In Episode 3 of Neurosurgery Blog’s Faces of Neurosurgery interview series, we spoke with Kim J. Burchiel, MD, FAANS, FACS, about his passions, his early mentors and what has driven him throughout his career. Dr. Burchiel is currently John Raaf Professor and Chairman Emeritus of the Department of Neurological Surgery at Oregon Health & Science University (OHSU).
Dr. Burchiel is most proud of his contributions to trigeminal neuralgia and deep brain stimulation, as well as building the department at OHSU. His favorite neurosurgical instrument is the computer, something that has changed the field more than anything else.
To the neurosurgeon in need of a book recommendation, he suggests “Undaunted Courage” by Stephen Ambrose — a book about the Lewis and Clark expedition to the west.
When asked about advice for individuals starting a neurosurgery residency, Dr. Burchiel said, “It’s very much like Lewis and Clark. It is a voyage into the unknown — a lot of difficulties lay ahead, and you need to be able to persevere, be resilient and you have to take it one day at a time.”
The full interview is available here and on Neurosurgery Blog’s YouTube channel.
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.
In Episode 2 of Neurosurgery Blog’s Faces of Neurosurgery interview series, we spoke with R. Michael Scott, MD, FAANS (L), about his early mentors, proudest achievements, and musical hobbies. Dr. Scott is currently Neurosurgeon-in-Chief-emeritus at Boston Children’s Hospital and Christopher K. Fellows Family Chair in Pediatric Neurosurgery.
Dr. Scott says that one of his proudest achievements is leaving behind an extensive legacy of patients throughout his career, as well as the residents he helped train. He is also proud of helping to better define Moyamoya disease and its surgical treatment.
He offers the following advice for neurosurgery residents, “Becom[e] an expert in something that interests you as you’re getting into residency.”
The full interview is available here and on Neurosurgery Blog’s YouTube channel.
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.
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 Atlantahere.
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.
The challenge of being a mother and a neurosurgeon is a topic that is rarely discussed, even in today’s society. It often feels like a taboo subject for women neurosurgeons and trainees, as if motherhood would somehow make one seem like a lesser neurosurgeon. With the extensive time dedicated to neurosurgical education, training and lifelong learning, it can be challenging to determine how motherhood fits into this life.
Perhaps one of the reasons this is not a widely discussed topic is that neurosurgery is still a male-dominated field. Women represent only 12% of neurosurgery residents and 5% of practicing neurosurgeons. In a recent survey of 126 women neurosurgeons and trainees, 49% of the respondents have children and 33% plan to have children. In addition to dealing with the challenges of achieving work-life balance, a startling barrier to become a neurosurgeon mom is that over 50% of survey respondents feel pressure or backlash from their colleagues for having children.
There needs to be some adjustments in the field of neurosurgery to make being a mother less of a hindrance and more accepted. Change is necessary on both the policy front and in the culture of the field. Formal parental leave and return to work policies should be established at every institution to promote equitable, gender-neutral policies for women and men, including for adoption and other family structures. Family leave policies are highly variable across practice environments, and only 25% of female neurosurgeons reporting having access to program parental leave allowances. Accommodations must be made for those during pregnancy and the post-partum period to ensure the health of the mother and baby. Access to lactation facilities close to the operating room/clinic and childcare is also crucial to those returning to work after parental leave.
Even with such policies in place, it still will not be enough until the culture regarding motherhood changes within the field of neurosurgery. Many women neurosurgeons report backlash from their colleagues for being pregnant and taking parental leave — ranging from microaggressions to being passed for career advancement opportunities. To prove to others that they will not let motherhood interfere with their job, many women neurosurgeons who have children work until their due date or return early from maternity leave. We need to do a better job normalizing being a mother and a neurosurgeon, which means taking breaks in the operating room for the physical needs of pregnancy and lactation. We need to have our male colleagues normalize taking paternity leave as well. They also need to speak up when they witness discriminatory behaviors towards women neurosurgeons. Finally, we need to speak up and advocate for ourselves and support others in our field who choose to become mothers.
Being a good mother and a good neurosurgeon is not mutually exclusive. It is hard, and we are our own worst critics when juggling these demanding jobs. With support and change on institutional and cultural levels, it may just make these two jobs a little more manageable.
The Motherhood & Neurosurgery webinar offers candid reflections on pregnancy and starting a family as a neurosurgeon. Panelists — Lola B. Chambless, MD, FAANS, Catherine A. Miller, MD, Lauren Albert Sand, MD and Doris Wang, MD, PhD — share advice for working while pregnant or nursing, and discuss how medical institutions can better support women surgeons through pregnancy and parenthood.
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 hashtags #CelebratingWINSat30 and #WomenInNeurosurgery.
In Episode 1 of Neurosurgery Blog’s new Faces of Neurosurgery interview series, Kalmon D. Post, MD, FAANS (L) was interviewed about his proudest achievements, his advice to graduating residents and his favorite surgical instruments. Dr. Post is currently the Department of Neurosurgery chair emeritus at the Icahn School of Medicine at Mount Sinai Hospital.
“I’ve done about 10,000 operations over [the] years, and I think taking care of people and their families has always been number one to me,” Dr. Post reflected on his proudest accomplishment.
To residents graduating and starting their careers, he says to remember, “First you’re not a neurosurgeon; first you’re a doctor. Think about the fact that you have patients and families in front of you, and your first goal is to comfort them and make them better.”
The full interview is available here and on Neurosurgery Blog’s YouTube channel
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.
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.
Having led a model for military-civilian collaboration at the Army Trauma Training Center in Miami, Fla., I was invited to be a reviewer of this report. I appreciated the wisdom of focusing on military-civilian trauma collaboration to save more lives from injury — whether on the battlefield or at home.
Such structured collaboration:
Shares best practices for civilian and military injury care and prevention;
Preserves hard-won lessons of combat casualty care;
Improves civilian access to trauma care;
Sustains military trauma surgeon and team skills; and
Promotes national readiness, particularly in the reflection of COVID-19 recovery.
With three years of hard work in advocacy, the MISSION ZERO Act was signed into law in 2019 as part of (H.R. 269/S. 1379), the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (P.L. 116-22).
This Act:
Followed the recommendations of the NASEM report;
Created the Military and Civilian Partnership for the Trauma Readiness Grant Program (MISSION ZERO) in the U.S. Department of Health and Human Services; and
Authorized grants to cover the administrative costs of integrating military trauma surgeons and teams into civilian trauma centers.
However, although the program was created (i.e., authorized), it has yet to be funded (i.e., appropriated). In 2020, the House of Representatives did include funding, but the Senate did not.
Five years later, trauma remains the leading cause of death for children and adults under age 44.
We are working quickly with the new Congress to achieve funding for Fiscal Year (FY) 2022. There is already good news. On April 27, 34 members of the U.S. House of Representatives sent a letter requesting full funding for MISSION ZERO to the House Labor, Health and Human Services, Education, and Related Agencies Subcommittee leadership. Sens. Chris Van Hollen (D-Md.) and Bill Cassidy, MD, (R-La.) are leading a similar effort in the Senate.
May is National Trauma Awareness Month, which is an opportunity for you to take action. So please ask your Senators and Representatives to support full funding at the authorized amount of $11.5 million for MISSION ZERO in the FY 2022 appropriations bills.
Fully funding this critical program will help improve injury care and public health response in our communities, states and nation, inclusive of our military health system.
Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter during National Trauma Awareness Month this May by following @Neurosurgery and @AmCollSurgeons, using the hashtags #TraumaAwarenessMonth and #Trauma.
At Neurosurgery Blog, we champion the vital role of health care in our lives. We acknowledge the profound influence of policymakers in Washington, DC, on this crucial aspect of society. Yet, the inner workings of health policy in our nation’s capital often remain hidden. Our mission is to actively investigate and report on how health care policy directly impacts patients, physicians and medical practice. We strive to showcase the expansive scope of neurosurgery, beyond the boundaries of brain surgery, emphasizing its diverse impact and significance.
Catherine A. Miller, MD
Doris Wang, MD, PhD
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.
Having led a model for military-civilian collaboration at the Army Trauma Training Center in Miami, Fla., I was invited to be a reviewer of this report. I appreciated the wisdom of focusing on military-civilian trauma collaboration to save more lives from injury — whether on the battlefield or at home.
ohn H. Armstrong, MD, FACS, FCCP
