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Cross-Post: First Female Neurosurgeon to Become a Medical School Dean: Julie G. Pilitsis Shares Her Path to Success

By CareerNo Comments

Our current series on Making and Maintaining a Neurosurgeon discusses how one transitions from student to resident to practicing neurosurgeon. This cross-post highlights the second chapter after practicing neurosurgery. Eleven years ago, Julie G. Pilitsis, MD, PhD, FAANS, set a goal to become a dean for a college of medicine.

To achieve this goal, Dr. Pilitsis worked toward gaining experience in the clinical, educational and research aspects of medicine at Albany Medical College. After a national search, she became the chair of The Department of Neuroscience and Experimental Therapeutics. Subsequently, she obtained additional leadership training through the Harvard course for chairs, Executive Leadership in Academic Medicine and earned a Masters in Business Administration. To help garner institutional budget experience, she joined the system’s finance committee. To gain philanthropy experience, she obtained formal training and worked closely with her institutional foundation.

In 2022, Dr. Pilitsis became the dean and vice president of medical affairs at Schmidt College of Medicine at Florida Atlantic University (FAU). She is the first female neurosurgeon to become a medical school dean. “A community is essential for all of us to get to where we are going. The central tenet of my time at FAU will echo that spirit of developing a health care workforce ‘of the community, for the community.’ I am proud to be a part of the neurosurgical community,” states Dr. Pilitsis.

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

Editor’s Note: Effective Jan. 8, Dr. Pilitsis is now the of the Department of Neurosurgery at the University of Arizona College of Medicine.

We hope you will share what you learn from our posts in the Making and Maintaining a Neurosurgeon series. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #Neurosurgery.

Cross-Post: ‘No other industry would tolerate this’: The problem with prior authorization in spine surgery

By Cross Post, Prior Authorization, Spine CareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting to items from other places that we believe will interest our readers. Today’s post originally appeared in Becker’s Spine Review on Sept. 25. Neurosurgeons Anthony M. DiGiorgio, DO, MHA, FAANS; Praveen V. Mummaneni, MD, FAANS and Luis M. Tumialán, MD, FAANS discuss prior authorization and the significant problems physicians face when it comes to receiving fair payments for services offered.

Denial of payment after prior authorization has become a grim reality in American health care. Insurance companies authorize procedures, and surgeons perform them as approved. Then, the insurance company denies payment. The authors state, “No other industry would tolerate this system. Yet, in healthcare, physicians, bound by their oaths to care for patients, endure a system that withholds payment.”

Ultimately, patients bear the brunt of this charade. The authors conclude the article by stating that patients deserve insurance companies that fulfill their contractual obligations.

Click here to read the full article.

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 #FixPriorAuth.

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.

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: 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.