MINUTES
CANS Board of Directors Meeting
Friday, January 16, 2004
Sutton Place Hotel,
Newport Beach , California

                              
1.         Formal Call to Order
The following were present at the meeting presided over by Ronald Rich, M.D., 
President: Drs. Abou-Samra, Bonner, Caton, Edwards, Hoyt, Hunstock, Kaczmar, Meredith, Rodriguez, Shuer, Vanefsky, Wade; Consultants: Drs. Florin, Lippe, Smith; Guests: Drs. Amyes, Ott and Dr. John Nelson (AMA).  The minutes of the September 6, 2003 Board Meeting were approved.

2.         CNS (Congress of Neurological Surgeons)
Dr. Rich stated that he received a response from the CNS about his letter regarding flaws with the CNS electronic ballot process. The CNS Executive Committee will review and report on their findings at the fall 2004 meeting.

The CNS has requested nominations  for 2004-2005 President-Elect, Vice President and Members-at-Large.  A motion was made and seconded to submit the name of Marc Vanefsky, M.D. for Member-at-Large. Motion carried.

3.         ER Survey
Dr. Scott Lederhaus prepared a summary of date he gathered from a recent survey sent to CANS members about ER call.  He found that that (1) larger physician groups have better negotiating power; (2) ER payments range from $200-$2000 (3) some neurosurgeons do not get paid at all to cover the ER; (4) some neurosurgeons have dropped cranial privileges. It was agreed that Dr. Lederhaus would present this summary of the 106 surveys returned at the Annual Business meeting January 17, 2004 . The data collected for this recent survey is limited and a second survey may need to be sent to gather more information.

 4.         CSNS Fall Meeting/Resolutions (Council of State Neurosurgical Societies)
Dr. Wade summarized CSNS resolutions discussed at the fall 2003 meeting:

a.         Resolution: Use of Physician Extenders was combined with Resolution: Scope of Practice Guidelines for Advanced Practice Nurses and PAs in Neurosurgery to form a work committee study to determine credentialing guidelines for neurosurgical assistants; 
b.         Resolution: Proposed CME Requirements by ABNS – a substitute resolution was adopted to resolve that CSNS Executive Committee prepare a report on CME requirements prior to the next meeting and that a forum be convened to form a proposal for maintenance of competence. 
c.         Resolution: Proposed Revision of CNS Bylaws, Nominations for Office – substitute resolution adopted to propose bylaw change to include regional Members-at-Large in the Executive Committee and that the CNS Nominating Committee be elected by the CNS membership
d.         Resolution: Availability of Names of Neurosurgeons Sanctioned by AANS/CNS – substitute resolution adopted to request AANS/CNS post this list to website accessible to membership using passwords.
e.         Resolution: Creation of Peer Review Journal Dedicated to Socioeconomic Issues – adopted amended resolution to evaluate feasibility of developing a publication
f.          Resolution: Socioeconomic Impact of Maintenance of Certification – adopted amended resolution to ask CNS/AANS to request the ABNS to include a fiscal note as part of their Maintenance of Competency plan.
                      

5.         Committees
Dr. Hunstock reviewed existing committees to update committee members as follows:
Bylaws: Drs. Edwards and Vanefsky
Membership:  Drs. Caton, Ott, Smith
Finance: Drs. Wade and Kaczmar
Communications: Drs. Bonner (editor),
Florin , Kusske, Prolo
Member Services: Drs.  Kaczmar, Wade, Caton, Abou-Samra
Long Range Planning: Drs. Abou-Samra, Caton, Kaczmar, Rich
Awards: Drs. Rich, Shuer, Hoyt
Nominating: Drs. Edwards, Hoyt, Rich, Smith, Shuer
Workers’ Comp: Drs. Lippe, Hunstock,
Florin , Rodriguez, Prolo
CMA House of Delegates: Drs. Prolo, Wade
The Long Range Planning committee needs to meet every 4-5 years to make sure goals are being met and remain timely.

6.         Membership Report
Drs. Sooho Choi, Lawrence Dickinson, Eldan Eichbaum, John Emery III, Kavian Shahi, Amir Vokshoor and Clifford Douglas were approved for membership.

7.         Treasurer's Report
The CANS monthly operating income and expenses are stable. The Annual Meeting will probably lose money since room block was not met and there will be a penalty.

8.         Annual Meeting
The meeting attendance is lower than in past years despite a strong and informative program. There was much discussion about what types of topics and activities would attract more attendees next year.  Some Board members felt that while topics such as Medicare and malpractice are important, there is not much that neurosurgeons can do to improve the situation.  It was agreed that a different more upbeat approach should be pursued. It was decided that the hot topic this year is ER coverage and reimbursement

9.         Future Meeting Sites
The January 21-23, 2005 meeting will be held at the Fairmont Hotel in San Jose . This hotel is centrally located near some major museums, one of which is the Tech Museum .  The 2006 meeting will most likely be held in southern California and a location will be found this year.

10.       Liaison with ACN
The Board decided to discontinue the joint Annual Meeting with the Association of California Neurologists (ACN). It was agreed that the two specialties have totally different agendas and would be better served by separate meetings focused on each specialty’s unique concerns.

11.       Workers’ Compensation/Second Opinion
Dr. Hunstock reported that effective January 1, 2005 , a second opinion program will be in place in the Workers’ Compensation system regarding spinal surgery. All board certified neurosurgeons and orthopaedic spine surgeons in California will receive credentialing forms from the Administrative Director.  A $500 fee per second opinion is being proposed.   

 12.       CMA Meeting
The Board approved the three resolutions written by Dr. Prolo who will present them to the CMA House of Delegates meeting in March:
a.  Resolution: OMFS Advisory Committee Funding – requests CMA to sponsor 
legislation to direct ten cents on each industrial claim to finance an OMFS advisory committee to DWC
b.  Resolution: Nursing Ratios Limit Health Care Access – CMA sponsor  emergency legislation to
delay implementation of nurse-to-patient ratios across all shifts 
c.  Resolution: Interim Policy Change of CMA House of Delegates (HOD) – requests that CMA HOD reaffirms the HOD as a legislative assembly that sets policy for CMA and that CMA staff and leadership must not violate the will of the HOD in the interval between annual sessions

13.       Dr. Nelson/ AMA

Dr. Nelson, President-Elect of the AMA, was invited to speak to the Board prior to his scheduled appearance at the CANS socio-economic meeting.  He stressed that physicians must work together and he will do his best to represent neurosurgeons’ interests but he needs to know what they are. He realizes that the communication structure of the AMA must be improved and he encourages letters and e-mail messages from physicians.  He will work to make AMA more relevant to all physicians.

 14.       Next Board Meeting 
The next Board of Directors meeting will be held May 15, 2004 at the Sheraton Gateway Hotel in Los Angeles .

 

JMT 

 to home page