Archive for the ‘Meetings’ Category

Our fall meeting is approaching which will be held in  Red Wing, Minnesota from September 16 – 18, 2011. Please submit topics for presentation by July 15th, 2011. We have had much success in the past in the quality and turn out of our meetings which are driven primarily by our membership participating as speakers in the scientific program. I would also like to especially invite our resident members to submit talks for our resident competition. We are excited to have Dr. James Bean as our keynote speaker for this event.

Please submit abstracts to: Wojahn.Mark@mayo.edu


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Minnesota Neurosurgical Society Meeting September 17-19, 2010

Friday, September 17, 2010

7:00-8:00 PM        Opening reception
8:00-8:10PM        Chyatte,Douglas: Welcome and introduction of keynote speaker
8:10-9:00PM        Orrico, Katie O.: Keynote speaker: Healthcare Reform:  Implication for Neurosurgeons and their Patients

Saturday, September 18, 2010

Scientific Session I: Moderator-Douglas Chyatte

7:30-7:35 AM        Chyatte,Douglas: Welcoming remarks
7:35-8:00 AM        Zhu, Wylie: MIS spine surgery
8:00-8:30 AM        Clarke, Michelle: En bloc Resection of Spinal Neoplasms
8:30-9:00 AM        Fogelson, Jeremy: RhBMP-2 applied to non-compressible collagen matrix
9:00-9:30 AM        Daniels, David: A propspective analysis of thrombophilic profiles in patients with dural venous malformations
9:30-10:00 AM      Haines , Stephen J.: TBA
10:00-10:30 AM    Perez-Cruet, Mick: Advances in Minimally Invasive Spine Surgery

10:30-10:40        Break

Scientific Session II: Moderator- Anthony Bottini

10:40-11:10 AM    Spinner, Robert: What’s new in peripheral nerve tumors treatment of Bell’s palsy
11:10-11:40 AM    Lanzino, Guiseppe: Radiosurgery treatment of intracranial dural AVF
11:40- 12:10 AM    Chyatte,Douglas: Presidential Address

12:10-1:00 PM    Lunch

Scientific Session III: Moderator- Guiseppe Lanzino

1:00-1:30 PM        Perez-Cruet, Mick: Council of State Neurosurgical Societies

1:30-2:00 PM        Monasky, Mark: Asset protection for Neurosurgeons
2:00-2:25 PM        Link, Michael: Cerebellopontine angle epidermoid tumorsLesion.

2:25-2:50 PM        Taussky, Philip: Treatment of paraclinoid aneurysms with modern flow diverters

2:50-3:00PM        Break

Scientific Session IV: Moderator- Douglas Chyatte
3:00-3:30 PM         Hunt, Mathew: Immunotherapy for canine menigiomas
3:30-4:00 PM        Baimeedi, Praveen R: Surgical management of brainstem cavernomas
4:00-6:00 PM        Naturalist cruise

Sunday, September 19, 2010

8:30-9:00 AM        Resident Award
9:00-11:00 AM    Business Session

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The second annual academic meeting of the Minnesota Neurosurgical Society is completed and, once again, has been a notable success. Katie Orrico, JD provided a clear

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The first academic meeting for the Society appeared to be an unqualified success, except perhaps for the weather. The facilities at Madden’s were nearly perfect for a meeting of this size with excellent conference facilities in proximity to the lodge and guest rooms.

The opening reception was collegial and the subsequent presentation and discussion with congressional candidate Maureen Reed, MD provided a preview of the subsequent national debate about healthcare reform.

(l-r)Drs. Bottini, Siddiq, Van Gompel and Chyatte

The subsequent academic program was well attended and provided an intimate small group setting for questions and discussion. Dr. Farhan Siddiq from the University of Minnesota received the Resident’s Award from the Society for his presentation, Comparison Between Primary Angioplasty and Stent Placement for Symptomatic Intracranial Athersclerotic Disease: Meta-analysis of Case Series. Dr. Jamie Van Gompel from Mayo Clinic was also recognized for his presentation, Cortical Ependymoma: An Unusual Epileptogenic Lesion.

Drs. Robert Spinner and Marshall Watson have volunteered to serve as members at large on the Society’s executive committee. Resident members Jeremy Fogelson, MD and Chris Janson, MD have also volunteered to serve as resident members at large. Dr. Giuseppe Lanzino has offered to serve as the Academic Meeting Coordinator for the 2010 meeting. That meeting has been tentatively planned for Friday-Sunday September 17-19, 2010 again at Madden’s Resort in Gull Lake, MN. The meeting has been moved forward three weeks to take advantage of better weather and utilize the resort facilities more fully over the weekend.

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The Society’s annual Academic meeting is less than a month away!  The three day conference will include five scientific sessions (with at least 18 presentations for a minimum of 10.5 hours of Category 1 CME credits) as well as the semiannual business session and an address by Minnesota congressional candidate, Maureen Reed, MD. Neurosurgical speakers include Steve Haines, Dave Piepgras, Mahmoud Nagib, Robert Spinner, Michael Link, Giuseppe Lanzino, Terry Hood,  Matt Hunt, Ramu Tummala, Mary Dunn, Dominic Cannella, Doug Chyatte, Tony Bottini and Jamie Vangompel.

The meeting will be held at beautiful Madden’s Resort on Gull Lake and room fees will be all inclusive (room, meals, use of resort facilities includng golf courses, tennis, croquet, trails, non-motorized boats, etc.). The schedule should also permit quality time outdoors and with family.

The fee for lodging, meals and resort activities is $553 single occupancy or $381 double occupancy (two conference participants); spouses stay for $80/night. Conference registration is $200 which includes tuition, syllabus and an evening reception. To reserve a place for the conference, open the links below to reserve a room at Madden’s and register for the meeting.

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Council of State Neurosurgical Societies Plenary Session:

Nerves: what is it, who belongs.

Neurosurgery Executives Resource Value & Education Society (NERVES) provides assistance in the art of neurosurgery practice management and is an initiative of the CSNS )Council of State Neurosurgical Societies). From the organization’s website:

What can NERVES provide to a neurosurgical practice?  First, NERVES establishes  a strong networking connection to other practices all over the United States.  Secondly, NERVES holds an annual education meeting adjacent to the AANS conference each year.  Informative speakers, breakout sessions, round table discussions, and vendor exhibits help administrators and managers further develop and enhance their practices. Thirdly, NERVES provides current benchmarking data.  In 2003 a NERVES data survey was distributed and collected from NERVES members.  This data addresses a wide variety of valuable information such as physician compensation & benefits, benchmarking data, total and work RVUS, and average CPT allowables by code.  In the first two years of the survey, data was compiled and became an important resource for neurosurgery practices to take steps to significantly increase their bottom line. Lastly, NERVES has developed and implemented a NERVESGOOGLE list serve for its membership. Practice managers can email questions out on the list serve and receive answers from other NERVES members.  This process has become a valuable tool to capture reliable practice management information in a quick fashion.

For more information, go to nervesadmin.com.

CSNS Resolutions, 2009:

Resolution to develop guidelines for peer to peer  utilization review process that addresses the need for specialty specific review, accountability and transparency

Asks for a white paper to address these issues. Appears that the AMA has recognized the problem with peer review issues for at least the past 20 years. Policy statements appear to exist in spades and tis will likely duplicate those efforts already expended over the past several decades which may not have effectively impacted the problem.

Resolution to reassess the use of methylprednisolone in acute spinal cord injury, resolution.

Asking for an interim update on these guidelines

CSNS and NERVES develop a list of resources regarding acceptable methods for determining usual and customary fees. Further resolution that the Washington Committee support pt access to neurosurgical care by preserving fair compensation for care provided out of network.

No debate

Trauma Surgeon management of traumatic brain injuries. Resolution: AANS and CNS to work with ABSN to issue a joint position statement to the AAST asserting that training required to fully understand and care for both acute surgical and non-surgical traumatic brain injuries requires the completion of a neurosurgical residency.

Discussion: Any barrier which prevents a neurosurgeon from participating in the care of TBI patients impedes patient care. Radical elements of Trauma Surgeons have backed down slightly in their push to perform emergency craniotomies. Another joint position statement may be duplicative and unnecessary. Maybe a better move would be to put out a position paper on neurosurgeon’s responsibilty in managing trauma. Do neurosurgeons shirk trauma responsibilities and create a practice opportunity for trauma surgeons to perform necessary services?

Resolution: CSNS investigate currently avail skills competency training and virtual reality training tools could efficiently contribute to neurosurgery resident training and potentially improve quality of care.

No debate.

Resolution: AANS/CNS through Washington Committee work to make any federal legislation that provides for transparency in the relationship between physicians and industry acceptable to neurosurgeons.

No meaningful debate.

Resolution: AANS/CNS through Washington Committee work to make any federal legislation that provides for transparency in the relationship between physicians and industry acceptable to neurosurgeons. The CSNS should create an educational module to inform our membership and the public about existing AANS and CNS Guidelines and Policies regarding management of conflict of interest pertaining to neurosurgeons and industry.

No meaningful debate.

Resolution: CSNS urges the AANS and CNS through the Washington Committee to support the general principle of a national medical device registry based on the concept of a unique device identification number (UDI).

Referred back to committee for more study before accepting this resolution. Concern regarding physician responsibilities about device recall, level of detail and documentation required.

Washington Committee Report:

Gail Rosseau possible candidate for Surgeon General

Proposals for Healthcare Reform:

Baucus and Daschle proposals

Cost containment will be paramount. Mo=re interest among employers in healthcare reform  because employer health benefit costs have more than doubled since Hillary care first proposed.

Most stakeholders agree on core principles; breaking points center on financing issues.

Daschle Plan:

Medicare outcome measures linked to pay. All Americans required to have health care. Federal Health Board insulated from “politics” would oversee Fed health Care programs, set terms for private insurers who participate in Fed employees insurance pool. Assess effectiveness and costs of treatment.

Sustainable Growth Rate formula for Medicare: Reform costs keep escalating. 318 billion more next 10 years if reimbursement remains flat.

Obama Plan: 329 billion to wipe out SGR debt now reduced to 38 bill.

Our proposal: Replace SGR with Service Category Growth Rate (SCGR): Imaging and testing, minor procedures are leading increases in volume; major procedure have declined in volume. SCGR keeps funding reform focussed on separate “buckets” of resource allocation.

operationpatientaccess.facs.org Surgery’s message regarding need for health are reform and patient access issues. Focus is unduly on primary care problems.


CMS Chronic Care Management, Medical “Home”

Hospital Readmissions and Bundling

Penalties for MD’s who exceed imaging ordering volumes of 5%.

Senate Finance Committee:

Best case: 6% increase for surgeons, 16% increase for primary care and rural surgeons.

Worst case: 35% decrease for surgeons, 30% decrease for primary care and rural surgeons.


Only Medicare reform may survive budget reconciliation process, if Dems can’t get 60 votes in the seante.

temporary Medicare physician payment fix to prevent 22% cut but with “poison pills” (budget neutral primary care bonus)

Neurosurgical training restrictions (“neurosurgery’s finest hour?”) Not favorable but better than anticipated. Max shift of 16 hours without sleep. Max in hospital call every third night. Neurosurgery program rules may be different than those accepted for other specialties.

Emergency Neurosurgical Care

Regionailzation demonstration programs;

better reimbursement for ER care

Summary: Hope not warranted at this point. See Despair.com

Coding and Reimbursement Committee

21% cut in 2010

61793 Stereotactic radiosurgery  17.75 wRVU, 32.05 total RVU

Issues was multiple mets Rx with -51 modifier

New Codes for Stereotactic radiosurgery 2009

10.79 wRVU, complex lesion wRVU same

Refinement panel to meet this all regarding neurosurgery’s appeal. Some additional RVU’s but not likely parity with pre-2009 codes.

Scrutiny for lowering code RVU’s based upon increasing volume and codes which often combine.

63655 laminectomy is undervalued

Issue to bundle codes 63075/22554 together for ACDF (occur together 95% of the time). New code due in 2011. Plate 22845 may also be bundled (70% concurrent submission)

Quality Improvement Update

Comparative Effectiveness Research CER: Topics submitted for investigation:


Cervical myelopathy

Vertebral augmentation

Health Information Technology Program (HIT)

Progresses from trivial bonuses to large financial penalties by 2015.

2009 PQRI measurement appropriate to Neurosurgery (Google)

CMS questions worth of these procedures: lumbar fusion, vertebroplasty, BMP, Axiallif, Xstop.

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The Spring 2009 meeting of the Minnesota State Neurosurgical Society was held at the BANK restaurant in Minneapolis on Friday evening, April 17th at 7 PM.

Agenda items included:

  1. 1.Approval of Society Bylaws

a. Incorporation: Our organization will be incorporated this spring. Bylaws were reviewed, minor revisions were discussed, accepted and approved. We will proceed with submitting our appliication to the state and pay appropriate legal and permitting fees.

  1. b.Not for Profit Status is pending.
  1. 2.Academic Meeting Planning, October 2nd-4th, 2009 Madden’s Resort, Gull Lake, MN

We need help in planning for the Fall, 2009 meeting, the first ever academic meeting for this organization. This three day event is planned for October 2-4th at Madden’s Resort near Brainerd.

  1. a.Program development: Members’ assistance in developing the format and program for this meeting would be invaluable. We are planning for coverage of a mix of socioeconomic and academic topics. A variety of prospective speakers were discussed but plans are far from finalized. Members are solicited for contributions regarding socioeconomic and academic topics and speakers. The meeting is only five months away so clearly this planning must proceed without delay.
  2. b.CME: This conference will be planned for an approximate 10-12 hour of CME credit for the weekend. CME will likely be certified through the Mayo Clinic. A variety of presentation formats were discussed, including lecture, short topic discussions, walking conferences, etc.
  3. c.Presentation collection (CME): The possibility of adding an online CME resource to the Minnesota Neurosurgical Society website was discussed but tabled for further review and development.
  1. 3.Issues of concern to neurosurgeons

a. Provider Tax: Current discussions at the state capital have included proposals to raise this tax targeted at physicians alone to a level as high as 3%. Meeting discussion centered around means of expressing our collective opinion to state legislators through a targeted mailing campaign.

b. Other Legislative Issues: Tabled pending completion of our incorporation.

c. Imaging Software, Quality and Safety: One of the issues identified last year by the Society has also caught the interest of the AANS. The chaotic state of imaging software development and the often abysmal images contained on many CD-ROMs have degraded clinical care and raised safety concerns for neurosurgeons. The Society again discussed a statewide survey to identify the best, and the worst, of these imaging programs.

  1. 4.MNS Member Issues
  2. a.Members at Large, other positions. We have need of two volunteers to serve as members at large on the board of this organization.
  3. b.Resident Member recruitment: Residents may join the society without cost. Discussion ensued regarding recruitment efforts for the Society at the state’s two neurosurgical training programs.

Consideration and suggestions for the Society’s issue agenda for the next year.

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Executive Committee Meeting Minutes

February 8, 2009

Westin Hotel/Bank Restaurant, 88 South Sixth Street, Minneapolis MN


Drs. Bottini and Chyatte attended. Invited, but not able to attend were Drs. McDaniel, Galicich and Fogelson

Secretary/Treasurer’s report

Total financial assets are $10,890.32 in the US Bank account plus $4350 in pending deposits (from membership dues) for a total =$15,240.35.

Received and approved membership application for 2009 thus far: 29 active; 2 associate; 4 senior. Total =35.

Second notice membership applications will be sent to potential members who did not respond to the first notice and residency program coordinators will be contacted to increase the number of resident members.

Bylaws and incorporation

The draft bylaws have been posted on the society’s web page for several months and the membership has had an opportunity to comment and suggest changes. As there have been no requests to change the current bylaws draft, the current bylaws draft was approved pending any changes that may be legally required. Funding for legal review of the bylaws and funding for formal incorporation of the Society was also approved. Dr. Bottini will move this process forward for the Society.

April 2009 Business Meeting of the Society’s Membership

A full meeting of the entire membership will be organized by Dr. Bottini in April 2009 for purposes of discussing the bylaws, incorporation, the fall CME meeting and other issues.

Minnesota Neurosurgical Society CME

The fall CME meeting will be held October 2-4, 2009 at Madden’s Resort at Gull Lake. It was agreed that the registration fee for this meeting will be $200 for attendees. It was agreed that this fee would be waved for residents. Dr. Bottini has been working on the logistics with the resort and reported that room and board and use of conference facilities would be about $225/attendee/day. It was agreed that Dr. Bottini would finalize the contractual negotiations with Madden’s and place the required deposit.

Dr. Chyatte has been working on the CME accreditation for the meeting. AANS joint sponsorship would cost the Society approximately $1800, while joint sponsorship through Mayo would be free. It was agreed to withdraw the AANS application and proceed with the Mayo application. Dr. Chyatte will move this process forward.

It was agreed that the Society would offer a $1000 award for the best resident’s paper submitted to the meeting.

The potential for enduring CME material resulting from the meeting was discussed and Dr. Chyatte will collect more information and bring this back to the group.

Corporate sponsorship was discussed. It was agreed that the Society will solicit corporate sponsorship for this meeting through unrestricted educational grants. Dr. Chyatte will move this process forward.

It was agreed that ‘save the date’ announcements would be sent out to announce the meeting to the membership.

Resident membership initiatives

Only 2 residents applied for membership this year so far. Initiatives to stimulate resident interest in the organization were discussed. Drs. Bottini will speak to the residency directors at Mayo and University of Minnesota. A resident liaison to the Society from the University of Minnesota will be identified.

The meeting was then adjourned.

Respectfully submitted on February 13, 2009,

Douglas Chyatte, MD Secretary/Treasurer

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Senator Norm Coleman was our featured speaker. He discussed his positions on Medicare cutbacks and the sustainable growth rate proposals for the system. He spoke about his efforts to improve access to rural healthcare, introduce legislation to allow federal funding for stem cell research and his work on the Senate Committee on Aging a to nd the Senate Medical Technology Caucus. He also provided some insight into the current crisis in the financial markets and the efforts underway this weekend to stabilize the capital markets.

Meeting Minutes

September 20, 2008

Westin Hotel/Bank Restaurant, 88 South Sixth Street, Minneapolis MN

Attendees and venue

Twenty-one members and guests of the Society, including residents from both the University of Minnesota and the Mayo Clinic met at the Lakes Room of the Westin Hotel for an informal cocktail reception including an opportunity to meet one-on-one with Senator Norm Coleman, (US Senator MN-Republican).

Keynote presentation

Following the reception, Senator Coleman had a round table discussion with the members of the Society focusing on health care, health care reform, tort reform and the current economic crisis. Senator Coleman answered numerous questions from the group and listen to the concerns and comments of the membership.

Senator Coleman stressed the importance of participating in the political process and observed that physicians, especially specialist such as neurosurgeons, do not participate in the political process and encouraged the society and its members to become more involved in the discussions related to health care and tort reform. Senator Coleman observed that, unlike physician organizations, the trial lawyers’ associations were active and effective participants in the political process.

Business session

After Senator Coleman’s presentation, Dr. Bottini called the business session of the meeting to order.

CSNS REPORT: Dr. Feldkamp presented a report on the current activities of the CSNS at the April 2008 AANS meeting. Dr.Kim is currently representing Minnesota at the CSNS at the September 2008 CNS meeting.

SOCIETY REJUVENATION: Dr. Bottini indicated the Minnesota Neurosurgical Society was currently in the early phase of organizational resurrection and rejuvenation and that there were a number of organizational issues facing the Society.

There was a discussion among the members about the Society with general agreement that there was a bona fide need for the Society and the Society should be resurrected. There was general agreement that interest among Minnesota neurosurgeons to participate in a state Society was greater now than in the past several years.

The mission and vision for the Society were discussed by the group.

MEETING SCHEDULE AND TOPICS: There was agreement that the Society should continue to hold two meeting a year, planned to precede the AANS and CNS meetings. Potential topics for next meetings were discussed and there appeared to be considerable interest on the topic of medical malpractice reform. There was interest among the membership to obtain CME credits for the meetings.

MMA: There was general agreement that the Society should send representative to the Minnesota Medical Association meeting. Dr. Kim is currently the Society’s MMA representative.

BYLAWS: Dr. Bottini indicated that the organization bylaws are missing and not with the materials transfer to either Drs. Bottini or Chyatte earlier this year. Dr. Bottini indicated a need to rewrite the bylaws if existing bylaws could not be found.

WEBSITE: Dr. Bottini introduced the Society’s new website to the group (mnneurosurgicalsociety.org) and talked about using the website as a venue for communication among the membership.

INCORPORATION: The group discussed the need to formally incorporate the society and voted on the matter. It was unanimously agreed to move forward with incorporation of the Minnesota Neurosurgical Society.

OTHER REPORTS: Dr. Chyatte gave the Treasurer/Secretary report indicating that the Society had 30 dues paying members, no non-dues paying members and total cash on had of $13,165.02.

RESIDENT MEMBERS: Neurosurgery residents from University of Minnesota and Mayo Clinic were invited to join the Society as non-dues paying members.

The meeting was then adjourned.

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