N A ICA SSO R C E I M A T A I E O N H T O S F N N O E U E R G O R L S U CC ONTENTSONTENTS O G IC A L T HE AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS AANS BULLETIN The quarterly publication of The American FEATURES Association of Neurological Surgeons Is Subcertification Good for Neurosurgery? As neurosurgery A. John Popp, MD, Editor 6 James R. Bean, MD, Associate Editor evolves, more physicians are considering the pros and Barbara Peck, Staff Editor cons of subspecialty practice. Deia Lofendo, Staff Writer Outcomes Initiatives Outcomes reporting instruments are OFFICERS AND DIRECTORS (1999-2000) 14 now available on N://OC®. Martin H. Weiss, MD, President Stewart B. Dunsker, MD, President-Elect Meet Your President AANS President Martin H. Weiss, A. John Popp, MD, Vice President 23 MD, sets the organizational agenda for his term in office. Stan Pelofsky, MD, Secretary Roberto C. Heros, MD, Treasurer New Orleans Highlights from the 67th Annual Meeting. Russell L. Travis, MD, Past President 24 Consolidation CSNS passes resolution requesting consolidation of AANS and CNS. Directors-At-Large: William F. Chandler, MD • Robert A. 25 Ratcheson, MD • Jon H. Robertson, MD • Volker K.H. Sonntag, MD • Fremont P. Wirth, MD • Jeffrey A. Brown, MD, NW Regional Director • Gary Vander Ark, MD, SW DEPARTMENTS Regional Director • Robert B. Page, MD, NE Regional Director • William E. Mayher III, MD, SE Regional Director 3 Newsline Reports on news, members, trends and legislation, including “From the Lyal G. Leibrock, MD, CSNS Liaison Hill” and “Neuro News.” David F. Jimenez, MD, Young Neurosurgeons Liaison 32 News.Org Reports on professional organization news, including AANS/CNS AANS NATIONAL OFFICE Sections and committees. 22 S. Washington St., Park Ridge, IL 60068 Phone (847) 692-9500; Fax (847) 692-2589 E-mail: [email protected] Web site: www.neurosurgery.org COLUMNS Laurie L. Behncke, CMP, Associate Executive President’s Message Martin H. Weiss, MD, discusses the future of organized Director — Programs 2 neurosurgery. Robert R. Cowan, CPA, Associate Executive Director — Administration 11 Guest Column: How One Specialty Experienced Subspecialization and Certification Raymond J. Jaskot, Director of Information Services Interview with the President of the American Board of Facial Plastic and Recon- Jacquelyn Lloyd, Director of Marketing structive Surgery, Peter A. Adamson, MD. Tony Loster, CGCM, Director of Print Production and 13 Neurosurgical Fellowships David F. Jimenez, MD, addresses the need for improved Fulfillment Services post-residency training programs. Susan A. Nowicki, APR, Director of Communications 16 Managed Care: Changes in the Marketplace John A. Kusske, MD, discusses the John R. O’Connell, Director of Development managed care organization of the future. Lisa Sykes, CMP, Director of Meetings Practice Management: Neurosurgery – The Cost of Doing Business June Wasser, Director of Professional Development 17 James R. Bean, MD, discusses two strategies to reduce costs in neurosurgical practice. CHANGE OF ADDRESS: AANS, 22 S. Washington St., 18 Coding Corner Greg Przybylski, MD, answers complex reimbursement questions. Park Ridge, IL 60068-4287 26 Research Foundation Foundation sets all-time record in 1998 fundraising campaign. © 1999 by The American Association of Continuing Medical Education AANS offers comprehensive pain management course. Neurological Surgeons, all rights reserved. 28 Contents may not be reproduced, stored in a 29 Membership AANS welcomes new Candidate members. retrieval system, or transmitted in any form by any means without prior written 30 Secretary’s Report Stan Pelofsky, MD, discusses the accomplishments of our permission of the publisher. organization over the past year. The AANS Bulletin is published quarterly by 37 Advocacy and the Standard of Care Chairman of the Professional Conduct The American Association of Neurological Committee, W. Ben Blackett, MD, JD, discusses the AANS guidelines for Surgeons, 22 S. Washington St., Park Ridge, IL 60068-4287, and distributed without charge to the providing expert medical testimony. neurosurgical community. Unless specifically stated Practice Profile Richard N. Wohns, MD, highlights his innovative practice- otherwise, the opinions expressed and statements 38 made in this publication are the authors’ and do building techniques. not imply endorsement by the official policy of the AANS. 40 Personal Perspective Editor A. John Popp, MD, examines the issues surrounding neurosurgical subcertification. Spring 1999 • AANS Bulletin 1 PP RESIDENTRESIDENT’’ SS MMESSAGEESSAGE MM ARTINARTIN H.H. WWEISSEISS,, MDMD led to the development of Sections that repre- sent the “focused” interests of our membership. United We Stand The leadership of the Sections will now Working Together to Secure the Future of Neurosurgery. participate in the deliberations of the AANS Board in order to enhance communication and understanding between the Sections and the AANS. hank you for the honor that you have Research and Education Young Neurosurgeons bestowed upon me in allowing me to Medicine is facing an extraordinary chal- Since Active membership in the AANS T serve as President of the AANS. Dur- lenge from both the private health insurance requires certification by the American ing my tenure as President-Elect, I have industry, as well as governmental sources. Your Board of Neurological Surgery, the Royal gained a deep appreciation of the dedica- Association is actively involved at all levels to College of Surgeons (Canada) or the Mexi- tion of our leadership to the Association and ensure that neurosurgery is fully represented can Council of Neurological Surgery, A.C., to neurosurgery; it is my sincere hope to carry in such negotiations. Our ongoing focus on there may be a perception among young these efforts forward in the coming year. growth and development of the discipline is neurosurgeons that they are not included essential if we are to ensure the position of neu- in the programmatic efforts of the AANS. Speaking up for Neurosurgery rosurgery in the hierarchy of medical practice. Nothing could be further from the truth! The AANS has been the spokesorganization This growth can only come from contin- Young neurosurgeons tracking for their for North American neurosurgery since ued investment in R&D by the Association and Boards are eligible for Active (Provisional) 1965, serving as the neurosurgical voice on all of the agencies and organizations that it rep- membership and residents in training may such topics as managed care reimburse- resents and supports. The Research Founda- participate in the AANS as Candidate mem- ment, FDA regulations and socioeconomic tion of the AANS actively supports neurosur- bers. All members at every level are encour- affairs. The Association has broadened its gical research efforts at every level, and its aged to participate in the activities of the membership base by welcoming into its recent decision to combine translational Association. The Chairman of the Young ranks certified neurosurgeons from Canada Neurosurgeons Committee now partici- and the Republic of Mexico. We also have Martin H. Weiss, MD, pates in the Board deliberations so that the invited representatives of their leadership is President of the AANS specific issues confronting our younger to attend our Board of Directors’ meetings and Professor and membership can be brought to the atten- as a way to enhance the relationship with Chairman of the Depart- tion of the Board in a very direct way. our North American colleagues. ment of Neurological Surgery at the School of Broader Representation Communications Medicine of the University During the past year, the AANS leadership The Bulletin constitutes one of numerous of Southern California has made a deliberate effort to reach out to communication efforts of the Association. our constituency. We recognize that this is a It is our major vehicle for the dissemina- research efforts (including clinical research) two way street - the leadership must have tion of Association-related material and so- with the strong basic science program presently input from our members to develop the pro- cioeconomic news. Including information in place bodes well for the development of new grams best designed to meet their needs. on CPT coding, legislation, managed care fundamental precepts for neurosurgical care. In the past, we have broadened participa- markets, and outcomes studies. It is your In terms of continuing medical educa- tion on the Board of Directors by developing forum for comment to the membership tion, the Association’s Professional Devel- the quadrant representative positions, thereby about such issues, and I would strongly en- opment Program offers the premier vehicle assuring input to the Board from each State courage you to bring your resources to the for dissemination of technical, cognitive Neurosurgical Society. With the addition of membership through this vehicle. and socioeconomic information relevant to Board participation by Section leadership and Our major scientific publication is the our practices. It continues to enjoy great the Young Neurosurgeons Committee, your Journal of Neurosurgery. Combined with its success in service to the membership. organization embraces every aspect and need online edition, Neurosurgical Focus, the of the entire community of neurosurgeons. Journal provides sophisticated peer re- Subspecialization I look forward to working with and for viewed neuroscience pertinent to our Although the AANS remains officially