History of the Joint Council of State Neurosurgical Societies

Regional, national and international neurosurgical societies were formed to disseminate advances in neurological surgery and to promote research. Socio-economic matters were usually privately managed between neurosurgeons and their patients. However, with the expansion of third party payers and Medicare, socio-economic matters no longer could be effectively resolved at local levels.

The Congress of Neurological Surgeons (CNS) established a Socio-Economics Committee in 1963 under the Chairmanship of the late Dr. William Mosberg. This Committee published the first Neurosurgical Fee Survey in 1966 and Neurosurgical Utilization Guidelines in 1969. In 1972, the American Association of Neurological Surgeons (AANS) joined the CNS in forming the Joint Socio-Economics Committee (JSEC).

The The Congress of the United States passed the Professional Standards Review Organization (PSRO) law setting up review organizations to monitor medical care. This law produced great concern among physicians. Representatives from state neurosurgical groups paid their own way to meet at the O'Hare Airport in Chicago to deal with the PSRO law in 1972. It was decided then to establish a National Advisory Group to deal with this matter. PSROs were set up on regional and state levels and it was recognized that these socio-economic matters would have to be dealt with at the state level. Many states did not have neurosurgical societies and the National Advisory Group, under the leadership of Dr. Frank Wrenn, promoted the establishment of state neurosurgical societies in those states which did not previously have state societies. There were 21 state neurosurgical societies in existence in September, 1974; now there are 37. Some of the remaining states are in two regional societies, the Midwest Neurosurgical Society (Nebraska, Iowa, South Dakota & Kansas) and the New England Neurosurgical Society (Connecticut, Maine, Massachusetts & New Hampshire).

The initial Joint Socio-Economics Committee (JSEC) had co-chairmen. Dr. Russel H. Patterson, Jr. was appointed by the AANS and Dr. Edwin Amyes was appointed by the CNS. Dr. George Ablin was the first Liaison Secretary. The National Advisory Group was under the umbrella of the Joint Socio-Economics Committee and reported to this Committee. The National Advisory Group established quadrants, the Northeast, the Northwest, the Southeast and the Southwest to represent the states in those regions. Eventually, each of these regions gained representation on the Board of the AANS. The National Advisory Group became the Council of State Neurosurgical Societies.

The Council of State Neurosurgical Societies (CSNS) and the Joint Socio-Economics Committee met together although each organization had separate chairmen and secretaries. The Council reported to the Joint Socio-Economics Committee. The organizational structure was streamlined in1985 and became the Joint Council of State Neurosurgical Societies (JCSNS) with a single set of officers. The council subsequently changed its name to simply the Council of State Neurosurgical Societies (CSNS) and functions as a joint committee of the AANS and CNS.

The CSNS acts as a representative assembly which is composed of members of the various state neurosurgical societies in the ratio of 1 representative per 50 neurosurgeons. Each state has at least one representative and states without a society may have one neurosurgeon from that state declared a delegate by the CSNS Chairperson. The Presidents of the AANS and CNS appoint members/delegates to the CSNS in addition to the state designated delegates and 12 neurosurgery residents are elected as delegates from the four Quadrants. The Council meets twice a year just before the annual meetings of the AANS and the CNS during which it considers resolutions submitted by delegates or its committees and receives reports from those committees as well as the AANS and CNS. Resolutions that are adopted by assembly vote are sent to the AANS/CNS for implementation.

The standing committees of the CSNS upon which all delegates are free to serve are: Communication and Education, Workforce, Medical Practices, Medico-Legal, Coding and Reimbursement, Neurotrauma and Young Physicians/Resident.

Submitted by John M. Thompson, M.D.
Former Secretary of JSEC and JCNS
Edited by Randall Smith, M.D., CSNS Historian
September, 2007