Neurosurgeons Face Difficult Medico-Economic Realities

Newswise — In the Collier and Lee counties of Southwest Florida, neurosurgeons have stopped treating emergency pediatric patients, forcing all patients to travel to Tampa for treatment. Medical liability insurance premiums have risen by 500 percent in the past 10 years. State and federal reimbursement has continued to drop. These are some of the current trends facing Florida neurosurgeons, and their colleagues nationwide. In a recent study, authors highlight the effects of medico-economic realities on the livelihood of Florida neurosurgeons. The study, "Medico-Economic Realities in a Changing Marketplace," will be presented from 10:30 to 10:40 a.m. on Thursday, May 6, 2004, during the 72nd Annual Meeting of the American Association of Neurological Surgeons in Orlando, Florida. The study will be presented by Eric R. Trumble, MD and Robert R. Trumble, PhD.

"We wanted to further investigate the effects of the recent medico-economic trends facing neurosurgical practice in the state of Florida," said Eric R. Trumble, MD, a coauthor of the study. "We found that a combination of these trends has led to a decrease in medical school admissions and a decrease in the neurosurgical workforce altogether."

In the state of Florida, among other states across the country, changes in the marketplace have included an increased cost of practicing medicine (Medical liability insurance rates), ancillary personnel and decreased reimbursement. In the recent study, the authors reviewed statistics they compiled from the Florida Department of Health, Agency for Healthcare Administration and national admissions' databases. They tracked and reported on reimbursement levels based on specific current procedural terminology codes. The authors could then assess and evaluate the overall costs relating to practicing neurosurgery.

The results indicated that Florida has 193 licensed allopathic physicians and three osteopathic physicians who each reported that they specialize in neurosurgery. Approximately 176 of these physicians accepted Medicaid in the last fiscal year, although Medicaid reimbursement is less than the medical liability cost on a per case basis. State and federal reimbursement for specific codes (Medicare and Medicaid) has dropped from 10 to 36 percent depending on the given code in the past 10 years. The results of the study also revealed that the pediatric neurosurgical subspecialty has been hit the hardest economically and by a reduced workforce.

The authors further emphasize the notion that more neurosurgeons need to involve themselves with the specialty's coordinated efforts to slow or reverse the damaging trends of the current medico-economic cycle.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,500 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the spinal column, spinal cord, brain and peripheral nerves.