2023 July AANnews

REGISTRATION STILL AVAILABLE FOR THIS MONTH’S SUMMER CONFERENCE

Emergency and Hospital Neurology

You still can register to attend this month’s AAN Summer Conference: Emergency and Hospital Neurology, set to take place July 28 and 29 both live online and in person at the Hyatt Regency in the Academy’s hometown of Minneapolis, MN. No matter how you attend, you can expect a lively two-day program dedicated to the most up-to-date information on the critically important topic of emergency and hospital neurology.

Tailored to the needs of the consultant neurologists at both tertiary and community practices, the curriculum will highlight the latest in clinically relevant scientific advances and casebased updates in all important neurohospitalist and neurocritical care topics. Gain knowledge that you can put to use after the conference from sessions that will optimize practice, teaching, and quality improvement.

July 28–29, 2023 AAN.com/Summer

AAN Advocacy: Where We Stand

Rufus Miles was not a neurologist. He was an administrator in the US federal government in the mid-to-late 20th century who created the maxim known as Miles’ Law, which states, “Where you stand depends on where you sit.” This adage succinctly describes the nature of politics, where interests can be singular, mutual, or competitive—and where you stand depends on which side (or sides) of an issue you find yourself sitting.

AAN leadership, member volunteers, and Academy staff have been working diligently on an array of issues affecting the practice of neurology and quality patient care. At the beginning of 2023, with the input of members who participated in our survey on their top concerns, three leading issues were identified as key action priorities, along with secondary topics the Academy is closely watching and addressing as needed.

Continued on page 7 ›

Applications Now Open for 2024 AAN Awards

Continued on page 5 ›

Applications are now being accepted until November 2 for 2024 AAN awards, which recognize outstanding achievements across career levels. The AAN values your unique contributions to the field of neurology and awards offer opportunities to be honored during conferences, receive travel stipends, or present your work to your colleagues.

New this year are special filter options, allowing you to sort awards by location, applicant type, career level, or practice setting to find the perfect award for you!

Visit AAN.com/Awards to learn more and apply. 

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

July Highlights

9

Meet Your New Board Member: Gregory J. Esper, MD, MBA, FAAN

Gregory J. Esper, MD, MBA, FAAN, is professor of neurology at Emory University School of Medicine and is a general neurologist. He earned his medical degree at Vanderbilt University, completed neurology residency at Washington University in St. Louis, and finished a clinical neurophysiology fellowship and a clinical research fellowship in electrical impedance myography at Harvard University's Beth Israel Deaconess Medical Center.

10

McClean Named First Recipient of New Leadership Development Award Honoring Cascino

Jeffrey C. McClean II, MD, FAAN, has been named the first recipient of a new Terrence L. Cascino Award for Physician Leadership.

10

Picture This: Your Artwork on the Cover of Neurology: Clinical Practice

Neurology ® Clinical Practice seeks original art for its issue covers in 2024!

The End of the PHE: Persevering and Thriving in Neurology

It’s now been three and a half years since we first heard about the mysterious virus that was rapidly causing severe respiratory illnesses in people and an alarming number of deaths. It soon became clear this was not just a common influenza but a horrifyingly deadly pandemic that gripped the world and changed how we lived and how we worked. Every country, state, province, and municipality wrestled with how to react to the COVID-19 pandemic and how to best help its citizens.

In the United States, the Health and Human Services Secretary announced a Public Health Emergency (PHE). Congress swiftly passed legislation to assist businesses and individuals. Regulatory agencies reviewed policies to reduce obstacles, including those affecting health care. “Pivot” became the new buzzword in business planning.

ƒ Submitted comments in response to the Drug Enforcement Agency’s proposed rule regarding prescribing of controlled substances via telehealth

ƒ Provided input for an updated CONNECT for Health Act

We’ve successfully engaged our membership in pushing for expansion as well. Telehealth was one of the AAN’s asks during 2022’s Neurology on the Hill and members enthusiastically responded to our five grassroots campaigns with nearly 10,000 letters sent to their representatives in Washington, DC.

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

News Briefs

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 40,000 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.

New DEA Training Requirement

The Consolidated Appropriations Act of 2023 enacted a new, one-time, eight-hour training requirement for all providers registered with the federal Drug Enforcement Administration (DEA). The training is on the treatment and management of patients with opioid or other substance use disorders.

Beginning June 27, 2023, the DEA will require practitioners to affirm that they have completed the new prerequisite on their DEA initial and renewal registration forms. Learn more about resources at AAN.com/Education to help members satisfy this requirement.

Pediatric Specialty Loan Repayment Program

The federal Health Resources and Services Administration has created a loan repayment program for those in pediatric specialties. The AAN has advocated for this program and is pleased to see it come to fruition. Applications for the program are due July 20. Learn more at https://bit. ly/43X7V5G and spread the word about this program to those who may qualify.

Section Meetings

Virtual business meetings for the AAN’s 41 Sections were held in May and June. Check SynapseSM Member Communities at https://synapse.aan.com/home for the latest discussions in your section. 

Early in the PHE, your AAN created the COVID-19 Neurology Resource Center and developed a wealth of resources to help members deal with urgent situations like quickly implementing telehealth visits and safely reopening their practices to inperson visits. We provided guidance about the federal funding and loans available to help keep their practices running and pay employees. In 2020, we offered free webinars to prepare members for Telemedicine and COVID-19, Financial Support for Practices, and Key Considerations for Reopening a Neurology Practice. To date, the AAN’s “Telemedicine and COVID-19" webinar is one of the most-viewed webinars, with over 15,000 views. In all, our COVID-19 Neurology Resource Center logged more than 200,000 page views.

On Capitol Hill, the AAN was a strong proponent of legislation that would expand the telehealth flexibilities allowed under the PHE. As Congress has looked for ways to continue these flexibilities, the AAN has endorsed several proposed bills, including:

ƒ Advancing Telehealth Beyond COVID-19 Act (H.R. 4040)

ƒ Telehealth Extension and Evaluation Act (S. 3593/H.R. 7573)

ƒ CONNECT for Health Act (S. 1512/H.R. 2903)

ƒ Telehealth Modernization Act (S. 368/H.R. 1332)

ƒ Telehealth Extension Act (H.R. 6202)

ƒ Protecting Access to Post-COVID-19 Telehealth Act (H.R. 366)

ƒ Protecting Rural Telehealth Access Act (S. 1988/H.R. 5425)

ƒ Permanency for Audio-Only Telehealth Act (H.R. 3447)

Most recently in 2023, the AAN has:

ƒ Signed on to a stakeholder request that the Centers for Medicare & Medicaid Services harmonizes deadlines impacting Medicare telehealth

ƒ Delivered comments to CMS about additional services that should be included on Medicare’s permanent list of telehealth services

Congress passed the Consolidated Appropriations Act, 2023, which expanded Medicare telehealth flexibilities, including audio only, for two years through December 31, 2024. While this helped eliminate the threat of a sudden end to telehealth flexibilities at the end of the PHE, the AAN will continue to advocate for a permanent expansion before the end of the 118th Congress. Further, many of the pandemic-era telehealth flexibilities— notably expanded services reimbursement—will be determined by CMS for 2024. The AAN will continue to gather member feedback to use in advocating for adequate coverage and reimbursement from the regulatory agency. To help members navigate the post-PHE federal policy landscape, the AAN has produced a summary outlining key telehealth deadlines.

In the early days of the PHE, the AAN worked to rapidly formulate recommendations for regulators across the Department of Health and Human Services and decision makers in the White House concerning the need for relief from regulatory burdens so that providers could focus on patient care. We stressed the importance of loosening of regulatory restrictions on telehealth, the paramount significance of ensuring adequate personal protection equipment and other resources to allow for continuity of care, and the urgency surrounding expedited financial relief for practices. As the PHE continued, the AAN worked to communicate key learnings that stemmed from practice changes during the PHE to policymakers. The AAN also provided formal comment on the need for permanent changes impacting telehealth and the need for a sustainable payment system to promote workforce sustainability.

Many members likely know that neurologists were early adopters of telehealth, principally with the expansion of telestroke prior to the pandemic. Today, neurology experiences higher telemedicine use among medical specialties, bringing care to patients for whom access is limited by geography, transportation, and/or health status.

In April 2021, the AAN’s Telehealth Subcommittee was launched under the Medical Economics and Practice Continued on page 4

Jackson

The End of the PHE: Persevering and Thriving in Neurology continued from page 3

Committee. In the two years since its inception, the subcommittee has produced numerous resources for members, including disease-specific exam guides, case studies, and policy summaries as the telehealth policy landscape continually evolves. They are available at AAN.com/telehealth. A series of educational teleneurology videos targeted at neurology residents is forthcoming.

I am a firm believer in silver linings, and while not minimizing the horrors and disruptions of the pandemic, there were some significant upsides that emerged over time. I asked a couple of my colleagues who were deeply involved in our PHE work what positives they drew from the last three years.

Dr. Bruce H. Cohen, who chairs the Advocacy Committee and is a member of our Board of Directors, shared with me, “We got to spend more time with our families allowing us to appreciate the art of life, focusing on the things that mattered, and putting aside what did not matter. In our professional life, we were able to foster new friendships via Zoom meetings, despite the drawbacks of the technology. In terms of patient advocacy, we cut through 10 years of administrative, regulatory, and legislative hurdles to get us ahead on telehealth, almost overnight. Within weeks, neurologists became adept at performing physical exams using telehealth services. It made it much easier for patients with neurologic conditions (physical or cognitive) to access medical care. That new access allowed me to conduct office visits with patients in our respective homes, bringing a new aspect to the physician-patient relationship.”

Dr. Brad Klein, also a Board member and chair of our Medical Economics and Practice Committee, noted, “While COVID-19 was devastating to so many patients and their families, a few potential silver linings did emerge. The pandemic catalyzed the adoption and acceptance of telehealth. It improved access to neurology services, particularly for patients in remote areas, reduced travel time and costs, and provided a convenient option for patients who may have difficulty physically visiting a clinic. Even though

AAN to Show Support for World Brain Day 2023: Brain Health

and Disability

we knew socioeconomic status, race, and other factors impacted health, the pandemic made these inequities even more blatant, requiring us to think more aggressively about health inequity at the bedside, from a population health perspective, and logistically for services like telehealth. The pandemic highlighted the importance of patient engagement and digital education in health care. Digital platforms, social media, and online resources helped patients become more empowered, with increased awareness and interest in their health. Neurologists showed remarkable resilience in their response to the crisis. They swiftly adjusted their practices, embraced telemedicine to ensure continuity of care, and became adept at rapidly acquiring and assimilating new information, staying up to date with ever-evolving scientific guidelines and research, as well as rapid legislative and regulatory changes. We developed stronger support networks, leaning on our colleagues and communities for guidance, collaboration, and emotional support. Emerging from the pandemic, we found new strength and resolve to provide the best possible care for our patients, no matter the circumstances.”

I think what Dr. Klein said bears repeating: “we found new strength and resolve to provide the best possible care for our patients, no matter the circumstances.”

We came to neurology because we embraced the unique challenges of brain disease and the desire to treat and cure them. We have continued in neurology despite the frustrating challenges inherent in our health care environment. If we indeed resolve to provide the best possible care for our patients, no matter the circumstances, we shall persevere and thrive in neurology. 

The AAN is gearing up to show its support for the World Federation of Neurology’s 10th annual World Brain Day: Brain Health and Disability on July 22 through a number of promotions. BrainandLife.org is building awareness around the day and the Academy is promoting the yearly event to its 40,000 members to encourage them to participate. This year's theme is designed to inspire a global initiative to close the gaps in disability awareness and reduce neurologic health care barriers. World Brain Day’s key aims are prevention, awareness, access, education, and advocacy. For more information about World Brain Day 2023, visit WFNeurology.org/world-brain-day-2023 

BRAIN DAY 2023 WORLD

Carlayne E. Jackson, MD, FAAN President, AAN

cjackson@aan.com @CarlayneJackson on Twitter

Registration Still Available for This Month’s Summer Conference

continued from cover

Programming includes:

ƒ Case-based updates in several areas including status epilepticus, intracerebral hemorrhage, arterial ischemic stroke, and more

ƒ Global talks on health disparities, inpatient neurology, neurology resident training, and wellness among physicians and trainees

ƒ Three case-based programming tracks in neurocritical care; hospital neurology topics; and business, training, education, and wellness, as well as diversity, equity, and inclusion

ƒ Hands-on skill building sessions on brain death, burnout, neurosonology, device programming 101, and point-ofcare EEG technology

ƒ Exhibit Hall offers the opportunity to network with organizations that are at the forefront of advancing patient care

Those looking to attend live online will enjoy a streamlined experience with seamless communication between the mobile and virtual platforms, as well as the ability to create agendas, view schedules, livestream sessions, watch recordings, view posters, and message other attendees all on your mobile device and desktop.

Visit AAN.com/Summer to learn more and secure your spot today! 

July

The conference will be co-directed by (L to R) Casey S.W. Albin, MD; S. Andrew Josephson, MD, FAAN; and Mark Milstein, MD, FAAN.

AAN Advocacy: AAN Advocacy: Where We Stand continued from cover

Below is where the AAN stands on these main issues.

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 Newss

ƒ The AAN submitted a Formal National Coverage Determination (NCD) Reconsideration Request to the Centers for Medicare & Medicaid Services regarding the existing NCD on Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease [CAG-00460N]. The AAN had originally submitted a request on February 2 and has been engaged in frequent communication with CMS since submission to refine and expand on our recommendation to promote access for appropriate patients if lecanemab were to receive traditional approval in the coming weeks.

ƒ Take action! Both the House and Senate are leading letters to CMS urging the swift finalization of a rule on prior authorization. The letter also encourages CMS to make additional updates that would align the rule more closely with the Seniors’ Timely Access to Care Act introduced last Congress. Visit AAN.quorum.us/campaign/48593/ and tell your legislators to sign onto the letter and support prior authorization reform.

ƒ With many state legislatures' 2023 sessions coming to a close, the Michael J. Fox Foundation (MJFF) for Parkinson’s Research has made tremendous progress advancing legislation to enact Parkinson’s disease registries in states across the country. To date, registries have been passed/established in California, Maryland, Nebraska, South Carolina, Utah, Washington, and West Virginia.

The AAN has been active in supporting this important initiative to advance Parkinson’s disease research. If you are interested in helping your elected officials learn more about Parkinson’s policy and research priorities, join the MJFF’s policy network at michaeljfox.org/advocacy and follow #AANadvocacy for more updates.

Issue in Focus

On June 4, President Biden signed into law the bipartisan deal lifting the debt ceiling until 2025. While we applaud the bipartisan effort to prevent the nation from defaulting on our debt, the deal presents some concerns to the research community as it creates stifling caps on FY24 and FY25 non-defense discretionary (NDD) spending.

NDD spending is the source of funds for NIH, AHRQ, FDA, and other research agencies, and in whole represents less than one-sixth of the federal budget. NDD funding is slated to freeze at $637 billion―$1 billion below the current FY23 levels. These caps will make it incredibly difficult to fund essential medical research at NIH, which was already on track to outpace the allocated funding.

The AAN was pleased to see that veterans’ health funding is set at President Biden’s requested level, with defense funding seeing an increase of about three percent over FY23 levels. While we are reassured with the FY23 funding for the VA Neurology Centers of Excellence, we will continue advocating for increased funding with our patient group partners.

Following passage of the debt ceiling deal, congressional appropriators have begun conversations on specific allocations for the various bills they are required to pass in regular order before January 1. If they fail to pass these bills, there will be a mandatory cut of one percent across all programs for the next fiscal year as imposed by the debt limit deal. The budget outline for FY24 and FY25 allows for a one-percent growth each year and includes a nonbinding outline for FY26–29 funding. 

Action on these priorities has taken many forms, from meeting with members of Congress and regulators at the Centers for Medicare & Medicaid Services, to authoring comment letters or signing support letters with collaborating organizations. We have also invited your direct participation through Action Alert emails that provide a quick and effective way for you to contact your members of Congress and express your views. To view a more comprehensive list of actions taken on your behalf on these priorities and other issues, visit AAN.com/advocacy/ priority-issues

REGULATORY BURDENS:

The AAN is fighting to reduce regulatory burdens.

Physicians, including neurologists, face growing administrative requirements from the federal government, insurers, and their institutions. Despite the medical community constantly working toward providing more efficient high-quality patient care, they are forced to adhere to many redundant and ineffective processes. Neurologists need relief from overwhelming regulatory requirements so they may prioritize caring for patients with complex diseases of the brain and nervous system.

Physician Wellness

Physician wellness and mental health has always been critical when addressing workforce challenges, but it has become even more pressing in the wake of the COVID-19 pandemic.

The AAN has supported efforts to increase access to mental health services, like the Dr. Lorna Breen Health Care Provider Protection Act, and advocates for policy changes that are conducive to physician wellness. These efforts ensure that physician health is not forgotten as our members care for their patients, and that physicians are able to stay in the workforce to provide their much-needed expertise.

ACCESS TO CARE:

The

AAN advocates for access to high-quality neurologic care.

Telehealth

The AAN believes that telehealth will continue to play an essential role in the care of patients with neurologic conditions.

The AAN supports coverage of telehealth services regardless of patient location, equitable provider reimbursement, simplified state licensing requirements, and expanded telehealth research and quality initiatives.

Drug Costs and Access

Prescription drug prices continue to rise. Drugs that treat complex, chronic conditions like Alzheimer’s disease, Parkinson’s disease, epilepsy, and migraine, and specialty drugs that require special handling or administration, such as those used for multiple sclerosis, are particularly expensive.

The AAN supports action to ensure that prescription medications are accessible for patients with complex, chronic neurologic conditions; and potential solutions which may include price negotiation and transparency.

The AAN supports reducing physician regulatory and administrative burdens such as prior authorization, step therapy requirements, and other administrative tasks so that neurology providers can spend less time on administrative tasks and more time on patient care.

NEUROLOGY WORKFORCE:

The AAN supports strengthening the neurology workforce.

Reimbursement

Our current Medicare payment system is broken. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which began as a well-intended and widely supported fix to previous issues in the payment system, is now fraught with barriers to patient access to care. These issues are compounded by the lack of an annual inflationary update for physician payment. Due to these widespread payment issues and other added workforce challenges, neurology practices continue to struggle to stay afloat and provide care to their patients.

The AAN is committed to payment reform efforts to promote a sustainable payment system and to working with regulators and legislators to ensure that the work done by neurologists is appropriately valued.

Immigration

The AAN values our diverse membership and the compassionate care that our members provide to patients around the world. Immigration policy is an important part of addressing the issues facing the neurology workforce in the United States. With international medical graduates (IMG) making up 31.5 percent of the active neurology workforce, these members are essential to providing quality neurologic care to patients across the country.

The AAN supports the reauthorization of the Conrad 30 program, including improvements such as increasing the number of waivers and creating additional employment protections. This allows more IMGs to provide quality neurologic care to patients in rural and underserved areas across the country. 

AAN members Andrew Sefain, MD, and Susan L. Scarberry, MD, FAAN, (foreground) shared neurology concerns with Rep. Kelly Armstrong (R-ND) (rear left) and an aide during the 2023 Neurology on the Hill.

Axon Registry 2022 MIPS Results Released

One of the many benefits of Axon Registry ® participation is that it provides participants with a solution to submit Merit-based Incentive Payment System (MIPS) reporting to the Centers for Medicare & Medicaid Services (CMS). The 2022 MIPS submission period ended on March 31, 2023.

For the 2022 MIPS submission period, 30 practices used the Axon Registry to submit their MIPS reporting. Thirteen practices submitted MIPS individual reporting, 19 practices submitted MIPS group reporting, and two practices submitted in both reporting types. During the 2021 MIPS submission cycle, 38 practices used the Axon Registry to submit their MIPS reporting. The number of practices submitting MIPS via Axon Registry for 2022 went down from that in 2021 because more practices applied for the 2022 MIPS hardship exemptions than for 2021 MIPS.

The estimated average score for practices that submitted MIPS reporting for all three categories (quality, improvement activities, and promoting interoperability), through the Axon Registry for the 2022 MIPS submission period was 66.56 points. Participants that use the Axon Registry for MIPS

submission can submit for three out of the four categories of the MIPS program. The fourth category, cost, uses Medicare claims data to calculate performance, which means clinicians and groups do not have to submit any data. The cost data usually becomes available in the late summer.

The MIPS final score will be between 0 and 100 points. Payment adjustments will be dependent on the overall performance of clinicians. Though the MIPS quality category requires the submission of six quality measures, most submissions included more than six quality measures, which aids in benchmark creation for future reporting years.

To enroll in or learn more about the Axon Registry, visit AAN.com/axon or contact registry @ aan.com 

Meet Your New Board Member: Gregory J. Esper, MD, MBA, FAAN

Gregory J. Esper, MD, MBA, FAAN, is professor of neurology at Emory University School of Medicine and is a general neurologist. He earned his medical degree at Vanderbilt University, completed neurology residency at Washington University in St. Louis, and finished a clinical neurophysiology fellowship and a clinical research fellowship in electrical impedance myography with Dr. Seward Rutkove at Harvard University's Beth Israel Deaconess Medical Center. He earned his MBA from Emory’s Goizueta Business School in 2009. Esper was recently recognized in Emory’s Physician Group Practice as a Diamond Provider, earning 99-percentile patient satisfaction ratings.

How did you initially get involved as a volunteer member for the AAN?

Early in my time at Emory, I was asked to be the medical director of our outpatient clinics, and began to get involved in the operations, finances, and electronic medical record deployment. I was looking for resources on the AAN website and came across the Medical Economics and Management (MEM) Committee. I emailed Amanda Becker, who was then the staff liaison. I mentioned my interests and reasons for wanting to join the group, and I was added to the listserv initially, and was invited by Dr. Laura Powers as a guest to one of the MEM meetings in early 2008. I was warmly welcomed by Dr. Powers and met Drs. Orly Avitzur, Neil Busis, Joel Kaufman, Marc Raphaelson, Peter Donofrio, Marc Nuwer, Dan Hier, and others. I was, well, in a word, “starstruck ”! These were major contributors to the AAN and the practice of neurology, and I had an opportunity to learn from and contribute alongside them.

and that happened because the board has always taken an expansive view of neurology and has created a fertile field of opportunities that create the best environments for people to grow in a myriad of ways. I’ve both experienced that and seen that with many of my colleagues. There is no greater honor than to contribute to that cycle of growth, and for the opportunity to pay it forward, I am very fortunate. Many neurologists who are early in their career look to differentiate themselves. Mid- and late-career neurology clinicians, educators, and researchers struggle in this constant change that is the world of health care and science but still have lofty professional goals and desires. I hope to positively influence the landscape and resources that can reduce barriers and improve flow.

What experiences and viewpoints do you bring to this role?

AANe-news. Because Your Time Is Valuable.

Sent to your email address the second and fourth Wednesday of each month, AANe-news™ delivers the latest top headlines and resources from the Academy so you can quickly scan and connect directly with the information you need to know. Another members-only solution from your AAN.

Now, 15 years later, I look back on those early moments and count myself so fortunate to have sent that email to Amanda. I’ve been able to sit next to Lyell Jones, work with Brad Klein, socialize with Allison Weathers and Dave Evans, and watch new leaders like Pearce Korb contribute in unforeseen ways. My time in MEM (now the Medical Economics and Practice Committee, or MEP) and its subcommittees have been so formative in my professional life, and the personal relationships forged during these years have been priceless.

Why did you wish to be on the Board of Directors?

I knew that April 2023 would be the end of my time as chair of the Health Services Research (HSR) Subcommittee and as a member on MEP. I still had an inner desire to continue to serve the AAN and its members in deep and meaningful ways. The AAN has been so formative in my own career,

I’ve been fortunate to have experiences as a general neurologist in practice on the front line and as an academic health system executive at Emory. I’ve learned that the best way to approach a situation is to ask, “What problem are we trying to solve?” The most important aspects of change begin with going to the place where the work is done to see, hear, and feel that which people who do the work experience. I have also learned so much from my HSR colleagues, especially Brian Callaghan, Kavita Nair, John Ney, Chloe Hill, and Adam de Havenon. In addition to passionate devotion and rigorous approaches to HSR science, fostering the ability to dialogue with spirit and candor towards the best overall outcome is critical for individual and team success. Most of all, I’m aware that nothing can be done without an aligned team who moves together towards a unified vision. 

McClean Named First Recipient of New Leadership Development Award Honoring Cascino

Jeffrey C. McClean II, MD, FAAN, has been named the first recipient of a new Terrence L. Cascino Award for Physician Leadership. The award was created to honor Cascino’s legacy with leadership development at the AAN, where he has served as the Leadership Development Committee Chair since the committee’s inception in 2015 until this past April. During his 10-year term, Cascino was instrumental in building and expanding the AAN Leadership Development offerings. He also served as AAN president from 2015 to 2017. “This award means so much to me, and I am deeply honored to be its namesake,” said Cascino. “Not only does the mission of the award align closely with the AAN’s core values—particularly communication, leadership, and professionalism—but moving forward it helps ensure the health of the global neurology community, and enhances member satisfaction, well-being, resiliency, and engagement by promoting outstanding, highly dedicated physician leaders both in the field of neurology and at the AAN.”

As such, McClean couldn’t have been a better choice for its inaugural recipient. A distinguished alumnus of the 2013-2014 Emerging Leaders Program, "McClean has demonstrated exceptional leadership, embodies the AAN’s core values, and has made noteworthy contributions to supporting the AAN’s mission and vision,” added Cascino.

LEADERSHIP DEVELOPMENT AAN

Since graduating from the program 10 years ago, McClean has been heavily involved with the AAN, serving on the Joint Coordinating Council on Equity, Diversity, and Inclusion; the IDEAS Subcommittee; the Member Engagement Committee; Brain & Life® Editorial Advisory Board; and as vice chair— and now as the new chair—of the Leadership Development Committee. McClean also recently was elected to the AAN Board of Directors. Outside the AAN, McClean serves as the chair of the Department of Medicine at Brooke Army Medical Center, where he oversees the largest clinical department in the largest, busiest hospital in the Department of Defense Health System.

“Terry Cascino has been at the forefront of the AAN’s visionary and transformational effort to identify and develop future leaders that will be critical to the future success of our organization and the field of neurology, “said McClean. “I am certainly a beneficiary of the AAN Leadership programs, and I’ve had the incredible opportunity to work on implementing this vision with Terry over the last several years, during which he has also been a mentor and friend. I am both humbled and honored to be the first recipient of this award that recognizes Terry’s tremendous accomplishments as a physician leader.”

Over the past decade, more than 350 AAN members have graduated from the AAN’s Leadership Development Programs to create an engaged and diverse alumni community. Many have become leaders within the AAN, with over 40 percent of graduates serving in current AAN committee, subcommittee, and board of director roles. Visit AAN.com/Lead to learn more. 

Picture This: Your Artwork on the Cover of Neurology: Clinical Practice

Neurology® Clinical Practice seeks original art for its issue covers in 2024! Submit your original digital image by November 1 for a chance to have it featured on a cover next year. If your artwork is selected, it will be included on a web page highlighting the winners, images, and covers in a virtual showcase. You also will receive a complimentary copy of the print journal featuring your artwork. Learn more at cp.neurology.org/cover-art 

Applications Open for 2024–2025 Health Care Equity Program

Inclusion is the reason the AAN was founded. The AAN is firmly committed to embracing the diversity of our members, staff, and the communities they serve, and affirms the need for equity and inclusiveness in our organization, our profession, and the care we provide for our patients. In this column, we share the wide spectrum of diversity, equity, and inclusion (DEI) work being done across the AAN.

The AAN seeks members who are actively certified neurologists residing in the United States or Canada to apply for the AAN Health Care Equity Program. The selected individuals will participate in a multi-faceted program guided to continue personal development and to help the participants create a customized roadmap aimed at mitigating health care disparities. Applications for the 2024–2025 program are open until November 2.

The program will kick off at the 2024 Annual Meeting and will meet virtually three times until graduation in March 2025. Cohort members will work on individual projects to mitigate health care disparities at their own institutions. At the end of the program, recipients will have gained knowledge on health care disparities and learned tools and resources they can put into action at their own institutions.

Participants are required to attend the 2024 Annual Meeting in Denver, virtual workshops, and cohort individual project calls. Along with complimentary registration for the 2024 Annual Meeting, participants will also receive a $1,000 award and recognition from the AAN.

The AAN Health Care Equity Program is sponsored by Bristol Myers Squibb and Eisai, Inc. For more information or to apply, visit AAN.com/dei 

L to R: McClean; AAN Leadership Program Mentor Ann H. Tilton, MD, FAAN; and Cascino at the 2022 AAN Annual Meeting in Seattle.

A History of Supporting Neurologists with Lifelong Learning Opportunities

When we look back on AAN’s history of providing continuing education to its members, we return to the reason for the founding of the Academy: Dr. Joseph Resch’s complaint to Dr. A.B. Baker that there was no organization he could belong to that would help him keep up his post-residency education on the latest developments in the field when he entered practice.

Since then, the AAN has been dedicated to educating neurologists and providing quality course curriculum to Annual Meeting and regional conference attendees, as well as through publications and online learning activities. The Academy’s aim has been, and still is, to deliver a continuing body of knowledge that sustains practicing neurologists, academicians, and residents alike—as well as business administrators and advanced practice providers—throughout their careers.

In 1994, Robert C. Griggs, MD, FAAN, was chair of the Education Committee and worked to expand the Annual Meeting Education Program to a full five days and the variety of courses and formats continued to increase. Practice management courses were added in 2002, later joined by coding lunches, reflecting trends in medical economics and increased emphasis on running the business of caring for patients. In 2004, under Ralph F. Józefowicz, MD, FAAN, the Education Committee and its Annual Meeting Subcommittee restructured the program to be more topic-focused.

to the classes in person. Really need to focus on a specific area? Then try our virtual delivery. We also have extensive offerings for our medical students, residents, fellows, nurse practitioners, physician assistants, business administrators, and the entire neurology clinical care team.”

Regional Conferences Offer Weekend Convenience

Annual Meetings Provide Needed Education Opportunities

However, the first “special course” had to wait until the 1951 Annual Meeting in Virginia Beach. Baker’s laboratory at the University of Minnesota, under the direction of Fae Y. Tichy, MD, FAAN, prepared slides representative of various conditions, principally from tissues and blocks in its collection. Each of the 40 registrants for the first Academy special course, on neuropathology, received a set of slides prior to the meeting. Its success led to immediate expansion into an annual Special Course Program, and Baker—an esteemed educator and chair of neurology at the University of Minnesota—assumed the role of director and made all course selections for the next decade.

Maynard M. Cohen, MD, FAAN, himself a Baker protégé from the U of M and later president of the AAN, became director in 1961, and during his term the number of offerings, including neuropathology, neurophysiology, and neuroanatomy, more than doubled. By this time, syllabi and audio tapes were prepared for many courses at the Annual Meeting. In 1971, the “Meet the Professor” sessions were added, which facilitated discussions between course participants and distinguished senior neurologists.

A major change came in 1979, when President Dewey Ziegler, MD, FAAN, named Theodore Munsat, MD, FAAN, to lead the Special Course Committee. Munsat professionalized, enlarged, and diversified the program. By 1981, Annual Meeting

programming had increased from 18 to 62 programs, including full- and half-day courses as well as dinner and breakfast seminars. Skills workshops were introduced at the 1987 Annual Meeting, which recreated a clinical setting and presented techniques critical to the practice of neurology. Governance of education activities and committee responsibilities was restructured over the years to enhance efficiencies and be more responsive to the needs of members. When Stanley Fahn, MD, FAAN, chaired the Education Committee in the late 1980s and early 1990s, he turned his own skill as a clinical teacher and his ability to capture patients’ movement disorders on videotape into the first prototype, casebased informal dinner seminar. Working with C. David Marsden, MD, Fahn quickly moved from the didactic to an interactive format where seminar participants brought their own problem cases for analysis by faculty and audience.

Recognizing the crucial role of outstanding educators in neurology, the AAN in 1990 established its first non-scientific award: The A.B. Baker Award for Lifetime Achievement in Neurologic Education, sponsored by the A.B. Baker Section on Neurologic Education. It pays tribute to Baker’s vision and reputation as educator and mentor to up-and-coming practitioners and researchers.

Cynthia L. Comella, MD, FAAN, the first woman to chair the Education Committee, introduced programing for advanced practice providers, created Annual Meeting tracks, and expanded our eLearning offerings. She was succeeded by A. Gordon Smith, MD, FAAN, who helped lead the revitalization of the Annual Meeting in Vancouver in 2016, where emphasis was placed on offering a variety of teaching methods, from traditional didactic to more interactive and informal, moving courses beyond the four walls and out into hallways and open spaces of the convention centers. Instead of charging per course, attendees paid a flat fee for nearly every available learning opportunity. This has given attendees the freedom to be more flexible on-site and has been very popular.

Flexibility in education programming expanded even further post-COVID, as the Annual Meeting was presented live online, as well as in person. As Joseph I. Sirven, MD, FAAN, current chair of the Education Committee, described the 2023 Annual Meeting, “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 diseases. Even better, these courses are delivered the way you want to receive them. Are you looking to network? Then come

For a time, the AAN offered conferences on specific topics such as dystonia/botulinum toxin and stroke/TPA. To appeal to busy neurologists and practice managers unable to attend the Annual Meeting, the AAN introduced three-day weekend regional conferences with multiple topics beginning in Fort Lauderdale, FL, in winter 2002. The Fall Conference, typically held in October, has provided an update on core neurology and practice management topics. These smaller gatherings of several hundred attendees offer a more intimate education setting and enable greater chances to engage with presenters and network with colleagues.

In 2006, the conferences were revamped with new programming options, including dystonia workshops, half-day and evening update programs, educational colloquiums, and new practice management programs for neurologists and members of BRAINS (Business and Research Administrators in Neurology Society).

A summer Sports Concussion Conference was presented from 2014 to 2021 to help bring concussion education to athletic coaches and trainers, as well as neurologists.

In 2015, the Breakthroughs in Neurology Conference made its debut, focusing on the latest developments in neurologic research. In conjunction with this conference, a new Career Essentials Conference—focusing on education for early career neurologists—was held in January 2018.

Following the COVID-19 crisis, the AAN summer conference was refreshed in 2022 with the Autoimmune Neurology and Neurology Year in Review in San Francisco, and the AAN

William A. Smith, MD, FAAN; President Elect Howard D. Fabing, MD, FAAN; and A.B. Baker, MD, FAAN. 1951 Annual Meeting, Virginia Beach.

Celebrating education. 1998 Annual Meeting, Minneapolis.

Skills workshop. 1998 Annual Meeting, Minneapolis.

Former president and Continuum founder Theodore L. Munsat, MD, FAAN, with Education Committee Chair Terrence L. Cascino, MD, FAAN. Annual Meeting 1998.

A History of Supporting Neurologists with Lifelong Learning Opportunities continued

Summer Conference: Emergency and Hospital Neurology offered this month in the AAN’s headquarters city of Minneapolis from July 28 to 29.

Technology Advances Expand Self-study Opportunities

While the pandemic wreaked havoc on the traditional formats for the 2020 Annual Meeting and Summer and Fall Conferences, the AAN drew upon its extensive and successful experiences with long distance/remote learning to deliver virtual education opportunities in several ways. Thanks to a grant from the American Board of Psychiatry and Neurology’s (ABPN), the 2019 Annual Meeting On Demand was made available for free to members as they faced restricted travel, work disruptions, and financial challenges.

Self-study has long been an important education component of the AAN since it mailed cassette tapes to members in the 1970s. The self-assessment publication Continuum: Lifelong Learning in Neurology ® was launched in 1993 by Munsat to help neurologists keep abreast of the latest clinical and

from page 13

scientific developments. Subscribers now number more than 14,300 worldwide, and the AAN and publisher Wolters Kluwer provide the World Federation of Neurology with 400 copies of Continuum each year to distribute to program coordinators in various low- and low-to-mid-income countries.

The first Quintessentials® practice improvement tool, “Stroke Prevention for the Practicing Neurologist,” went online in 2000. Quintessentials allowed neurologists to compare their practices to evidence, expert opinion, and their colleagues and to stay current on treatment and practice trends.

The Internet and CD-ROM audio files were harnessed to deliver Annual Meeting educational programs via Annual Meeting On Demand and other selfassessment resources, such as NeuroSAE®, which debuted in 2007. NeuroLearn and Patient Safety Education was also made available. Many of these products were designed to help neurologists prepare for the ABPN-mandated continuing education or self-assessment components for maintenance of certification, now known as “continuing certification.” Due to members’ frustrations with the ABPN’s maintenance of certification requirements, the AAN responded on several levels, from advocating to ABPN for changes that would lessen the time burden on neurologists to developing a myriad of resources to assist members. MOC education resources were added as free benefit for members beginning in 2015. The Academy has continued to produce new education products, including NeuroBytes videos launched in 2019; NeuroPanels, launched in 2022; and NeuroReady ®

Practice management webinars were offered beginning in 2009 to help solo and small practice neurologists and business administrators understand the many changes in the health care environment, particularly with regard to coding and reimbursement as the Centers for Medicare & Medicaid Services rolled out new regulations.

The AAN's eLearning portfolio began to grow in 2010 forward with NeuroSAE, NeuroPI, and

NeuroLearn. In 2011, the Academy introduced Learning Across Your Lifetime to help members determine their continuing education requirements throughout their career, and to provide them with recommended AAN education resources to help them meet those needs, including webinars for practice managers and the APP Neurology Education Series for advanced professional practitioners.

The Academy continues to find unique ways to engage members and help them further their education, including the popular Neurology Question of the Day, which began in 2020.

Academy Prepares for Members for Leadership Roles

In 2002, the first Donald M. Palatucci Advocacy Leadership Forum was offered to members who sought to learn how to become an effective advocate for their patients and the field of neurology. Named to honor a late member of the Board of Directors who was passionate about grassroots advocacy, the Palatucci Forum has trained more than 560 graduates—including many international members.

The first Emerging Leaders Forum (now Program) class launched in 2013 was followed the next year by Diversity Leadership. Since then, the Academy has developed a wideranging Leadership Development Program that includes:

ƒ Director Mentorship Leadership Program

ƒ Diversity Leadership Program

ƒ Enhanced Resident Leadership Program

ƒ Emerging Leaders Program

ƒ Palatucci Advocacy Leadership Forum

ƒ Practice Leadership Program

ƒ Transforming Leaders Program

ƒ Women Leading in Neurology Program

These programs recognize leadership potential in AAN members and provide the tools to harness that potential and take it to the next level in their careers and communities. No other suite of programming in the country matches this caliber of leadership development that incorporates training, personalized coaching, and mentoring, tailored specifically for each leadership cohort. While many of these programs span months of learning and interaction with peers, the Academy also promotes development of skills through Leadership University, currently available at the Fall Conference and Annual Meeting.

“Viewing leadership as a learned skill that we practice and refine (as opposed to an intrinsic talent) makes leadership feel remarkably accessible to everyone,” said Thabele (Bay) Leslie-Mazwi, MD, member of the Transforming Leaders Program Class of 2019. “We are all leaders in our daily lives in some form. It might be within our families or friendship circles, within our divisions, within our departments, or at a larger regional or national level.”

Anti-racism Education Program

In 2021, the AAN was awarded a grant from the Health Equity Innovation Fund of Genentech and the Genentech Foundation to support groundbreaking solutions to promote health equity and diversity in STEM from kindergarten to career. One of 40 recipients, the Academy was the only neurology-focused organization chosen for the grant out of nearly 380 academic institutions, health systems, nonprofits, patient groups, think tanks and community organizations that applied. The resulting Anti-racism Education Program is an ondemand, self-paced anti-racism core curriculum unique for neurologists and designed to be completed over several months with built-in time for reflection. Four modules cover:

ƒ Setting the Stage: Reflections on Race, Identity, and Socialization

ƒ The History of Racism in Neurology: Member Experiences with Bias and Racism

ƒ Patient Care Stories: Vignettes in Clinical and Academic Neurology

ƒ Institutional Structures: Racism in Training and Anti-racism Leadership

Continued on page 16 ›

Continuum Editor-in-Chief Aaron E. Miller, MD, FAAN, 2012.

Sports Concussion Conference. 2015 Denver.

Breakthroughs in Neurology Conference. 2015 Phoenix, AZ.

Thabele (Bay) Leslie-Mazwi, MD

Women Leading in Neurology Program Physician Liaison Cynthia L. Comella, MD, FAAN, and Program Leadership Consultant Joanne Smikle, PhD, Minneapolis 2018.

A History of Supporting Neurologists with Lifelong Learning Opportunities continued

Support for Academic Neurology

Academic neurology departments face many challenges, including health care reform, research funding cuts, work force issues, graduate medical education funding cuts, reduced reimbursement for clinical services, increasing regulatory burden, and workforce burnout. In response, the AAN launched its Academic Initiative in 2017 under the leadership of Ralph L. Sacco, MD, MS, FAHA, FAAN, and immediately kicked off efforts by establishing a Neurology Department Chair Work Group and holding its first Neurology Department Chairs Summit in 2018. Since then, efforts have included sharing best practices on topics such as revenue generation and funding the education mission; bringing together women chairs of neurology departments and academic business administrators; developing resources for division chiefs and diversity officers; developing webinars for departments to share information on COVID response,

from page 15

financial repercussions, and reactivating departments after the initial surge; and diversity, equity, and inclusion initiatives, including a webinar on Neurology Departments Addressing Systemic Racism. The summit was renamed the Ralph L. Sacco Neurology Chair Summit in 2022 in honor of the education leader who passed away in January 2023. In 2021, leadership created an Academic Neurology Committee and four subcommittees: Department Chair Subcommittee, Diversity Officer Subcommittee, Division Chief Subcommittee, and Advancing Women in Academics Subcommittee.

“Neurology academic departments deliver clinical care to neurology patients, lead transformative cutting-edge research, and train the leaders of tomorrow in both neurology and neuroscience,” said Sacco, then chair of the Academic Neurology Committee. “Academic departments and neurologists are critical to the field of neurology and neuroscience and to patients and trainees, but they are also vital to the health of the Academy. As such, it was imperative to examine the needs of academic neurology department in a holistic manner and develop tangible resources and solutions in support of the future of academic neurology. This committee structure can support these aims, similar to the way the Medical Economics and Practice Committee focuses on the clinical and business aspects of the practice of neurology.”

A linchpin of the AAN’s efforts to cultivate future neurology professionals since 1998, the Student Interest Group in Neurology (SIGN) program introduces medical students to the specialty. There currently are 136 active SIGN chapters, with 30 of those on international campuses. These efforts align with

Since 1993, the bimonthly self-assessment publication Continuum: Lifelong Learning in Neurology® has helped neurologists keep abreast of the latest clinical and scientific developments. Continuum was created by former AAN President Theodore Munsat, MD, FAAN, who was the founding program director, and Elliott Mancall, MD, FAAN, who served as the first editor from 1993 to 2002. During the term of Editor-in-Chief Aaron E. Miller, MD, FAAN, subscriptions grew from 2,000 to more than 9,000, and Continuum received ABPN approval for lifelong learning and self-assessment components of maintenance of certification. Steven L. Lewis, MD, FAAN, followed Miller in 2013. After Lewis’s term expired, Lyell K. Jones, Jr., MD, FAAN, took the reins in 2023.

Continuum® Audio was launched in 2012 to provide deeper insights into each printed issue via discussions with article authors. Initially separate subscriptions, Continuum and Continuum Audio were bundled together for subscribers beginning in 2017.

the Academy’s goals to increase the pipeline by engaging with students so they choose neurology. We provide scholarships and programming to bring awareness, then continue to foster their career pathways by providing novel ways, resources, tools, for them to flourish as neurologists, researchers, and educators.

Innovation, Convenience, and Value

With the guidance of volunteer members who are leaders in neurology education, innovation, convenience, and value will continue to drive the creation of new resources for Academy

members. The AAN has come a long way from A.B Baker’s first education program slides, but it has never wavered from the founder’s desire to provide top-notch education and training programs for neurologists across the globe—ensuring the best possible care for our patients now and into the future. 

Diversity Leadership Program participants Richard Young, MD, FAAN; Rodney Leacock, MD; and Omotola Hope, MD, chatted at the AAN headquarters. Minneapolis, 2017.

President Ralph L. Sacco, MD, MS, FAHA, FAAN, applauded the Diversity Leadership Program presentation. Minneapolis 2017.

Fall Conference, Las Vegas 2011.

Neurology Department Chair Summit 2022.

Members in Training: Renew Your Membership for 2023–2024 Academic Year

Do you have an AAN Junior membership? If so, it’s time to renew your membership for the 2023–2024 academic year, which runs July 1 through June 30. Only by renewing now can you maintain uninterrupted access to the resources and connections you’ll need—when you need them—to enhance your training and professional development over the next year. Visit AAN.com/membership to see all the ways your membership with the world’s largest and most trusted community of neurology professionals provides valuable resources to help you bolster your patient care and professional success, and visit AAN.com/memberdues to renew today.* 

*If your training program typically pays for your AAN membership, please contact your program coordinator for assistance.

DATES & DEADLINES

JULY

July 12

Neurology Career Center Speed Networking Careers.aan.com

July 22

World Brain Day WFNeurology.org/world-brain-day-2023

July 28–29

AAN Summer Conference: Emergency and Hospital Neurology Minneapolis and Online AAN.com/Summer

July 31

Application Deadline:

UCNS Fellowship Training Program Accreditation UCNS.org/Accreditation

Submission Deadline:

UCNS Continuous Certification Reading List UCNS.org/ArticleSubmission

AUGUST

August 3

Registration Opens: AAN Fall Conference AAN.com/Fall

Where the Top Jobs and Top Talent Connect!

August 31

Early Registration Deadline: AAN Fall Conference

AAN.com/Fall

SEPTEMBER

September 14

Application Deadline: 2024 Research Program Grants AAN.com/ResearchProgram

September 28

Advance Registration and Hotel Deadline: AAN Fall Conference AAN.com/Fall