President's Column
Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.
April 2023
Looking Back and Ahead
When I began my term as president of the American Academy of Neurology in April of 2021, we had just held our first—and hopefully last—fully virtual Annual Meeting due to the COVID-19 pandemic. Newly vaccinated and optimistic about the future, I predicted in this column, “We are beginning to glimpse brighter days…we will emerge stronger than ever.” While the past two years have not brought the halcyon period I had hoped for, in many ways, this organization has indeed excelled despite onerous challenges, and is far more robust for it.
Our membership has grown to over 40,000 and our retention rate for US neurologists has risen to 95 percent, an enviable retention rate for a medical specialty organization. It has been a time of reflection and strategic planning for the AAN Board of Directors (BOD), which focused on member value and considered how to best support neurology through myriad changes. Our educational offerings expanded even further into the digital space, recognizing the appeal of the flexibility of a robust online learning platform that has included conferences, prep courses, and webinars on demand as well as our Question of the Day mobile app, monthly NeuroSAE, NeuroBytes videos and podcasts for micro learning. Meanwhile, our committee, section, board, and programmatic work moved onto a digital platform without missing a beat.
During the first two years of the pandemic, the BOD increased its quarterly meetings to monthly, and sometimes more often, to address the daunting difficulties of the public health emergency. After over a year on Zoom, the BOD finally met in Orlando in April of 2021 by creating a safe and closed environment in two homes and dividing up tasks as chefs, sous-chefs, drivers, servers, clean-up crew, and entertainment. Charles C. Flippen II, MD, FAAN, AAN treasurer, shared his family recipe for pancakes, Natalia S. Rost, MD, MPH, FAHA, FAAN, chair of the Science Committee, added secret spices that made an impressive shakshuka, and Lily Jung Henson, MD, MMM, FAAN, brought her own pecans from Georgia to make delicious pies. It was exhilarating to watch neurologist-chefs take over the kitchen and direct volunteer sous-chefs like Jose G. Merino, MD, MPhil, FAHA, FAAN, editor-in-chief of Neurology® and Joseph I. Sirven, MD, FAAN, chair of the Education Committee, in prepping and chopping duties. (Both seemed to take particular pleasure in wielding large knives.) While Brad C. Klein, MD, MBA, FAAN, chair of the Medical Economics and Practice Committee, performed admirably in a magic show, James N. Goldenberg, MD, FAAN, served as a one-man IT department to ensure that the hybrid meeting could be enjoyed virtually by those who were unable to attend. It was a productive and fruitful meeting as we discussed the AAN’s strategic plan, formulated a vision for brain health, and exchanged ideas for innovation to meet a changing environment.
As the pandemic numbers worsened, we returned to virtual meetings in the fall of 2021. In an attempt to combat Zoom fatigue, I invited pets to join us, and loved meeting the many dogs of the board, including Ili Anderson, Maxwell Goldstein, River and Halie Jackson, Henry and Daisy Miyasaki, Chloe and RJ Kilgore, Kola and Kobe Kissela, among other well-groomed guests. We also welcomed a new baby in October of 2021, Shiloh Emery, who joined us at our January 2022 in-person board meeting, along with her mother, Maisha T. Robinson, MD, MSHPM, FAAN, chair of the Member Engagement Committee.
It had become apparent in the year that followed the trauma of the pandemic that neurologists in all types of practice were reconsidering work-life balance and reimagining new employment opportunities, while staffing shortages grew. Our retreat focused on the workforce crisis, informed by conversations I had with a variety of AAN members for a series of Neurology Today® stories about departures and new beginnings and the experiences of BOD members in their varied practice settings.
We were excited to return to other in-person meetings in 2022, while maintaining online options for participation from our experiences during the pandemic. The Education Committee worked on creating updated programming for the 74th Annual Meeting in Seattle, and highly successful Fall and Summer Conferences were held in Las Vegas and San Francisco, respectively. The latter conference presented Autoimmune Neurology and Neurology Year in Review. During my term as president, I launched two new committees: the Committee on Public Engagement, which oversaw the Brain Health Summit in Washington, DC, on September 15, 2022, and the Academic Neurology Committee, which hosted its Chair Summit on December 12, 2022, and was renamed the Ralph L. Sacco Neurology Chair Summit in honor of his steadfast vision for helping academic departments thrive.
AAN committees held hybrid sessions that allowed those who could not attend to join in person. The Quality Committee successfully launched Emerging Issues in Neurology reports, which are to provide timely informal guidance derived from expert consensus until an evidence base is established that can inform evidence-based recommendations; the Axon Registry® Quality Achievement Award program, recognizing neurology practices for their levels of quality performance; and built a quality informatics team to develop products and services that will help members put technology to work for them, rather than the other way around. The Medical Economics and Practice Committee created resource toolkits for managing staffing challenges, improving practice efficiencies, and access to care. To support implementation of telehealth, it collated an extensive library of telehealth practice guides, case studies, coding guidance and resources. To increase recognition of general neurology and private practice, it created three new membership awards. It continued to address reimbursement for evaluation and management (E/M) services and educated members about updates to outpatient E/M in 2021 and inpatient E/M in 2023.
The Advocacy Committee worked with policymakers to generate solutions to reduce prior authorization burden that has culminated in recent rulemaking that, if finalized, would establish critical guardrails on a variety of payers’ use of prior authorization and implement standards that support electronic prior authorization. To support access to care throughout the pandemic, the AAN provided policymakers with critical recommendations that have allowed patients to use telehealth to maintain access to care and to ensure that patients do not lose access upon termination of the public health emergency declaration. The committee also actively engaged with lawmakers in Washington, DC, to help avert devastating cuts to physician Medicare reimbursement. To ensure patients can access the life-saving treatments they need, the committee has continued to work with Congress to reform prior authorization and step therapy requirements and actively advocated for legislation that will allow Medicare to negotiate drug prices.
The Science Committee created a bigger, more inclusive Annual Meeting Science Program with over 3,000 original science submissions, a bustling Research Hub, busy Invited Science, Neuroscience in the Clinic sessions, and expanding Emerging Science. The quality of science continues to grow across the spectrum of career stages, types of research—basic, translational, clinical—and subspecialties. The AAN was committed to research funding, despite the pandemic challenges and the committee expanded its support by developing new Health Disparity awards. The Clinical Research Subcommittee expanded research programming for trainees at the Annual Meeting, introduced Resident Research Scholarships, and started the Clinical Research webinar series to bring research closer to clinical practice settings and diversify clinical trial participation.
Our worldwide outreach has blossomed over the past two years, and I was particularly eager to meet a wide variety of international members, brainstorm with global organizational leaders, and develop new friendships as a result. It has been rewarding to see the AAN continue to grow a diverse and inclusive membership bound by a shared love of neurology.
This Academy braved the pandemic through the efforts of more than 800 member volunteers, 27 committees and 34 subcommittees, 41 sections, and above all, 200 staff, who kept their eyes on the mission of the AAN, while valiantly leading through technical and logistical challenges. I credit their commitment, ingenuity, and tenacity for this organization’s ultimate success.
As I pass the torch to the next generation of leaders, my heart is replete with gratitude, and the future is bright with hope. I am grateful to all of you in our broader membership who so often shared with me your experiences, ideas, concerns, and support. It has been an honor to get to interact with so many dedicated individuals in my service to this organization for the past two years. I came to know the AAN and its members through writing for and editing our varied and storied publications for the past two plus decades and I now look forward with great pleasure to returning to the pen, where I hope to stay in touch.
Orly Avitzur, MD, MBA, FAAN
President, AAN
oavitzur@aan.com
@OrlyA on Twitter