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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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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.

June 30, 2022
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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.

June 2, 2022
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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.

November 17, 2021
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Cross-Post: A Way Forward For The Imaging Appropriate Use Criteria Program: Aligning Quality Metrics

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 Health Affairs on Aug. 26, 2021. The article, “A Way Forward For The Imaging Appropriate Use Criteria Program: Aligning Quality Metrics,” discusses proposed changes to the Centers for Medicare & Medicaid Services (CMS) calendar year 2022 proposed Medicare Physician Fee Schedule (PFS) Rule and implementation of the Appropriate Use Criteria (AUC) program. Mandated by the Protecting Access to Medicare Act (PAMA), the AUC program requires physicians ordering advanced diagnostic imaging to consult with AUC using an approved clinical decision support mechanism before the radiologist can provide the scan.

As the Health Affairs piece points out, following the release of the  PFS, the House Appropriations Health Subcommittee included in its report a provision for CMS to inform Congress about the implementation of the AUC program, including any challenges and successes. The AANS and the CNS have urged Congress to repeal the AUC program, given the additional burdens on physicians and potential delays in imaging services. At the very least, the neurosurgical societies have recommended that Congress adopt legislation that directs CMS to incorporate AUC for diagnostic imaging into the existing Quality Payment Program.

Click here to read the full article in Health Affairs.

Editor’s Note: We encourage everyone to join the conversation online by following @Neurosurgery and using the hashtags #Neurosurgery and #Medicare.

September 13, 2021
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Cross-Post: Bipartisan Bill Would Improve Medicare Patients’ Access to Care

By Cross Post, Health Reform, Prior Authorization, Regulatory ReliefNo 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 American Spectator on July 21, 2021. 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 H.R. 3173, the Improving Seniors’ Timely Access to Care Act, could bring transparency to the process of prior authorization in Medicare Advantage (MA) plans.

Prior authorization is a tool insurance companies use to limit the services they provide for their customers. If passed, this legislation would reduce prior authorization hassles and help curb unnecessary delays for patients. “It’s quite rare for a piece of legislation to have the direct ability to truly impact the lives of so many of my patients. It’s even rarer for that legislation to have bipartisan support,” according to Dr. Menger.

To bring needed transparency and oversight to the MA program, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) are urging Congress to adopt H.R. 3173, the Improving Seniors’ Timely Access to Care Act. Please contact Congress and ask your Representative to co-sponsor H.R. 3173.

Click here to go to neurosurgery’s Advocacy Action Center to send an email to your Representative asking them to co-sponsor the Improving Seniors’ Timely Access to Care Act. A sample message, which can be personalized, is provided.

Click here to read the full article in The American Spectator.

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 following @Neurosurgery and using the hashtag #FixPriorAuth.

July 26, 2021
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Faces of Neurosurgery: Dr. Franklin Lin Keeps His Family Safe During COVID-19 Pandemic

By COVID-19, Cross Post, Faces of NeurosurgeryNo 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 are relevant to our readership. Today’s post originally appeared on FOX 5 Atlanta on May 26, 2021. In the video segment, Franklin Lin, MD, FAANS, a neurosurgeon at Wellstar Kennestone Hospital in Atlanta, Ga., and his wife decided it would be safest for him to move out of his home and into a hotel at the beginning of the COVID-19 pandemic.

“A couple weeks turned into three weeks, three weeks turned into four weeks, and the pandemic just kept getting worse,” said Dr. Lin. He would spend time connecting with his family over Zoom and across the fence of their Marietta home. After getting vaccinated, Dr. Lin wanted to make sure that he couldn’t unknowingly transmit the virus to others. In February, as it became clear that likely wouldn’t happen, he came home after spending 11 months in a hotel.

The full interview is available below and at FOX 5 Atlanta here.

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 following @Neurosurgery and using the hashtag #FacesOfNeurosurgery.

June 10, 2021
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