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Members of the American Association of

Neurosurgical Surgeons:

My tenure as president of

the American Association of

Neurological Surgeons (AANS)

came during a very turbulent time

for American neurosurgery, and,

while the organization moved

forward to address the challenges

and help structure the future, I

found myself equally drawn to

visit neurosurgery’s past.

The 2015 AANS Annual Scientific Meeting theme was

Neurosurgery’s Founding Principles

. While our specialty is still

in its first century, the leaps forward in that time are nothing

short of miraculous. Such major advancements were possible

because of the specialty’s adherence to the principles of

respect, autonomy, integrity, innovation and dedication.

Harvey Cushing, the founder of the specialty, was

the first surgeon to perform these operations with a

reasonable chance that they would do more good than

harm to his patients. Today, thanks to all the patients and

neurosurgeons who have gone before us, neurosurgeons

perform cranial, spinal, peripheral nerve and extracranial

vascular procedures using open and endovascular

techniques. We use radiosurgery, focused ultrasound, neural

stimulation and intradural infusion to treat neurological

and neurobehavioral disorders. Today, our patients expect

recovery, repair, a cure.

While trying to balance the needs and expectations of our

patients with all of the external requirements we face or

may soon be facing, I foresee a pressure for us to redefine

neurosurgery. In the quest for efficiency and “patient

safety,” we are encouraged to leave the care of our patients

in the clinic to a physician’s assistant, the care of our

patients on the floor to a hospitalist and the care of our

ICU patients to an intensivist.

If we do this, we will become technicians, not physicians.

If we abandon the pursuit of innovation in surgical

procedures and medical devices, we minimize the chance

that neurosurgery can continue to invent miracles and

diminish the future of the specialty we chose to embrace.

The Neurosurgery Research and Education Foundation

(NREF) is neurosurgery’s best vehicle to foster

neurosurgical research by providing a private, non-

government source of funding for research training

in neurosurgery. In addition to the classes, grants and

fellowships offered by the NREF to help bolster education,

the AANS is actively reaching out to medical students,

setting up chapters and opening up medical student-

specific forums during the Annual Scientific Meeting.