It is my privilege to be elected Chair of the Council of State Neurosurgical Societies (CSNS).  I am excited to serve the team of volunteer neurosurgeons who comprise the CSNS, an organization providing grass roots advocacy for our specialty.  We are fortunate to have such a phenomenal group of dedicated surgeons who take time away from their families and their practices to advocate for neurosurgery patients.

The CSNS is the representative body for all neurosurgeons.  When issues arise in the practice of neurosurgery, it is the CSNS delegates who bring resolutions that address these challenges.  Resolutions are debated by CSNS members representing state societies, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) caucuses, and military neurosurgeons.  Once passed, the resolutions are forwarded to our parent organizations, the AANS and CNS, for action.  The CSNS serves as the voice for practicing neurosurgeons in the United States.

As chair of the AANS/CNS Washington Committee, I saw the tremendous impact of the CSNS.  The challenges of prior authorization and retroactive denials were themes of multiple resolutions, driving advocacy by our Washington Committee. Data generated by the CSNS illustrated the impact of telehealth on neurosurgery practices and was instrumental in guiding advocacy efforts. Active debate of gun legislation led to a survey of practicing neurosurgeons, to ensure that our advocacy reflects our members. Through the CSNS we learned more about narrow networks, surprise billing, and the vital needs of preserving access to neurosurgical services.  CSNS resolutions directly impacted the activity of our AMA delegation, providing foundation for the neurosurgery team’s work in the House of Delegates.

I was extremely proud when the CSNS joined the AANS, CNS, the Joint Section on Disorders of the Spine and Peripheral Nerves (DSPN), and the Cerebrovascular Section in supporting the Surgical Care Coalition in it’s campaign to prevent Medicare cuts for practicing neurosurgeons.  Many CSNS members contributed to this effort and were active in our work to prevent cuts in Medicare funding.

The CSNS is vital as a leadership incubator for the next generation of neurosurgeons.  Our medical student socioeconomic summer fellowships and resident fellowships provide opportunities for education and mentoring of neurosurgeons devoted to socioeconomic issues.  Part of my goal as CSNS Chair is to open the door to our meetings, and to make sure that every resident with an interest in socioeconomics knows that they are welcome to learn and to participate.

Our specialty faces many challenges.  Continued downward pressure on reimbursements, onerous prior authorization rules and frequent denials, narrow networks that restrict patient access, a broken medical liability system, quality reporting requirements that focus on checking boxes and not on patient care, and inefficient EHRs all limit our members from doing what they were trained to do: to care for their patients.

While we face challenges, I am reminded of comments made by my Vice Chair, Luis Tumialan, who noted that after every CSNS meeting he leaves energized, ready to continue the fight for our patients.  The energy, intelligence, and insight of our members is tremendous and inspiring.  I am excited to see what we will be able to accomplish, and I welcome you to join us.