Sept 19 2002
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Sept 19 2002
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Thursday, September 19, 2002 Lake Buena Vista, Florida
MINUTES OF JOINT MEETING OF THE AMERICAN COLLEGE OF OSTEOPATHIC SURGEONS, NEUROSURGICAL SECTION AND AMERICAN ORGANIZATION OF THE NEUROLOGICAL SURGEONS I. The annual business meeting of the American College of Osteopathic Surgeons, Neurosurgical Section and American Organization of Neurological Surgeons was called to order by its president elect, Dan Miulli, D.O. II. The minutes from the 2001 meeting in Palm Desert, California, were submitted by the former Secretary/Treasurer, Keith Kattner, D.O. A motion to approve the minutes was made by Dr. King and was seconded by Dr. Kanoff. The minutes were approved as read. III. SECRETARY/TREASURER’S REPORT: Keith Kattner, D.O. The Treasurer’s Report was submitted by Dr. Keith Kattner. Currently, the Neurological Section has three bank accounts. The balance in each of the accounts is as follows: Account #1: Commercial Savings $1890.35 + $12.26 Account #2: Certificate Deposit $3182.47 + $45.54 Account #3: Checking $34,319.39 + $16,459.25
It was noted that $10,900 were owed in dues by members and residents of the section. $9100 of this was collected during the course of the year by sending out FOUR requests for dues. $1800 is still outstanding. The outstanding dues are owed by one attending, Sally Ann Hallgren, D.O., and fourteen residents. The ACOS submitted an invoice to the section for debts outstanding from the Boston and Palm Desert meetings. These charges were for coffee breaks, breakfast, and incidental charges such as copies, faxes, and speaker related travel or honoraria. Dr. Kattner explained that when he was program chair for the Boston meeting, he knew he had gone over budget. As a result, when the invoice was received, Dr. Kattner elected to pay for these expenses out of his own pocket, totaling $3871.00. The total amount still outstanding from the Palm Desert meeting is $4419.25. Dr. Miulli made a motion to pay the ACOS for the debts outstanding, it carried. A second motion was made to reimburse Dr. Kattner for the funds he paid out of pocket for the Boston meeting, it also carried. Checks will be cut to both the ACOS and Dr. Kattner totaling $8290.25. ACTION: Dr. Moncman will convert up to $16,000 of the checking account into Certificate of Deposit and ACTION: open a non-profit account for donations from benefactors used for meetings and other educational expenses.
IV. CORRESPONDENCE: Lou Jacobs, D.O. No correspondence was received during the last year.
V. ACOS-NSS/AONS AWARDS A. Dr. Routsong presented his mentor Dr. Armen Marouk ACOS-NSS/AONS Reuburg Award in recognition for his years of service and teaching in osteopathic neurosurgery and medicine. B. Dr. Stephen Eichert was responsible for securing a $3500.00 grant from Medtronic Sofamor Danek to be used for an ANNUAL ACOSNSS Resident Achievement Award. This award was designed to promote and encourage independent and creative work by the residents in training. Residents were contacted and asked to submit their annual paper for review by a committee. In addition to a plaque, monetary awards in the amounts that follow will be presented to the winners. First Place: $1500.00 plus $500.00 for travel to the ACOS meeting to present the paper; Second Place: $1000.00; and, Third Place: $500.00. The winners were as follows: (1) Rob Dickerman, D.O.: Basis of Persistent and Recurrent Cushing’s Disease: An Analysis based on Findings at Repeat Pituitary Surgery, (2) Ward Buster, D.O.: Temozolomide in Combination with Irinotecan for Treatment of Recurrent Malignant Glioma, and (3) Francis Kralick, D.O.: Correction of Cephalocranial Disproportion by Expansion Craniectomy and Shunt Revision for Pansynostosis: Technical Note. Neither Dr. Dickerman nor Dr. Kralick were in attendance to receive their awards, they will be sent to them. For future annual papers to be considered for the Medtronic Sofamor Danek Resident Paper award, they must be submitted to the ACOS-NSS by July 1 of each year. ACTION: A notification will go out to the residents May 1 and the final reminder June 15. VI. OLD BUSINESS A. Rotating Internship Dr. Miulli inquired as to whether there had been any advancement regarding matching medical students into programs with internships already established. No new information was available. This subject will be dismissed from subsequent meetings unless it is brought forward by others. However, doctors are being accepted into Neurosurgical programs during their fourth medical school year. There was no consensus as to encourage or discourage the practice. Any comments should be addressed to Dr. Miulli B. Neurosurgical Website
Dr. Detamore reported that instead of having a separate website for the ACOSNSS, the section will have information available via a link on the ACOS website at www.acos-net.org.
C. Neurosurgical Poster
This year, only three residents prepared posters for the ACOS meeting and very few residents chose to attend the conference. This is the largest meeting of osteopathic neurosurgeons each year. It is an excellent opportunity to not only attend a quality educational activity but also to promote and network among our peers. The decrease in resident interest and participation is unfortunate and a trend we would like to see changed. It was suggested that the program directors encourage the residents to participate in the organization and program in the future.
D. ACOSNSS/AONS Journal
Dr. Miulli discussed some obstacles regarding publishing the AONS Journal. The first addition of the journal included the residents’ annual papers, which was then distributed to the active members. Since that time, papers have been requested on numerous occasions; however, there has been little interest among the residents to turn the papers in for publication in the journal. It simply needs to be submitted in electronic form by email or on disc. This is a good opportunity for the residents to get published in a peer reviewed journal. No suggestions were made as to how to encourage the residents to participate in this endeavor. Dr. Miulli indicated that there had been some discussion about making the journal the proceedings of the ACOSNSS meeting, however lectures and/or slides have not been turned in either. ACTION: A motion was made and carried to have the residency program directors direct the residents to submit their annual papers to Dr. Miulli via e-mail The section will continue to pay for the publication of the journal. The articles will be peer-reviewed and an on-line version will be available. All articles should be turned in to Dr. Miulli by January. Note: Since these minutes are very late going out the articles should be turned in by March 1, 2003.
E. ACA Program Report
1. Length of Program: In the past, the attendance on the final day of the conference (Sunday) has been poor at best. It was confirmed through the ACOS that the group can forego having lectures on Sunday and still offer the same amount of CME credits, provided that the educational activities on Thursday, Friday, and Saturday are lengthened in order to make up for the lost time on Sunday. It was decided to leave it up to the discretion of the Program Chair as to whether or not to schedule activities on Sunday.
2. Program Guidelines: The program guidelines that were distributed at the beginning of the meeting, discussed and approved last year, were submitted to the ACOS for the Neurological Surgery Section. No further comments, changes, or suggestions were made to the program guidelines. A motion to accept the guidelines was made and carried. The ACA ACOS-NSS/AONS ACA Program guidelines are attached to this document.
3. Program Reception: The membership was asked by Dr. Miulli regarding whether or not to schedule an annual reception during the ACA meeting. It was noted that this is a forum in which to present awards and also meet new members of the section. There was some concern about funding, particularly from pharmaceutical companies, however as long as the guidelines for commercial support are followed it shouldn’t be an issue. A motion was made by Dr. King to have an annual reception, unless there are extenuating circumstances. The motion was seconded by Dr. Dixon. The motion was approved.
4. ACA Program Chairs:
1. 2003 – Chicago – Robert Dixon, D.O. 2. 2004 – San Diego – Larry Armstrong, D.O. 3. 2005 – Orlando – Michael Campenelli, D.O.
5. ACA Program – Chicago:
Dr. Dixon requested input from the membership regarding next year’s program in Chicago. He requested suggestions for speakers and topics that the membership is interested in.
The responses were: RECEPTION Wednesday night 100% YES Pay extra for reception 50% YES 50% NO Reception 80% Museum 29% Hotel Business Meeting Friday AM 100% YES Speakers: Hunt Bajar, Thomas Origatano, linac guy at Northwestern, Sean Mullin Sr Univ of Chicago Topics: Complex spine fusion, vagal nerve stimulation, cavernous aneurysms, pituitary endoscopy, Trauma-ICP management HANDS ON COURSE: 95% YES Would you pay $50? 80% yes Area of hands on course: Spine instrumentation, Minimally invasive, cranial
VIII. COMMITTEE REPORTS If you would like to become a the ACOS-NSS representative to a committee please contact Dr. Miulli
A. AMERICAN OSTEOPATHIC BOARD OF SURGEONS REPORT: Stephen Eichert, D.O. Recertification exam 1997.
C. BOARD OF GOVERNOR’S REPORT: Richard Kanoff, D.O. Meeting did not take place yet
D. STRATEGIC PLANNING: Michael Moncman, D.O. Nothing to report
E. RESIDENT EVALUATION COMMITTEE REPORT: Keith Kattner, D.O.
The current neurosurgery standards and guidelines were updated and copies of these were sent to the membership by Tracy Lofty at the ACOS for input, changes, suggestions, and approval. All responding program directors agreed to the changes, but there was a note that there should be a three-month neurology rotation. Tracy received a fair number of responses with recommendations. The residents’ paper requirement was reemphasized, shifting the responsibility of ensuring it’s completion and scientific integrity to the program directors. Additionally, changes were made to the volume of cases needed to adequately support a residency program. Instead of the required 50 cases per resident per year, it was changed to 400 cases per chief per year. Since several programs are now under the supervision of allopathic physicians, another change to the residency program standards is that either an allopathic or osteopathic physician may be program chair. Other amendments to the standards included changes to the required electives. Previously, electives included rotations in gynecology and orthopedic surgery. Instead, rotations in areas more relevant to neurosurgery will be encouraged, such as neuropathology, neuro-anesthesiology, neurology, and critical care. ATTACHED current neurosurgery standards and guidelines.
Two programs were eliminated by their hospitals: Tulsa and Bi-County. Two new programs have been started; one at St. Barnabas in New York and the other at BroMenn Regional Medical Center in Bloomington, Illinois. Both of the new programs will be re-evaluated within one year as required. Arrowhead was inspected. It was recommended for approval pending the receipt of necessary paperwork. Dayton has not yet been inspected, and is overdue. Garden City was approved for three years, Philadelphia was approved for 5 years, and Detroit was approved for two years during the most recent inspections.
Attached Resident log form, originally based upon CPT codes, have been revised for more accuracy.
F. AWARDS COMMITTEE REPORT: Larry Armstrong, D.O. Nothing to report.
G. MEMBERSHIP COMMITTEE REPORT: Robert Baker, D.O.
Dr. Baker emphasized that in order to maintain membership in the AOA and/or to maintain Fellowship status, members are required to attend the AOA meeting once every three years. It seems that the best way to increase membership is to have the attendings and program directors encourage the residents to participate. An issue that will be discussed in the Membership meeting on Friday, September 20, relates to licensure. Currently, only licensed physicians are allowed to be members of the AOA and ACOS. With respect to the decreasing membership, two reasons that have been cited are dual membership and the cost of membership and attending the conferences. These will be issues that will need to be addressed in the future.
H. CODING AND REIMBURSEMENT COMMITTEE REPORT: David MacDougall, D.O.
Dr. MacDougall did not have anything specific to report. However, he did provide an explanation for what the committee is involved in. He receives notification from the AOA, in conjunction with the AMA, on identifying the need for CPT codes for new procedures. As he evaluates procedures, he takes into consideration whether any physicians in the section might be interested in doing the procedure. For example, some of the pain procedures may have some appeal to neurosurgeons. If a procedure has a code designation, there is a much better chance of getting reimbursed for it. The committee has no input on reimbursement per se, this would be more appropriately titled Coding Committee.
I. SPINAL SURGERY SECTION: Gregory Mavian, D.O.
There is discussion among those in the orthopedic section to establish their own spine section. It was asked if anyone thought it necessary to establish a spine section in neurosurgery. Since spine surgery is such a major component of neurosurgical practice, it was decided that seeking a special section would not be appropriate at this time.
J. ACA GRANTS AND EXHIBITS COMMITTEE: Clark J. Okulski, D.O. No report
K. ACA SCIENTIFIC EXHIBITS AND POSTER SESSIONS COMMITTEE: Robert A. Dixon, D.O. Dr. Dixon would be happy to assist residents in planning for the poster section. There continues to be only a small number of posters presented for awards. Program directors should require one poster from each program each year. ACTION: Dr. Dixon could contact the program directors in July 2003 to encourage poster presentation. The section will send out an announcement in late July 2003 to the program directors and residents encouraging poster presentation at the ACA.
L. BYLAWS: NO MEMBER If you would like to become the NSS representative please notify Dr. Miulli
IX. NEW BUSINESS
A. RESIDENT DUES
Since several residents are delinquent in paying their dues, a question came up about whether or not the section should require residents to pay dues. Discussion ensued regarding what the resident members get in return for paying dues. As the primary function of the section is to promote education, it was suggested that possibly an annual review course be arranged for the residents, funded through either section dues or member dues. ACTION: It was determined that a committee should review and discuss this matter further. The course may be valuable before written boards in April. The committee consisted of Dr. Miulli, Dr. Siddiqi, Dr. Kattner and Dr. Moncman. The committee should meet February 2003 via a conference call. The secretary-treasurer will make the arrangements.
B. RESIDENCY PROGRAM DIRECTORS REPORT
1. Long Island Jewish Medical Center, NY: Schneider, M.D. ACTION: The secretary will obtain this Doctor’s information, including e-mail address, so that we can invite him to join as a member of the AONS.
Dr. Robert Decker is no longer the program director for this residency program; the duties have been transferred to Dr. Schneider. Dr. Schneider was unable to attend the meeting. It was asked that he submit a written report following the meeting. ACTION: After his information is obtained the secretary will request a written report by April 2003 to be attached to these minutes.
2. St. Barnabas Hospital, NY: Salvatore Insignia, D.O.
Dr. Insignia is the new program director for this hospital. There are some concerns being raised because he has not been board-certified for two years. One resident started in this program in July. ACTION: After his information is obtained the secretary will request a written report by April 2003 to be attached to these minutes.
3. Garden City Hospital: Lou Jacobs, D.O.
Dr. Jacobs has two residents in training and three open slots.
4. Philadelphia, PA: Richard Kanoff, D.O.
The program was recently inspected and approved for 5 years.
5. BroMenn Regional Medical Center: Keith Kattner, D.O.
Dr. Kattner indicated that this is a new program. Currently, he has two first year residents, two second-year residents, one third-year, one fourth-year, and one sixth-year. He explained that the first two years of the program are spent at Olympia Fields, which includes a matched internship. The program has been funded for 10 positions. Since they are in the three year Medicare period, Dr. Kattner has elected to take on many residents. At the end of the third year, Medicare will decide how many positions to fund. Dr. Kattner is hoping to have enough positions available for a possible Ph.D. program to be incorporated into the residency program. He anticipates taking one resident a year following the three year term. There was some discussion regarding his sixth year resident who transferred from a program whose directorship was changing and the future of the program uncertain.
6. Arrowhead Regional Medical Center: Javed Siddiqi, M.D.
The program at Arrowhead was started three years ago. Though allotted eight positions, they currently have five residents. They were reviewed by Dr. Smith recently and are waiting for the paperwork to be completed. They are anticipating a five-year approval. There are currently six attendings in the group and will be eight at the end of the year.
7. Dayton: Dr. Gregg Mavian or Scott West, D.O. No report. ACTION: The secretary will request a written report by April 2003 to be attached to these minutes.
8. Dr. Goodall ACTION: After his information is obtained the secretary will request a written report by April 2003 to be attached to these minutes.
9. Dr. Hamm/Piper ACTION: After his information is obtained the secretary will request a written report by April 2003 to be attached to these minutes.
10. Dr. Okulski Closed
11. Dr. Wilson Closed
NOTE: The written report should contain: # residents, #funded spots, #teaching faculty, #posters submitted for ACOS-ACA and other national meetings, #residents taking written/passing written/taking/passing oral/board certified as % total, quality of annual papers, need for annual review course, pros & cons, trauma, cranial work, spinal work, need for fellowships
C. ACTION: Resolution made and carried by the section. It is important that the Program Directors meet in the section to discuss Residency Programs. In the past there has been a separate Residency Program Directors meeting in addition to the Annual Business meeting. The two have been combined because of the significant overlap. Since Resident Education is a significant part of our mission the ACOS-NSS/AONS resolve that the Residency Program Directors or their appointed alternates must attend the ACOS-NSS/AONS annual business meeting and provide a report and discussion of their program and their concerns.
Dr. Kattner will also bring this up for passage at the RESC committee.
E. ELECTION OF NEW OFFICERS
Dr. Miulli becomes the Chair. Dr. Keith Kattner was on the slate for Chair-elect. No other nominations were submitted. A motion was made to elect Dr. Kattner, which was approved unanimously. Nominations were accepted from the floor for Secretary/Treasurer. Dr. Richard Kanoff nominated Dr. Michael Moncman for the position. No other nominations were submitted. A motion to elect Dr. Moncman as Secretary/Treasurer was made and approved unanimously. Nominations were accepted for a member-at-large to be on the discipline nominating committee. Dr. Lou Jacobs was nominated for this position. No other nominations were submitted. A motion to elect Dr. Jacobs to the discipline nominating committee was made and approved unanimously. Dr. Rodney Routsong was nominated and elected unanimously to serve on the Board of Governor’s in one year after the conclusion of Dr. Kanoff’s term.
F. FELLOWSHIP GUIDELINES
It was mentioned that an extra year at the end of residency training would improve and increase the experience of newly trained neurosurgeons going out into practice. Discussion ensued regarding the regulations of fellowship training. Currently, there are no guidelines in place for fellowship training – anyone can start a fellowship program. However, that is likely to change soon. It was suggested that these fellowships will have to be accredited and will be regulated by a governing body. ACTION: The section instituted a committee, which must include residency program directors, to establish guidelines for osteopathic neurosurgical fellowships. Dr. Kattner, Dr. Siddiqi, and Dr. Miulli volunteered to be involved in this process. Others are encourage to join, if you are interested please notify Dr. Miulli Dr. Miulli indicated that he would send the ATTACHED DRAFTED FELLOWSHIP GUIDELINES in development to the members of the committee by February 2003 for further input.
G. MEMBER INFORMATION It is imperative that the section have updated information on all of its members. This is needed to communicate all items. You can see by these minutes that there are several action items. We will attempt to obtain the information as soon as possible. If you happen to speak to other members not present at the meeting please have them contact Dr. Miulli via e-mail
No other new business items were addressed. Meeting adjourned. |