AANS Bulletin Vol. 14 No. 1 Spring 2005
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For advertising information, see the Bulletin’s rate card at http://www.aans.org/bulletin/ or contact Bill Scully, [email protected], (201) 767-4170. C ONTENTS VOLUME 14 NO. 1 PRESIDENT’S MESSAGE 5 | Knowing Where to Put the Power On Education and Innovation First Among AANS Strengths Robert A. Ratcheson, MD FEATURE 36 | Annual Meeting: Neurosurgery Also Means Business Socioeconomic Programs Support Neurosurgical Practice Manda J. Seaver NEWS AND EVENTS ON THE COVER 8 | Newsline: From the Hill 13 | To Care Is Human: It’s Quality That Three states pass liability reform legislation. Neurosurgery Must Define 10 | Newsline: Neuro News 14 | Characterizing Quality Institute of Medicine calls for a spinal cord The Opportunity of Outcomes Research injury network. Robert E. Harbaugh, MD 30 | News.org The AANS expands functionality of online CME 17 | Practice Guidelines—Why Bother? tracking at www.MyAANS.org. IOM, MedPAC and Others Call for Evidence-Based Quality Care 44 | Calendar of Neurosurgical Events Mark E. Linskey, MD The 13th World Congress of Neurological Surgery is held June 19-24. 18 | P4P for Specialists Gains Velocity Whether They Improve Quality or Not, P4P Programs Are Coming Michelle Bertagna and Richard Gliklich, MD OPINION 20 | Congress Considers P4P Legislation 11 | Personal Perspective January 2006 Implementation Would Assessing healthcare quality: Medicare’s 2 percent Affect Neurosurgeons reduction is no idle threat. Barbara E. Peck, JD James R. Bean, MD 21 | The P4P Initiative: How NERVES Can Help 31 | Letters A Practice Administrator Argues for Reader says more exposure to neurosurgery in Neurosurgery’s Involvement medical school can ease ER coverage troubles. Mark Mason Continued on page 4 Spring 2005 • AANS Bulletin 3 C ONTENTS DEPARTMENTS 40 | Bookshelf 29 | Residents’ Forum New books tackle medical liability, lost idealism. Outcomes, certification and reimbursement: NeuroLog looms large in the future of Cheryl A. Muszynski, MD; Gary Vander Ark, MD neurosurgical residents. 22 | Coding Corner Brian R. Subach, MD Neurosurgeons surveyed May–August will help determine Medicare’s work RVUs. 26 | Risk Management Family limited partnerships are one way Gregory J. Przybylski, MD to protect personal assets. 24 | Education Robert Dowd, JD Patient transfers spark town-gown tension. 31 | Timeline Deborah L. Benzil, MD If neurosurgery’s pioneers had been subject to outcomes oversight then, where would neurosurgery 28 | Governance be now? The AANS adopts guidelines for corporate relations. Michael Schulder, MD Jon H. Robertson, MD 38 | Washington Update 32 | NREF The 2004 DMLR campaign posted huge successes, These NREF supporters donated July 1-Dec. 31, 2004. but neurosurgery presses on for liability reform, primarily through NPHCA. 42 | NS Innovations New endovascular technologies are on the A. John Popp, MD, and Katie O. Orrico, JD horizon for aneurysms and more. Felipe C. Albuquerque, MD AANS MISSION WRITING GUIDELINES in a future issue edited for length, clarity and style. The AANS is dedicated to advancing the specialty of neuro- www.AANS.org/bulletin Correspondence is assumed to be for publication unless logical surgery in order to provide the highest quality of otherwise specified. neurosurgical care to the public. ARTICLE SUBMISSIONS AND IDEAS BULLETIN ONLINE AANS BULLETIN Articles or article ideas concerning socioeconomic topics related to neurosurgery can be submitted to the Bulletin, The current issue and searchable archives to 1995 are avail- The official publication of the American Association of [email protected]. Objective, nonpromotional articles that able at www.AANS.org/bulletin. Neurological Surgeons, the Bulletin features news about the are in accordance with the writing guidelines, are original, AANS and the field of neurosurgery, with a special emphasis and have not been published previously may be considered on socioeconomic topics. PUBLICATION INFORMATION for publication. The AANS Bulletin, ISSN 1072-0456, is published four times James R. Bean, MD, editor The AANS reserves the right to edit articles for compliance a year by the AANS, 5550 Meadowbrook Drive, Rolling Robert E. Harbaugh, MD, associate editor with publication standards and available space and to Meadows, Ill., 60008, and distributed without charge to the Manda J. Seaver, staff editor publish them in the vehicle it deems most appropriate. neurosurgical community. Unless specifically stated other- Articles accepted for publication become the property of the wise, the opinions expressed and statements made in this BULLETIN ADVISORY BOARD AANS unless another written arrangement has been agreed publication are the authors’ and do not imply endorsement upon between the author(s) and the AANS. by the AANS. Deborah L. Benzil, MD Patrick W. McCormick, MD Frederick A. Boop, MD Cheryl A. Muszynski, MD © 2005 by the American Association of Neurological Alan S. Boulos, MD Katie O. Orrico, JD PEER-REVIEWED RESEARCH William T. Couldwell, MD Surgeons, all rights reserved. Contents may not be repro- A. John Popp,MD The Bulletin seeks submissions of rigorously researched articles Fernando G. Diaz, MD duced, stored in a retrieval system, or transmitted in any Gregory J. Przybylski, MD concerning socioeconomic topics related to neurosurgery. Haynes Louis Harkey, MD form by any means without prior written permission of Michael Schulder, MD Selected articles will be reviewed by the Peer-Review Panel. David F. Jimenez, MD the publisher. Brian R. Subach, MD Submit articles to the Bulletin, [email protected]. Ali F. Krisht, MD Gary D. Vander Ark, MD Peer-Review Panel led by Mick J. Perez-Cruet, MD; ADVERTISING SALES Deborah L. Benzil, MD; William E. Bingaman Jr., MD; Bill Scully, Cunningham Associates, (201) 767-4170, or DEPARTMENT EDITORS AND CORRESPONDENTS Frederick A. Boop, MD; Fernando G. Diaz, MD; David F. [email protected]. Rate card, www.AANS.org/bulletin. Deborah L. Benzil, MD (Education); Frederick A. Boop, MD Jimenez, MD; Lyal G. Leibrock, MD; Mark E. Linskey, MD; (CSNS Report); Alan S. Boulos, MD (Computer Ease); William Richard N. Wohns, MD T. Couldwell, MD (NS Innovations); David F. Jimenez, MD (Risk Management); Mark Mason (Practice Management); Cheryl A. Muszynski, MD (Bookshelf); Katie O. Orrico, JD LETTERS (Washington Update); Gregory J. Przybylski, MD (Coding Send your comments on articles you’ve read in these Corner); Michael Schulder, MD (Timeline); Brian S. Subach, pages or on a topic related to the practice of neurosurgery MD (Residents’ Forum); Gary Vander Ark (Bookshelf) to [email protected]. Correspondence may be published 4 AANS Bulletin • www.AANS.org P RESIDENT’ S M ESSAGE R OBERT A. R A TCHESON, MD Knowing Where to Put the Power On Education and Innovation First Among the AANS Strengths ower comes not from power everywhere, but from agencies’ developing requirements. knowing where to put it on,”wrote Norman Maclean, The AANS has put its efforts toward speaking not of neurosurgery but rather of the grace- helping AANS members manage the “P ful art of casting in his book, A River Runs Through MOC process through the attainment and It, a metaphoric tale of fly fishing and life. documentation of continuing medical The emergence of spring after a seemingly endless Midwestern education credits in fulfillment of these winter rekindles thoughts of a humming stream and colorful trout requirements. The American Board of under the vast Montana sky; while I have attempted to suspend Neurological Surgery has chosen the such tempting thoughts until after my term as AANS president AANS as the single source to track, validate and the 2005 AANS Annual Meeting have concluded, the strategy Robert A. Ratcheson, MD and store CME requirements for individu- Maclean describes so succinctly does have current application to als in the MOC program. The AANS’ password-protected Web site, our profession. Whether navigating a complicated neurosurgical MyAANS.org, serves as the virtual center for CME credit tracking procedure, managing the competing demands of a busy practice, and management. The site, with its new design and continual or prioritizing the initiatives of your multifaceted professional updates, contains many unique features for managing CME cred- association,“knowing where to put the power on” is perhaps more it, such as customized reports, personalized transcripts, subspe- an art than a science. cialty transcripts, certificates of credit from AANS-sponsored, What are the priorities of neurosurgery today? How can the jointly sponsored and endorsed meetings, and a new feature that American Association of Neurological Surgeons identify the right allows members to select a delegate who can manage the entire priorities and then set and achieve specific goals? These questions online tracking process for them. The site provides convenient I have asked myself, particularly during the past year, and dis- access to additional CME offerings; these include meetings and cussed with the Executive Committee and the Board of Directors courses, as well as the opportunity to obtain CME credits online with input from the 40 or so committee chairs and the more than through Neurosurgical Focus and soon, through the Journal of 200 committee members who comprise the volunteer leadership Neurosurgery, as well as links to a wealth of pertinent online infor- of the AANS. We may not always agree with one another, but mation, such as the new AANS CME policy for the three-year through ongoing deliberations among keen-witted colleagues, the cycle that began Jan. 1. Members will find the site easier to navi- better ideas tend to take hold. And it is those ideas, those initia- gate and responsive to members’ requests and suggestions. tives, where we have tried to “put the power on” over the past year. Offering New Member Benefits and Opportunities Furthering Neurosurgical Education Our commitment to neurosurgical education must address the First and foremost, the AANS is an educational organization, and needs of neurosurgery’s next generation. This year the AANS this year a preponderance of the AANS effort has been directed made significant new additions to existing long-time benefits for toward education and educational issues.