The meeting itself included an excellent round table discussion on the impact of Covid-19 on neurosurgical practice in California. We had neurosurgeons representing private practice, Kaiser practice, academic practice as well as subspecialty representatives to discuss the special impact on trauma neurosurgery, spine neurosurgery, and cranial neurosurgery. Effects discussed included impact of staff, payroll and over-head, loss of income, shift of cases to ambulatory centers, loss of capital equipment budgets, impact on academic research productivity as well as the negative effects of elective case spectrum restriction on senior resident and fellow training experiences. Everything is being affected.

It also included excellent State and Federal healthcare policy and political shift updates as the result of the recent election from Mr Janus Norman from the CA Medical Association as well as from Katie Oricco of our own Neurosurgery Washington Office. Things are clearly going to be different this year and it is hard to predict all that well come down the pike in advance. At the state level the trial lawyers have collected the necessary signatures to run a ballot measure that, if passed, would decimate MICRA. It not only raises the cap on no economic damages but broadens liability and essentially pays lawyers up front on settlements and awards. They didn’t run the measure on the last election because of the pandemic and “hero” status of healthcare workers in general. It will be very expensive to defeat as the lawyers are well funded. Despite reassembling the coalition to fight the measure, there will also certainly be a large “financial ask” of all doctors and associations to raise capital. We can’t lose this fight. Moreover MICRA is the model legislation for tort reform in the US. Consequently there are a lot of out of state stakeholders who are weighing in. At the federal level our Washington Office is continuing to try and get the recent increase in E&M coding reimbursement applied to the E&M visits currently bundled into our 90-day global CPT reimbursement codes (they were not increased). At the same time they predict another attack on the 90-day global which failed on its last attempt. If successful, Ms Oricco predicts an ~$50,000 hit annual per neurosurgeon in the U.S. Finally, the person nominated for Secretary of HHS under the Biden administration is our own CA State Attorney General Javier Becerra. A lawyer and a career politician, who has no medical experience or training and who has never managed a medical bureaucracy. He has been a strong proponent of a single party payer system in the U.S., coming out strongly and publically in support of Bernie Sanders’ “Medicare for All” plan during the primary. He also has a history of targeting faith-based third party payers in CA with legal actions for their objections to covering certain provisions enfolded in Obamacare. It remains to be seen how surgeons, and especially subspecialty surgeons like us, will fair under this sort of leadership at HHS over the next four years.

All eleven neurosurgery residency training programs in California were very well represented with impressive and innovative abstracts which were very well received. Awards were given for the best Socio-Economic abstract, the best Clinical abstract and the best Basic Science abstract. Finally, after a very appropriate introduction by our first CANS Historian, Dr Don Prolo, the CANS Lifetime Exceptional Service Award to Dr Phil Lippee, was graciously accepted posthumously by his wife Gail Lippe, with many of the other members of the Lippe family also in attendance.

According to the CANS bylaws change approved last fall, in the absence of a formal CANS Annual Session, the CANS Officers and Directors are continued for an additional year 2021-22. Whether or not we will be able to safely have an in-person Annual Session over Martin Luther King weekend Saturday and Sunday January 13-14, 2022 remains to be seen. In the meantime please reserve your calendar now for these important dates. In the meantime your Officers and Board are committed to continuing to work hard on your behalf and strengthen and advance the structure and mission of our society.

I would like to once again remind all CANS members of their Annual Dues commitment. Many of us use the CANS Annual Session registration opportunity as the time where we pay our outstanding and/or 2021 CANS dues to allow us to register. This year we will not be having a formal CANS Annual Session, and will also miss the opportunity this year to for significant income for our operational budget from our Annual Session. Thus, this year it is extremely critical that every member take the time to follow this hyperlink to our CANS website and pay our CANS annual dues https://cans1.org/membership-renew/. I would ask every CANS member to please do this right now as you are reading this in order to help our organization remain fiscally healthy going forward. This is extremely important, and your participation and support of our organization is greatly appreciated!

I continue to hope that all of our members continue to remain healthy and safe during this trying time with Covid-19. CANS has yet to hear of any member who has been sick with Covid-19, but we very much want to know and keep track of any such event(s) to measure and document the direct personal impact of the pandemic among individual California Neurosurgeons. Anyone who knows of a CANS member, or any California neurosurgeon, for that matter, who has been sick with Covid-19, please contact our executive secretary Emily Schile with the particulars at emily@cans1.org
Please stay safe everyone. Please support CANS and the CMA, they are fighting for you. All the best, and Happy New Year!