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  • Editor's Note:

    Author: Martina Stippler, MD, FACS

    Dear readers:

    This issue of the Congress Quarterly takes a look at health care economics with a neurosurgical lens. Many hospital systems and private practices were financially challenged in 2020. While many emergent and urgent neurosurgical procedures proceeded as usual, even during the peak of the COVID crisis in the spring, elective procedures in many systems decreased dramatically, straining bottom lines. The post-COVID world will certainly be different; we still don’t fully appreciate the lingering effects of COVID on different aspects of clinical practice, such as resident selection and training, national meeting formats, patient interactions and operative volume. Our specialty’s vulnerability to the COVID shock was the inspiration for this issue’s topic – Health care economics.

    In this issue Dr. Levy and Dr. Scarrow examine two topics you may find interesting: How to measure the value of sub-specialty neurosurgeon within an academic department (beyond RVUs); next, how we should think about the ever-increasing administrator/ clinician ratio. By one measure this has increased by more than 3,000% over the last 35 years.

    Dr. Gordon approaches the economics of neurosurgery from a different angle: he discusses how post-graduate education is funded and reports on his work examining the economic value of an on-call neurosurgery resident.

    Stacey Lang asks whether the COVID crisis has placed private practice neurosurgeons at a disadvantage over employed neurosurgeons—or, indeed, is the opposite true? She asks whether the private practice surgeon’s ability to be nimble and forward thinking, without a multi-layered approval process is an asset in uncertain times. Dr. Stephen Ondra picks up on this idea and he reports on current trends shaping health care economics now and in the future.

    It has been my pleasure to curate the CNS Quarterly for you this year. I hope you enjoyed reading it and were as inspired by the presented ideas.

    As you look ahead to 2021 and begin to consider your philanthropic plans, I’d hope to draw your attention to the work of the CNS Foundation and the newly created Future Women Leaders in Neurosurgery Scholarship. Please consider donating to this fund at or use the QR code below. 

    Thank you to all our volunteer contributors. Without you there would not be a CNSQ. Thank you for sharing your wisdom, insight and know-how with all of us.

    Stay healthy, stay resilient. Here’s to a better 2021!

    Martina Stippler

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