angeles Times on April 13, titled “Opinion: As a San Diego neurosurgeon, I see the devastating toll of the raised border wall.” In the op-ed, Alexander Tenorio, MD, a neurological surgery resident at the University of California San Diego, poignantly discusses the horrific spinal cord and brain injuries caused by falls from the border wall.

Dr. Tenorio relays stories of patients coming to the emergency department with serious injuries, such as a 30-year-old male with an unstable spinal fracture after falling off the border wall. The patient had a severe spinal cord injury. Dr. Tenorio “walked over to the trauma unit and saw the terrified young man, lying immobile with a collar supporting his neck. Instead of concerned family, he was surrounded by Border Patrol officers.”

Since the height of the border wall in San Diego was raised in 2019, there have been a record number of traumatic spinal injuries sustained in border falls. Dr. Tenorio can attest to the unnecessary human suffering the higher wall imposes on people. As the son of Mexican immigrants who crossed the same border in the 1980s when fleeing violent threats in their hometown, Dr. Tenorio understands that his patient’s life story could easily have been his or his parents’.

Dr. Tenorio concludes the op-ed urging political leaders to halt the planned border wall extensions and provide greater resources for hospitals serving border regions.

Click here to read the op-ed.

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 using the hashtag #neurosurgery.

April 14, 2023
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Cross-Post: Alabama Hospitals Need Competition

By Advocacy Agenda, Cross Post, Health ReformNo 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 March 17, titled “Guest opinion: Alabama hospitals need competition” In the op-ed, Richard P. Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala., discusses why the “game of Hospital Monopoly needs to end.”

Alabama is facing a crisis regarding hospital operating costs. Alabama hospitals posted a 79% decrease in operating margin from 2019-2022, putting rural hospitals at risk for closure. Total hospital expenses have increased by $2.6 billion from pre-pandemic levels, with Alabama hospitals spending 30% more on labor in 2022 than in 2019.

Dr. Menger argues that reform needs to break up the large hospital system mergers, acquisitions and consolidation. “This is destroying competition, limiting care options for patients, and burning out our physician and nurse workforce,” according to Dr. Menger. The solution requires reform, accountability and competition.

  • The first solution is to reduce the administrative bloat of health care. Hospital executive salaries have far outpaced any physician salary increase, and reform needs to focus on the patient and the physician.
  • The second solution is holding non-profit hospitals accountable when they receive government monies. Due to market consolidation, large hospital systems are everywhere in their community and can use that sprawling stature to manipulate the drug market.
  • The third solution is to inject competition into the stale hospital-dominated system. Recent rulings have usurped non-compete clauses, allowing doctors to compete for wages in a regional market.

Click here to read the full op-ed by Dr. Menger.

Editor’s Note: Organized neurosurgery aims to improve competition in the health care system by increasing scrutiny of hospital and other health care consolidation, removing restrictions on physician ownership of hospitals and other ancillary services, establishing network adequacy standards and broadening health insurance coverage options.

In the recently released 2023 Legislative & Regulatory Agenda, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons outline health policy action items the neurosurgical societies plan to advance with Congress and the Biden Administration.

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

April 3, 2023
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Cross-Post: We need more than brain injury awareness: We need new treatment

By Cross Post, TBI, Traumatic Brain InjuryNo 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 op-ed originally appeared on Roll Call. Rep. Bill Pascrell Jr. (D-N.J.), co-chair and founder of the Congressional Traumatic Brain Injury Task Force, and Vishal Bansal, MD, FACS, discuss the need for more than brain injury awareness — the need for new treatment.

Each March, Brain Injury Awareness Month promotes learning more about brain injury and ending its dangerous effects. The American Association of Neurological Surgeons puts annual direct and indirect costs of the full spectrum of traumatic brain injuries (TBI) — from mild to severe — at $48 billion to $56 billion in 2019 and $76.5 billion today. More than 3 million patients visit hospital emergency rooms with suspected TBI annually.

Rep. Pascrell and Dr. Bansal state, “We have achieved widespread acknowledgment in recent years that TBI is a public health issue that contributes to disability and death. Yet, little has changed in the standard of care for concussions as the medical community is still striving for therapy that would treat both the symptoms and the underlying concussion. We can do more and should do better.”

Despite progress, concussions are still a significant unmet medical need. The authors conclude the op-ed by stating that more resources are needed today to support cutting-edge research and development for effective treatments for concussion.

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 and using the hashtags #neurosurgery and #BrainInjuryAwareness.

March 24, 2023
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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

February 24, 2023
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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.

November 3, 2022
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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.

October 28, 2022
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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.

October 19, 2022
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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.

July 25, 2022
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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.

July 22, 2022
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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.

July 14, 2022
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