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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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Cross-Post: Medicare for All, Surgery for Some

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 when we believe they hit the mark on an issue. Today’s post originally appeared in The American Spectator on April 29, 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 the recent Centers for Medicare & Medicaid Services (CMS) announcement to begin prior authorization for specific procedures, including spine surgery, starting July 1. Insurance companies currently use prior authorization to limit the services they provide for their customers.

According to Dr. Menger, “The prior-authorization process does not serve as a national guidelines-based quality control process to ensure local physicians adhere to stringent medical standards. Rather, it serves as opaque obfuscation and deterrence.” Prior authorization is generally not driven by scientific data. It delays care and serves as an obstacle to medically necessary patient care, disrupting the patient-physician relationship.

Click here to read the full article in The American Spectator and here for the CMS prior authorization policy.

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.

May 25, 2021
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Cross-Post: Overlapping Surgery: A Safe and Smart Way to Fix COVID-Related Backlogs

By COVID-19, Cross PostNo 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 April 1, 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. and Anthony M. DiGiorgio, DO, MHA, assistant professor of neurosurgery at the University of California San Francisco in San Francisco, Calif. highlight the opportunity for overlapping surgery to assist with the backlog of neurosurgical cases due to COVID-19.

Across the country, many non-urgent surgeries were canceled or delayed due to COVID-19. Overlapping surgery is the practice of a surgeon being responsible for more than one operating room at a time with non-critical portions of the procedure overlapping. When properly and ethically integrated, Drs. Menger and DiGiorgio use overlapping surgery in neurosurgery to better use health care resources and improve access to care.

In 2016, the American Association of Neurological Surgeons, American Board of Neurological Surgery, Congress of Neurological Surgeons and Society of Neurological Surgeons issued guidelines for the use of overlapping surgery.

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

Editor’s Note: We encourage everyone to join the conversation online by using the hashtags #Neurosurgery and #COVID19.

April 9, 2021
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Highlighting the Global Influence of Women in Neurosurgery

By AANS Spotlight, Cross Post, Women in NeurosurgeryNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other sources that we believe are relevant to our audience. Since this week featured International Women’s Day, we wanted to bring your attention to the March 2021 Neurosurgical Focus issue on International Women Leaders in Neurosurgery: Past and Present exploring women’s roles in neurosurgery over the years.

Topics include the impact of culture and history on women’s progress and the global influence of women in neurosurgery. Historical reports highlight noteworthy examples of women neurosurgeons around the globe who have demonstrated vision and leadership. The series discusses the presence of women neurosurgeons at the podium at scientific and medical society gatherings and the emerging roles of women as leaders in international organizations. Various aspects of research are described, including funding gaps and publication rates.

The series proposes strategies to expand opportunities for success for women neurosurgeons. A future that actively encourages the best and brightest medical students to choose neurosurgical careers — regardless of gender, ethnicity, religion, culture, sexual orientation or identity, socioeconomic strata or any other individual defining characteristic — will best serve the needs of the profession and patients.

Read the following articles in the series:

 

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 using the hashtag #WomenInNeurosurgery

March 10, 2021
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Practice Restructuring in the COVID-19 Era

By CNS Spotlight, COVID-19, Cross PostNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other sources that we believe are relevant to our audience. We wanted to bring attention to this article from the Winter 2021 issue of Congress Quarterly titled “Considerations for Private Practice Groups in the Age of COVID.” Stacey Lang, an executive administrator at the University of Pittsburgh Medical Center and a volunteer with the Neurosurgery Executives’ Resource Value & Education Society, outlines both short-term and long-term considerations for practice restructuring in the COVID-19 era, including staffing, facility and scheduling matters.

According to a recently released American Medical Association survey, the average number of weekly office visits per provider fell by over 50%. In addition, while on average physicians experienced a 32% drop in revenue since February, approximately 20% saw reductions of 50% or more. Less than 20% of physicians reported no decrease in revenue. Given the duration of the pandemic thus far, it is difficult to remember what everyday practice was and to imagine that we will, at some point, return to normal, albeit a new normal.

To read the complete article, click here.

Editor’s Note: We encourage everyone to join the conversation online by using the hashtags #COVID19 and #Neurosurgery.

February 16, 2021
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