Attendance: 45 delegates from state societies, 12 delegates appointed by the AANS and 17 delegates appointed by the CNS and all 13 resident fellows.

Meeting Highlights:

1.  The neurosurgical practice management organization (NERVES) noted a membership of 310 practices encompassing 440 neurosurgeons and 220 non-doc providers.  The practices were 69% private, 26% academic and 5% hospital based.  Their average neurosurgeon turns out over 11,000 RVU’s a year, takes home around 650K, gets 53% of revenue from FFS, 23% from Medicare, 8% from Work Comp and 6% from Medicaid and gets 2K/24 hours from trauma/ED coverage.

2.  Of the 5000 or so community hospitals in America, 1673 are trauma centers with 203 Level I and 271 Level II.  About half the level I & II centers are ACS certified (the rest are locally declared) and most of the 1,100 or so Level III-V centers are self designated.

3.  Historically, about one-half of the eligible state society delegates and the appointed AANS/CNS delegates show up at the CSNS meeting.  The 13 resident fellows have an 80% attendance rate.

4.  The official position of the AANS/CNS Washington Committee is to work toward changing or repealing the Obamacare Independent Payment Advisory Board, the penalties for not participating in PQRI and the public reporting of doc performance date unless the criteria are transparent and approved by neurosurgery.  They will push for a national EMS/Trauma system and killing the SGR as well as promoting private contracting between doc and medicare patient (without requiring the doc to quit Medicare altogether) and, of course, liability reform.

5.  The Neurosurgical Political Action Committee has raised about 450K this election cycle from the usual 9% of America’s neurosurgeons and needs another 50 K for November.

6.  Rusty Rodts, President of the CNS, pointed out the new annual meeting scheduling designed to improve the attendee’s experience.  He highlighted the commencement of first meeting session on Sunday afternoon before the opening reception, the termination of each day’s agenda earlier in the afternoon leaving a little more time for attendee fun and evening dinner seminars (which were sold out for this meeting).  He also indicated a realignment of the Congress’s support for political endeavors in light of its 501(c)3 charter which, as a purely educational organization, severely limits support of political items (such as the AANS/CNS Washington Committee—the AANS has no such limitations since it is a 501(c)6 trade association).

7.  Saw Jim Bean, M.D., from Lexington, Kentucky, receive the Leibrock Lifetime Achievement Award for his many outstanding contributions to national neurosurgery including stints as CSNS Chairman and AANS President.

8.  A report was given pursuant to a previous resolution that noted there are currently 109 specialty hospitals in the USA, up from 92 in 2003 and 29 in 1990.  Most of them are for cardiology or general orthopedics with only 31 dedicated to spine.  It appears that none of the 31 are owned solely by neurosurgeons but all have neurosurgeons on staff with staff ownership varying from 2-10% per doc.

The assembled CSNS delegates took the following actions on the submitted resolutions.

RESOLUTION I-2010F— Adopted

Title:   CSNS Meeting Timing and the Delegate

BE IT RESOLVED, that the Membership/State Societies Committee conduct a survey of CSNS delegates to obtain preferences regarding meeting length and schedule and to report survey results at the spring 2011 CSNS meeting.

RESOLUTION  II-2010F—Not adopted

Title:   Comparing Decompression in Degenerative Lumbar Stenosis With and Without Fusion

BE IT RESOLVED, the CNS and AANS promote the establishment of a clinical study which answers the question "In the surgical treatment of degenerative lumbar stenosis without a spondylolithesis, deformity or preexisting instability, what patient criteria should be present to suggest that a lumbar decompression with arthrodesis would be superior to a decompression alone in producing the best patient outcome?"

RESOLUTION III-2010F—Adopted (and combined with Resolution VIII)

Title:  Neurosurgery Patient Registries

BE IT RESOLVED, that the CSNS advocate for the immediate creation of a joint committee with the AANS and the CNS for evaluating and optimizing health information technology with said committee reporting to the CSNS on a semi-annual basis and that CSNS develop and educational program regarding the above to be presented at the spring 2011 CSNS meeting.

RESOLUTION IV-2010F—Adopted

Title:   CSNS Support for Intraoperative Neurophysiologic Monitoring

BE IT RESOLVED, that the CSNS create a resource document that explores the indications and implications of Intraoperative Neurophysiologic Monitoring including CMD regulations, health insurer policies for reimbursement, medico-legal ramifications and established clinical utility.

RESOLUTION V-2010F--Adopted

Title:   Exploring the format, duration, and standardization of hand-offs across neurosurgical residencies

BE IT RESOLVED, that the CSNS study and report on the elements necessary for optimal hand-offs between neurosurgeons.

RESOLUTION VI-2010F—Not Adopted

Title:Advocacy for Healthcare Reform

BE IT RESOLVED, that the CSNS request the Washington Committee change its focus of advocacy in the area of healthcare system reform to support for a single-payer healthcare system for the USA.

RESOLUTION VII-2010F—Adopted

Title:   CSNS Website Link to the Online Emergency Department Neurosurgery Coverage Regionalization Project

BE IT RESOLVED, that the CSNS create a link (for members only) on its current homepage (cnsonline.org) to provide online access to the Emergency Department Neurosurgery Coverage Regionalization Project.

RESOLUTION IX-2010F—Adopted

Title:   Fraudulent Disclosure

BE IT RESOLVED, that the CSNS request the AANS/CNS more clearly define their policy regarding conflict of interest disclosures and the ramifications of failure to disclose in presentations and publications, and that such policies meet or exceed the standards of other similar organizations.