2023 January AANnews

NEED TO BE INCLUDED INSTIGATED AMERICAN ACADEMY OF NEUROLOGY

Celebrate the World's Largest Association of Neurologists and Neuroscience Professionals

This year is the 75th anniversary of the founding of the AAN in 1948. AANnews marks this occasion with a series of articles on how the Academy grew from 50 initial members to becoming the world’s largest association of neurologists and neurology professionals, with 38,000 members worldwide.

The creation of the American Academy of Neurology was one of the final salvos in a decades-long philosophical sparring over which medical specialty in the United States should be preeminent in treating disorders of the brain: neurosurgeons, psychiatrists, or clinical neurologists.

The work of pioneer brain surgeon Dr. Harvey Cushing and psychoanalyst Dr. Sigmund Freud fascinated a public keen on cures for the complicated vicissitudes of the human brain. Clinical neurologists, on the other hand, had little in the medicine cabinet for treatment and no one with similar public stature to champion their cause. Dr. Wilder Penfield, a disciple of Cushing, claimed that clinical neurologists would be supplanted by neurosurgeons and psychiatrists.

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2023 Palatucci Advocacy Leadership Forum

Applications for the upcoming Palatucci Advocacy Leadership Forum will be open January 19 through March 28. The program will take place August 3 to 6 in San Diego, CA. This awardwinning program offers critical training in the areas of grassroots advocacy, leadership, relationship building, and media skills to help you take a problem or issue and mold it into a strategic action plan.

Up to 30 neurologists and third- and fourth-year residents, and up to two international neurologist members, will be

This logo was used during the AAN's first 50 years.

Early Annual Meeting Registration Savings End February 2

Visit AAN.com/AM today to secure your early registration discounts for the 2023 AAN Annual Meeting coming April 22 to 27 both in person in Boston and live online. The last day to take advantage of the deep early-bird savings is February 2.

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The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction.

The Vision of the AAN is to be indispensable to our members.

Contact Information

American Academy of Neurology 201 Chicago Avenue Minneapolis, MN 55415

Phone: (800) 879-1960 (toll free) (612) 928-6000 (international) Email: memberservices@ aan.com Website: AAN.com

For advertising rates, contact: Michael J. O’Brien II Account/Relationship Manager Wolters Kluwer

Phone: (978) 578-4514

Email: Michael.Obrien @ wolterskluwer.com

January Highlights

AAN

Editor-in-Chief: Melissa W. Ko, MD, MBA, CPE, FAAN

Managing Editor: Angela M. Babb, MS, CAE, APR

Editor: Tim Streeter

Writers: Ryan Knoke and Sarah Parsons

Designer: Siu Lee

Email: aannews@ aan.com

AANnews® is published monthly by the American Academy of Neurology for its 38,000 members worldwide. Access this magazine and other AAN publications online at AAN.com.

The American Academy of Neurology ’ s registered trademarks and service marks are registered in the United States and various other countries around the world.

“American Brain Foundation” is a registered service mark of the American Brain Foundation and is registered in the United States.

The inclusion of advertisements and/or promotions of Sponsors and other Internet sites or resources that offer content, goods, or services on the Website does not imply endorsement of the advertised/promoted products or services by AAN.

5 AAN Guidelines

Featured in Free Digital Pocket Guides for

Members

The AAN has partnered with Guideline Central to offer members free access to digital, quick reference Pocket Guides of AAN guidelines for your digital devices or desktop.

9

Emerging Leaders Program Graduate Selected for Prestigious Health Equity Fellowship

“The AAN Emerging Leaders Program helped to clarify my vision as a leader during really challenging times in the pandemic,” said 2020 graduate Karen Orjuela, MD.

15

American Brain Foundation Accelerates Efforts in 2023

As we enter 2023, we plan to further our commitment to our belief that by curing one disease, we will cure many through these accelerated efforts.

News Briefs

Register for Free “Ask Me Anything About MIPS Value Pathways” Webinar

Join expert panelists on January 24 at 3:30 p.m. CT for an informal, open Q&A session to gain a better understanding of Merit-based Incentive Payment Systems (MIPS) Value Pathways (MVPs) and learn more about the short- and long-term incentives associated with the program. Register at AAN.com/MVPwebinar

The AAN Celebrates Neuroscience Is… Rewarding Day

As part of the AAN’s effort to celebrate Neuroscience Is…™ Rewarding Day on November 30, the general neurology community and students were asked to post in social media on why they find neuroscience rewarding with the hashtags #NeuroscienceIs and #FutureNeurologist. November 30, 1840, is the birthday of German neurologist Wilhelm Henrich Erb, MD, who is credited with popularizing the reflex hammer so widely used in today’s neurological exam and symbolizes the field of neurology. 

Atemkeng N. Tazi from Saint James School of Medicine in Chicago participated in the Neuroscience Is… Rewarding Day.

Chief Executive Officer: Mary E. Post, MBA, CAE

Join Us in Boston—or Live Online—for Our Exciting 75th Annual Meeting

The 2023 AAN Annual Meeting being held April 22–27 promises to be the most thrilling meeting to date, and not just because many of you are enjoying travel again or because few cities rival Boston’s offerings in the spring, but because it marks the AAN’s 75th anniversary, and the celebration will continue week-long. Earlier this year, I joined the Meeting Management Committee to tour the convention center and brainstorm ideas to

Joseph I. Sirven, MD, FAAN Chair, Education Committee

This year’s educational offerings are back to a full calendar of nonstop education customized the way you want it.

We will have over 200 courses in a variety of formats. Every general and subspecialty area will be available to meet your needs. There are core classes fundamental to each neurologic discipline, plus cutting-edge sessions highlighting the rapid transformation of clinical neurology. There are skills workshops as well as multidisciplinary courses underscoring the commonalties between various neurological conditions and

commemorate the Academy’s history, and I can assure you that the days will be full of excitement, festivity, and surprises.

I’ve invited my colleagues who chair the Education, Science, and Meeting Management Committees to give you a sneak peek.

Natalia S. Rost, MD, MPH, FAAN, FAHA Chair, Science Committee

On behalf of the Science Committee, I am delighted to introduce the AAN’s 75th Scientific Program. We are jubilant as we celebrate the AAN’s accomplishments of the past three-quarters of the century—but we are especially proud of the milestones that the AAN’s Science has reached. We have come a long way from our first scientific program unveiled at the meeting in French Lick, IN, in June of 1949, with a total of 38 papers presented and chaired by no other than Dr. Robert Wartenberg! But the traditions set in place at that time for the AAN Science―“hot-off-the press” scientific reports, covering diverse neurological subjects, and of great relevance to neurology practice at the time―continue to carry on at the 75th Annual Meeting with tremendous impact. The 2023 Scientific Program will offer: ƒ 7 plenary sessions ƒ Over 2,600 abstract presentations, 47 platform sessions, and 14 poster sessions

Orly

Avitzur, MD, MBA,

FAAN | President, AAN oavitzur@aan.com | @OrlyA on Twitter

diseases. Even better, these courses are delivered the way you want to receive them.

Are you looking to network? Then come to the classes in person. Really need to focus on a specific area? Then try our virtual delivery. If you are looking to expand your career options or better understand the practice of neurology, we’ve got you covered. We also have extensive offerings for our medical students, residents, fellows, nurse practitioners, physician assistants, business administrators, and the entire neurology clinical care team. If you need a break and are looking for infotainment over a cup of coffee or a glass of wine, then check out the Head Talks stage and Annual Meeting Hub offerings. It’s incredibly exciting and waiting for you. Please join me and I’ll see you there.

6 Neuroscience in the Clinic sessions

4 Invited Science sessions, where the best of subspecialty science from a wide field of collaborating society meetings will be presented including:

Society for Neuro-oncology

International Parkinson and Movement Disorder Society

American Academy of Sleep Medicine

And my personal favorite―over 25 award presentations running the gamut from high school students to trainees to mid-career to lifetime achievement!

The Annual Meeting Scientific Program does not stop at traditional scientific presentations. As always, the Science

Sirven

Rost

Avitzur

Committee continues to innovate to deliver creative engagement formats for attendees of all career stages and walks of our glorious profession. In this spirit, we look forward to celebrating the achievements of our Research Program awardees and winners of the numerous scientific awards. We are excited to engage at the Emerging Science session and to browse the poster neighborhoods. We are also delighted to present, for the second year, the 2023 Research Hub―an innovative space concept where the science and research programming is experiential, approachable, and interactive― offering multiple formats, various pace of activities, and an intimate setting.

We have another great year of science ahead, and whether you are a trainee or an established investigator, the 75th AAN’s scientific program will be a thrill!

H. Tilton, MD, FAAN Chair, Meeting Management Committee

No matter how you experience the 2023 Annual Meeting, you can expect to find an endless choice of top-tier educational opportunities in several different learning formats focused on every specialty imaginable, all the valuable CME you need for the year, the latest science covering every specialty; and the opportunity to connect with friends from around the world. Check back often for more information as the program is finalized and choose your own adventure!

In-person attendance will offer a wide range of experiences, including the 75th Anniversary Celebration. There will be skills workshops along with all the educational, networking, and Hub opportunities.

Virtual Registration with attendance through our online platform includes the daily online-only program featuring interviews and cutting-edge research summaries, access to AAN Rewind, live Q&A after most sessions with the in-person audience, and an online poster gallery.

Experiential Learning Areas have been reimagined as eight Hubs for the 2023 Annual Meeting. Hubs offer unique educational and networking opportunities around a specific focus to meet your needs and spark your curiosity. They are designed to foster collaborative learning, share unique education delivery methods, and provide content not found in a traditional classroom. 

GUIDELINES

AAN Guidelines Featured in Free Digital Pocket Guides for Members

The AAN has partnered with Guideline Central to offer members free access to digital, quick reference Pocket Guides of AAN guidelines for your digital devices or desktop. Current available AAN Pocket Guides include:

Antiseizure Medication Withdrawal

Early Parkinson Disease

Painful Diabetic Polyneuropathy

Patent Foramen Ovale

Prevention, Diagnosis and Treatment of Lyme Disease

Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis ƒ

The Care of the Patient with Amyotrophic Lateral Sclerosis: Drug, Nutritional, and Respiratory Therapies Guideline Central provides health care professionals with evidence-based clinical decision-support tools that are current, practical, and easily accessible. It partners with the AAN and over 45 other medical specialty societies to provide quick-reference tools that clinicians can rely on for credible guidance in the management of medical conditions at point of need. Pocket Guides are great for quick reference at point of care, educating students or residents, quality improvement efforts, and clinical documentation for coding, billing, and compliance.

Features include: ƒ Quick access to key recommendations, figures and algorithms, tables, and more ƒ Recommendation filtering

Offline viewing via iOS and Android mobile apps

Notes and bookmarks

Find within guidelines and search across all guidelines

Guideline Alerts—personalized monthly digests with new guidelines ƒ

Synchronization between web and mobile accounts

The Pocket Guides are offered in print (4.25” x 7.25”), online, mobile (iOS and Android), and Application Programming Interface. Integration for electronic health records is coming soon.

Visit GuidelineCentral.com/AANmembers and register to receive your free access today. Once you have created your account, new AAN Pocket Guides will be automatically added to the “My library” section of your account as soon as they are published. 

Tilton

Ann

Former ELAs Are Now Hubs, Offer Unique Educational and Networking Opportunities

The Annual Meeting’s former Experiential Learning Areas have been reimagined as Hubs for the 2023 Annual Meeting. These new spaces will employ unique and interactive education delivery methods and networking opportunities to foster collaborative learning around focused content not found in a traditional classroom. This year’s Hubs include Academic, Innovation, Leadership University, Practice and Policy, Trainee and Educator, Research, Wellness, and the always popular HeadTalks.

Hubs Spotlight

HeadTalks

The iconic stage is back! HeadTalks will once again bring innovative stories, games, panel discussions, and unique topics you won’t see or hear anywhere else during your week in Boston. Step away from the heavier content of the meeting for the following fun and interactive ways to learn and get inspired:

ƒ Game Shows: Neuro Feud, Neurology Trivia, Neurology Pictionary, Neuro-Jeopardy, Neurology on the Screen, NeuroZone

ƒ Panel Discussions: Reflections from Women in Neurology, Standing on the Shoulders of Giants, NeuroPanels Live, Leading Through Adversity

ƒ Unique Programming: Neurology of Shakespeare, As Seen on TV, Neurology of Wine Tasting

Wellness Hub

Take a break and visit this calming, light-filled space to relax and rejuvenate physically and mentally. You can also gain valuable tools to use in your everyday life to improve resiliency and wellbeing in your career, workplace, and home life. Take part in fun physical activities, intimate conversations facilitated by experts, and other creative and interactive activities, including: ƒ Cooking demonstration ƒ Yoga ƒ Bollywood dance ƒ Restorative sound bath ƒ

Fireside chats for specific member types, such as APPs and trainees

ƒ Interactive sessions on building a wellness culture at your organization

Learn more about 2023 Annual Meeting Hubs at AAN.com/AMHubs 

Annual Meeting Industry Partnerships Offer Sneak Peek into Latest Research, Products

With so many excellent ways to learn and network at the 2023 Annual Meeting in Boston, don’t forget that one of the best ways to get a sneak peek at the newest and most cutting-edge research, as well as products advancing patient treatment and care, is through the Academy’s valuable industry partners. In addition to tirelessly working to improve the lives of patients and caregivers, industry partners also provide support that helps ensure the excellence that has become synonymous with an AAN Annual Meeting experience. As you plan your week at the Annual Meeting in Boston this April 22 through 27, make room in your schedule for these not-to-be-missed opportunities.

Exhibit Hall

Building time to explore the Annual Meeting Exhibit Hall is critical for ensuring you are equipped with the best patient resources before leaving the meeting. It’s here that you can engage with a diverse range of organizations, including non-profits and patient advocacy groups, offering unique resources and the latest products to improve patient care, help caregivers, and strengthen the neurology community. Look for opportunities to:

ƒ Network with organizations that are at the forefront of advancing patient care

ƒ Learn about novel ways to treat patients and new technologies to improve your practice

ƒ Hear from hospital networks with expanding career opportunities

The Exhibit Hall will be open Sunday through Wednesday during the meeting. Visit AAN.com/AM for more information on participating companies and to customize your on-site experience.

Industry Therapeutic Updates

Industry Therapeutic Updates (ITUs) provide an opportunity for pharmaceutical companies, device companies, or other appropriately related organizations comprising the AAN Industry Roundtable to share information about pipeline activity and promote emerging therapies and projects with Annual Meeting attendees. All programming is in accordance with the standards set for the industry by the Food and Drug Administration and will take place at designated hotels on Saturday, Monday, Tuesday, and Wednesday evenings beginning at 6:00 p.m. and in the convention center during lunch from 11:45 a.m. to 12:45 p.m. Visit AAN.com/AM for more information. 

Early Annual Meeting Registration Savings End February 2

Join Us in Person or Live Online

Whether you join us in person in historic Boston or live online from anywhere, the 2023 Annual Meeting will offer an unforgettable educational and networking experience—no matter your career level or geographic location. Both attendance opportunities will feature:

ƒ 200+ education programs offering CME credits for the entire year ƒ 2,600+ scientific abstracts presented on multiple platforms, some offering CME ƒ 7 plenary sessions featuring leaders in neurology ƒ 8 Hubs for interactive and innovative learning ƒ 100s of industry partners to connect with who are focused on improving neurologic care

Get the Best Value by Adding On Demand

Bundle your Annual Meeting registration with Annual Meeting On Demand to save 40 percent on regular On Demand pricing and get extended access to most session recordings and the ability to claim CME through March 1, 2024.

Celebrate 75 Years of the AAN!

With 2023 marking 75 years since the founding of the AAN in 1948, if you join us in Boston, you can take part in the fun with a special 75th Anniversary Celebration Sunday, April 23, at the Museum of Science. One complimentary ticket is included with your registration fee (RSVP required). 

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2023 Emerging Science Abstracts Deadline Is February 1

February 1 at 11:59 p.m. CT is the deadline to submit previously unpublished research in which key aspects must have been completed after the October 2022 abstract submission deadline. Submissions for the 2023 Annual Meeting’s Emerging Science Program must be new and of sufficient scientific importance showcasing timely, significant, and innovative content to warrant expedited presentation and publication. Visit AAN.com/23Abstracts to learn more and to submit. For questions, contact science@aan.com 

Your Practice Questions Answered at practice @ aan.com

The practice @ aan.com email inbox is an efficient way to reach staff and member expertise on practice-related topics such as payers, MIPS/MACRA, coding, and practice management. Staff experts respond within one business day and can seek the assistance of the Practice Support Network (PSN), a group of 30 practicing neurologists and graduates of the AAN’s Practice Leadership Program, or the Business Support Network (BSN), six business administrators in various practice settings, for real-world expertise. Below are some common questions that have come into the inbox recently.

Practice Management

Q: We are considering a merger with another small practice. Will a larger practice be able to command higher reimbursement rates?

A: While the AAN does not offer consulting services and cannot comment on how a merger could impact reimbursement rates, we reached out to the PSN for their real-world experience. Members of the PSN recommended hiring an external firm that specializes in valuation and legal matters to oversee the process. The firm will be able to assist in performing due diligence, so all parties are aware of the benefits, risks, and projected financials of the merger before proceeding. The projected financials should contain information regarding reimbursement changes. Additionally, the AAN’s micro learning series Navigating Relationships with Your Payers will provide insight on building relationships with payers and negotiating contracts. Visit AAN.com/education/practiceeducation-webinars. Lastly, both parties should also consider the ramifications of a merger, such as being able to leverage economies of scale; for example, the practices may be able to command better purchase pricing for medical supplies due to their larger size.

Payment Policy

Q. Can I bill an office visit on the same date of service when performing Botox services if I use modifier 25?

A. According to CPT, separate, significant physician evaluation and management (E/M) work that goes above and beyond the

physician work normally associated with a preventive medicine service or a minor surgical procedure is additionally billable. Meaning, if an E/M service is billed on the same day as a Botox service, it needs to have a distinct diagnosis code not related to the Botox service to be paid using the 25 modifier. Currently, included in the code valuation for procedures is counseling and patient history, consent, and review of the procedure. When working with private payers, it is always important to review their coverage policies on the use of modifier 25 prior to claims submission.

Quality Payment Program

Q: I am a MIPS participant, and I keep hearing about MVPs. Is it required that I participate in this new program?

A: The MIPS Value Pathways (MVP) track builds off the “traditional” MIPS pathway. MVPs are subsets of measures and activities, established through rulemaking, that can be used to meet MIPS reporting requirements beginning with the 2023 performance year. The MVP framework aims to align and connect measures and activities across the quality, cost, and improvement activities performance categories of MIPS for different specialties or conditions. There are three neurologyfocused MVPs for reporting in 2023: Stroke, Neurodegenerative Conditions, and Episodic Conditions. For now, MVPs and reporting of MVPs are optional. CMS will determine if an MVP may be applicable to your practice in the QPP participation Lookup tool each year. Visit AAN.com/QPP for more information about the available MVPs. 

Axon Registry Ready to Help You Succeed for Both MIPS and MVPs in 2023

Last year, CMS announced a new program as an alternative to MIPS called MIPS Value Pathways (MVPs). The Axon Registry ® is ready to meet your practice reporting needs whether you opt to report via a new MVP or traditional MIPS. The MVP framework aims to align and connect measures and activities across the MIPS performance categories of quality, cost, and improvement activities with interoperability and population health as its foundation.

For the field of neurology, two new MVPs debut in January 2023. The Axon Registry has incorporated quality measures to meet all three neurology-eligible MVP requirements for the 2023 performance year:

ƒ Optimal Care for Patients with Episodic Neurological Conditions

ƒ Supportive Care for Neurodegenerative Conditions

ƒ Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes

CMS has stated that MVPs will replace MIPS but has not provided the date MIPS will sunset. Practices that start using MVPs now can benefit from having a benchmark for future

years and feedback from CMS before reporting is required. The Axon Registry can help implement MVP usage to practices and assist with reporting requirements. Visit AAN.com/MVP to find out more information on MVPs.

To see the AAN’s summary of the 2023 Physician Fee Schedule, visit AAN.com/QPP

To learn more about the Axon Registry and enrollment information, visit AAN.com/Axon. Contact registry @ aan.com with questions. 

MEMBERSHIP

Emerging Leaders Program Graduate Selected for Prestigious Health Equity Fellowship

“The AAN Emerging Leaders Program helped to clarify my vision as a leader during really challenging times in the pandemic,” said 2020 graduate Karen Orjuela, MD. “It was a pivotal moment in my career to clarify my goals and next steps.”

Armed with heightened skills in the areas of communication management, personality traits and teamwork, and listening, Orjuela’s post-Emerging Leaders clarity and focus led her to new leadership roles within the AAN, including joining the AAN’s Research Subcommittee, serving as the topic chair for cerebrovascular diseases for the AAN Annual Meeting, being elected the Neurohospitalist Section Chair for the 2021–2023 term, and assisting in the

development of the Spanish curriculum for the AAN Annual Meeting.

More recently, Orjuela was selected to be one of the Pozen-Commonwealth Fund in Health Equity fellows at Yale University, a 22-month, degree-granting program that covers the cost of the MBA for Executives program and gives health care practitioners the leadership skills and the deep understanding of teams, markets, and organizations necessary to tackle major inequities in the US health care system.

“The help from the [Emerging Leaders] coach, the mentors, and my peers were

invaluable,” she added. “I could even imagine becoming a national leader in health equity; now I believe there is room to advance neurology health for all, applying entrepreneurship, innovation, and research principles.”

To learn more about the AAN’s Emerging Leaders program, visit AAN.com/education/emerging-leaders

The 2022–2023 Emerging Leaders Program is supported in part by AbbVie; argenx; Alexion, AstraZeneca Rare Disease; Bristol Myers Squibb; Harmony Biosciences; Supernus Pharmaceuticals, Inc. 

Orjuela

Need to Be Included Instigated American

Academy of Neurology continued from cover

The American Neurological Association, ensconced in New York City since its founding in 1875, limited its membership to 250 and was heavily skewed toward East Coast academic neurologists and neurosurgeons.

However, the human carnage of World War II raised demand for more neurologists to treat the hundreds of thousands of injured veterans. Neurology residencies, curtailed during the war, began to expand.

Lt. Col. Joseph A. Resch, MD, returned from the war in 1946. The young Wisconsin doctor had served seven years in the US Army Air Force and managed the hospital services for a fighter wing in New Guinea. Now 32, he was a resident in neurology at the University of Minnesota under Abraham B. Baker, MD, FAAN, chair of the Neurology and Psychiatry Division. Resch had a young family and was eager to establish his career— as a neurologist.

“Now all of us neurologists, very honestly, we did psychiatry too,” Resch recalled in 2008. “We had six months of our three years [in training] with psychiatry and that was the trouble with the field. You got going with psychiatry [so that] you had a good income—goodbye neurology, or you did a little, but that wasn’t your main deal.

“I got in with Dr. Baker and [Joe] Brown, who were the best teachers in the world,” Resch continued. “They wanted to know how we were doing, and what do we think about things. That’s when I popped off, I guess, to the chief and said, ‘Well, neurology, in this situation, what do you do when you finish? There’s nothing that you can really belong to for a young neurologist.’ The American Neurological Association, a very old professional society, was really an organization for department heads or faculty people. They required to be a member you had to have your boards, you had to have a list of publications and write a thesis. That’s pretty well not available for the fellows or brand-new neurologists…. So, Dr. Baker said, ‘Relax, we’re doing it.’ And they did, and it was really something.”

Baker was sympathetic to Resch’s concerns. The times were changing. If neurology was to move from the shadow of psychiatry and stand as a distinct specialty of medicine, it must organize and grow.

Baker began developing the idea of a new organization, collaborating with Russell N. DeJong, MD, FAAN (University of Michigan); Francis M. Forster, MD, FAAN (Georgetown University); and Adolph "Ady" L. Sahs, MD, FAAN (University of Iowa). He invited 52 key neurologists to become charter membersand Fellows of the new American Academy of Neurology, and 50 accepted.

Breaking with tradition”

“In planning the Academy, you must keep in mind that one was breaking with tradition,” Baker later recalled. “The American neurological tradition at that time was the American Neurological Association and to consider a new neurologic group on a broad democratic scale was not to be tolerated. Therefore, for two years, I spoke to many important leaders in the neurologic field trying to stimulate some support for this new idea. Therefore, it was fairly well known that such a society was being considered and I believe most people felt that no one would have the courage to start such a group.”

Future AAN President Joseph M. Foley, MD, FAAN, humorously recollected, “I was cool to the idea of joining an organization started by obviously paranoid Midwesterners. Unlike some of my fellow Bostonians, I knew at least Forster and [Pearce] Bailey and had some awareness that the founders probably did not have horns or cloven hooves, hay behind the ears, and the smell of hog on their sturdy boots. Many of my teachers in this, my native city of Boston, thought it improbable that anything of nobility was likely to emerge from the Midwest Plains or whatever they might have out there.… The most vicious attitude on the East Coast in those years was not hostility; it was disinterest and apathy. There was a kind of alternating annoyance and amusement at the impudence of the upstarts.”

Frank Forster saw it a little more sharply. “[In] the beginning there [was] some antipathy between the early members of

There’s nothing that you can really belong to”

Bailey Baker

Brown Resch Foley Forster

the AAN and some members of the ANA. This … was due to the strong Eastern influence and the elitism of the latter…. The primary motivation of the AAN was not against the ANA but rather to create a more inclusive organization. This was sort of like the Rooseveltian New Deal. From the cradle to the grave became from first-year resident to emeritus! And not only inclusive in membership but with active interplay between members. Of course, this would appear as a direct challenge to the more senior members of the ANA.”

There were calls to discipline Baker. “Abe, Ady, Russ, and I were already members of the ANA, albeit rather recently so (Ady wondered privately to me if we might be expelled from the ANA for that venture!),” said Forster.

Neurology needs a progressive middle class”

But there was a handful of key ANA members who supported Baker, according to Joe R. Brown, MD, FAAN, the Academy’s first secretary and eventual president.

“One of these, Robert Wartenberg of San Francisco, was an enthusiastic, outspoken, and vigorous supporter. He protected Abe Baker from disciplinary action. Frederic Lewey of Philadelphia, a quiet, dignified, scholarly gentleman who was highly respected, used his influence within the American Neurological Association to promote tolerance of the Academy. Paul Yakovlev of Boston and Johannes Nielsen of Los Angeles similarly gave their support. These four men were particularly instrumental in ensuring that the formation of the Academy could be accomplished without too much disruption in the

neurologic community. Alphonse Vonderahe of Cincinnati and Houston Merritt of New York also were instrumental in pointing out the different roles of the two organizations and in easing an accommodation between the established Association and the fledgling Academy after it was established.”

Forster explained, “My mentor at the University of Cincinnati, Dr. Vonderahe, who would belong to the older group, had an uncanny ability to understand things. And he looked over the situation and said, ‘Frank, you know, this is like the United States government. The American Neurological is the Senate, and the American Academy of Neurology is the House of Representatives.’ And with that theme, we were able to convince pretty much everybody that there was nothing [wrong] with the Academy.”

Baker escaped disciplinary action, but competition between the two organizations existed well through the 1950s. Even in 1992, former ANA President Fred Plum noted the seismic shift in power from the East Coast Brahmins to the Young Turks of the Midwest with a touch of rue.

“The Academy made it clear that there were more young people than old people who were doing first-rate analyses in neurological medicine. That is all there was to it. The Academy was collecting numbers very much the way alleys collect trash in a wind storm and that is not a very good metaphor. We will put it more favorabl[y]: very much the way that apple pickers choose the fall… I think it started probably as a Midwest … intellectual rebellion against the ANA as being too slow, too old, too fixed, and so on. So the tables became turned and the leadership of the ANA realized that the Academy was where the action was and if they hoped to prevent obsolescence they had to change.”

In January 1951, AAN President Pearce Bailey, MD, FAAN, [himself the son of a famed New York City neurologist] squarely framed the situation in the premiere issue of Neurology ®: “The scope of the Academy is nationwide and hence antagonistic to the geographic sectionalism which always has hemmed in the neurology of the past. It should be recalled that the early American neurologists were all aristocrats, originating for the most part from the northeastern section of the United States and guided by the principles of rugged individualism. There were no middle or lower classes in the neurology of the early days.... Neurology needs a progressive middle class and the Academy, by virtue of its organizational plan, is equipped to help develop such a group.”

Next month: The Four Horsemen and the Lobotomist 

Free Health Care Equity Webinar Offered February 14

Inclusion is the reason the AAN was founded. To be an organization that is the home for all neurologists. It is what makes us stronger. To support our goal of being a fully inclusive, deliberately diverse, and anti-racist organization and our core values of Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), we are excited to share progress and updates with you.

As part of the AAN’s IDEAS programming for members, a free webinar on “Health Care Equity for Neurologists” will be presented by Bruce Ovbiagele, MD, MSc, MAS, MBA, FAAN, on February 14 at 3:00 p.m. CT.

By the end of this course comprising three lectures, using exemplary cases or scenarios, participants should be able to:

ƒ Describe the concepts of health equity, health disparities, vulnerable and underserved populations, social justice, implicit bias, structural racism, and cultural sensitivity

ƒ List prevailing major disparities in neurology and promising avenues to bridge them

ƒ Appreciate the roles that training and research can play in overcoming neurological disparities

ƒ Appreciate that reduction of neurological disparities will require greater emphasis on non-medical (social) determinants of health

RESEARCH

ƒ Recognize importance of the health system as well as the community and social context as modifiable targets to address brain health equity challenge

ƒ Appreciate the need for workforce diversity to address health inequities and neurological disparities

ƒ Understand the potential contributions of advocacy and leadership to bridging neurological disparities

The live webinar is eligible for 1 hour of CME credit. A recording of the webinar—not eligible for CME—will be posted later to YouTube.

Visit AAN.com/HealthCareEquityWebinar for more information or to register. 

Neurology Today Ranks the Top Stories of 2022

Every year, Neurology Today ® asks members of its editorial board to highlight the news that moved their subspecialty forward in clinical, professionalism, and policy areas. Look for the Editorial Board Top Picks from

2022 in behavioral neurology/dementia, cerebrovascular disorders, epilepsy, multiple sclerosis, movement and neuromuscular disorders and more in the January 19, 2023, print issue and the Neurology Today website. To read more

about the advances that moved the field forward in 2022— and why they’re important—visit http://bit.ly/NT-BestAdvances 

Ovbiagele

Capitol Hill Report

Capitol Hill Report presents regular updates on legislative and regulatory actions and how the Academy ensures that the voice of neurology is heard on Capitol Hill. It is emailed to US members twice monthly and is posted at AAN.com/view/HillReport Below are some recent highlights.

Latest Advocacy News

ƒ The Medical Marijuana and Cannabidiol Research Expansion Act was signed into law on December 2. The AAN signed onto two letters earlier this year urging the passage of the bill.

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AAN sent a letter to House and Senate leadership reiterating the Academy’s top advocacy priorities for the end of the year, which include protecting the health care workforce, ensuring continued access to telehealth, streamlining the Medicare prior authorization process, and investing in medical research and veterans.

ƒ The Academy joined several other organizations in support of the inclusion of the SURS Extension Act (H.R. 6576) in a year-end legislative package. The legislation extends an important technical assistance program known as the Quality Payment Program— Small, Underserved, and Rural Support, which provides support to practices who participate in Medicare value-based payment initiatives.

ƒ The Centers for Medicare & Medicaid Services released a proposed rule on December 6 to address challenges with prior authorization (PA). The rule would advance interoperability and improve the PA process by requiring Medicare and Medicare Advantage plans to adopt electronic PA, respond to PA requests in specific timeframes, require public reporting on the use of PA, and much more. This rule will have a significant impact on provider and patient experience and should help in the Academy’s efforts to get the Improving Seniors Timely Access to Care Act signed into law. The Academy will submit comments on this proposed rule in the new year.

Issue in Focus

Alzheimer’s experts from around the world met in San Francisco for the 15th annual Clinical Trials on Alzheimer’s Disease conference. While a variety of sponsors presented results from their clinical trials, it was Eisai’s presentation of their Phase 3 CLARITY AD trial for their monoclonal antibody directed against amyloid for the treatment of Alzheimer’s disease (AD), lecanemab, that generated the most excitement. Experts presented an article published in the New England Journal of Medicine that found that lecanemab was able to meet primary endpoints demonstrating statistically significant clearance of amyloid plaque as well as a 27-percent reduction in cognitive decline over 18 months as measured by the Clinical Dementia Rating―Sum of Boxes.

The FDA is scheduled to make its accelerated approval decision on lecanemab on or before January 6, 2023. Should the therapy be approved, it would immediately fall under the National Coverage Determination (NCD) finalized earlier this year in response to the approval, and the surrounding controversy, of aducanumab last year. That NCD stipulated that all therapies in the same class as aducanumab would only be covered by Medicare under a mechanism known as Coverage with Evidence Development which only allows for coverage in the context of a randomized controlled trial.

Eisai, the Alzheimer’s Association, and many other stakeholders are already making the case for lecanemab to be removed from the constraints of the NCD so that the estimated 1.2 million patients with early AD or mild cognitive impairment can access this therapy as soon as possible.

The AAN has been heavily involved in this space since prior to the approval of aducanumab in May 2021 and has already begun outreach to CMS and other key stakeholders in order to best represent our members’ interests as these new therapies emerge. 

Apply for 2023 Palatucci Advocacy Leadership Forum continued from cover

selected to participate. They will be assisted by 10 advisors and four faculty who have graduated from the program.

The Palatucci Advocacy Leadership Forum teaches neurologists how to:

ƒ Promote state and federal legislation

ƒ Be more confident in public speaking and in front of a camera

ƒ Organize and reinvigorate state neurological societies

ƒ Lobby for fair reimbursement

ƒ Help draft position statements that affect future legislation

For more information or to apply, visit AAN.com/PALF 

AMERICAN BRAIN FOUNDATION

American Brain Foundation Accelerates Efforts in 2023

The American Brain Foundation exists to fund vital research across all brain diseases in pursuit of improved treatments, prevention, and cures. To date, the Foundation has provided more than $34 million to aid nearly 300 researchers investigating a broad spectrum of brain and nervous system disorders. As we enter 2023, we plan to further our commitment to our belief that by curing one disease, we will cure many through the following accelerated efforts:

ƒ Funding a new class of Next Generation Research Grant recipients to support innovative investigations by the best and brightest early-career researchers

ƒ Continuing our Cure One, Cure Many program to provide large-scale catalyst funding to the world’s top researchers for multiple disease areas

ƒ Investing in the future of neurology with a new research grant, the Clinical Research Training Scholarship in Peripheral Neuropathy

ƒ Ensuring everyone has access to diagnoses and treatments through continued investment in the Health Disparities research fund

ƒ Bringing together patient organizations and neuroscientists to address the urgent need for research into neuroinflammation, a crucial underlying mechanism that contributes to many neurologic diseases

ƒ Galvanizing the public to support brain disease research

Learn how you can support us in 2023 by visiting AmericanBrainFoundation.org. For every research study we can fund, we take another step closer to a future without brain disease. 

Applications Open for Certification in Neuro-oncology

The United Council for Neurologic Subspecialties is now accepting applications for certification in Neuro-oncology through April 1, 2023. The four-hour, 200 multiplechoice question certification exam will take place the week of October 16 through 20, 2023, and will be administered online with virtual live proctoring. There are currently 301 physicians certified in the neurologic subspecialty of Neuro-oncology.

The 2023 examination schedule is:

ƒ Application Period: January 1–April 1

ƒ Extended application deadline ($500 fee applies): April 1

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Examination registration period: June 1

ƒ Examination Week: October 16–20

Visit UCNS.org/NOcertification for more information on eligibility and to apply. 

Resident Sought to Join Continuum Editorial Board

AAN member residents are encouraged to apply to serve on the Continuum® Editorial Board. The Editorial Board provides oversight of Continuum: Lifelong Learning in Neurology ®, the official CME journal of the AAN, and Continuum® Audio. It is responsible for providing input on the direction of Continuum, for topic and guest editor suggestions, and review and evaluation of issues in accordance with the ACCME.

One resident will be selected to serve a two-year term on the Editorial Board starting on July 1, 2023, representing the perspective of Junior members of the Academy for Continuum, which is provided complimentary to all Junior members. The resident member is expected to attend editorial board meetings in the spring and fall during their term. Eligible applicants should be starting their PGY-3 or PGY-4 year training in July 2023 (or PGY-4 or PGY-5 if in child neurology residency).

“Continuum really lives up to its name in delivering the highest quality clinical education to neurologists, across the full spectrum of our careers. Having trainees serve on our Editorial Board gives us access to their valuable perspectives. It’s also a distinctive opportunity for residents to learn about academic publishing and to connect with esteemed neurology clinicians and educators,” said Continuum Editor-in-Chief Lyell K. Jones, MD, FAAN.

To apply, candidates should submit a one-page letter of interest, CV, and a letter of recommendation from their program director or department chair. For more information or to apply, contact Amanda Doering, Continuum Managing Editor, at adoering @ aan.com by April 1, 2023. Applicants will be notified of selection by May 15, 2023. 

Jones

DATES & DEADLINES

JANUARY

January 1

Applications Open: UCNS Neuro-oncology Certification UCNS.org/NOcertification

January 19

Applications Open: Palatucci Advocacy Leadership Forum AAN.com/PALF

January 24

Free Webinar: Ask Me Anything About MVPs AAN.com/MVPwebinar

January 31

Application Deadline: UCNS Accreditation UCNS.org/Accreditation

FEBRUARY

February 1

Submission Deadline: Emerging Science Abstracts AAN.com/23Abstracts

Applications Open: UCNS Clinical Neuromuscular Pathology Certification UCNS.org/CNMPcertification

February 2

Early Registration Deadline: 2023 Annual Meeting AAN.com/AM

February 14

Free Webinar: Health Care Equity for Neurologists AAN.com/HealthCareEquityWebinar

February 14–20

RITE® (Residency In-service Training Exam) AAN.com/RITE

MARCH

March 5–7

Neurology on the Hill AAN.com/NOH

March 13 Happy AAN 75th Anniversary!

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ACADEMIC NEUROLOGY has unique challenges…

And only the AAN has the unique tools and resources to address the specific needs of all academic constituents— across all departments, levels, and roles. Access these resources at AAN.com.

March 14

Neurology Compensation and Productivity Survey Begins AAN.com/Benchmark

March 28

Application Deadline: Palatucci Advocacy Leadership Forum AAN.com/PALF

March 30

Advanced Registration/Hotel Deadline: 2023 Annual Meeting AAN.com/AM