AAN Advocacy Expresses Needs of Neurology to Lawmakers and Regulators

During its early years, the AAN ’s advocacy efforts rested on the shoulders of founder A.B. Baker, MD, FAAN, and the Academy’s second president, Pearce Bailey, MD, FAAN. Bailey, whose father had been a distinguished New York neurologist, knew the circles of influence in both the Big Apple and on Capitol Hill, as he was the chief of the Neurology Section of the Veterans Administration Central Office and on staff at Georgetown University and the District of Columbia General Hospital.

Baker said of Pearce Bailey: “He probably is one of the smartest politicians who ever came to Washington. He knew everybody. He knew exactly when to move in which direction. He knew which people ought to be contacted to get things done. And his advice and help was tremendous in making the Academy move forward and getting accomplished that which would have taken us a long time without an open door to the right person or the right people who could help us get what we wanted. It was very good to have a man like Dr. Bailey on your side.”

“Abe could see the political future of neurology depended upon the establishment of an Institute,” related Francis M. Forster, MD, FAAN, in 1988. Bailey and Baker collaborated with Mary Lasker, a prominent New York socialite and medical research activist, a pair of Washington lobbyists, and several key congressional supporters to press for a single institute within the National Institutes of Health dedicated to neurology research. The NIH established the National Institute of Neurological Disorders and Blindness in November 1950.

“About the time of the [1951] Virginia Beach meeting, the director of the NIH, who was a biochemist and nutritionist, was invited to attend the meeting,” said Forster. “He was cultivated by Abe and the rest of us and the main thrust was to have Pearce Bailey, then in the VA Central Office, become the first director of the NINDB. This was accomplished.” Bailey was named director of the NINDB shortly thereafter and served in that capacity until 1959. The agency became known as the National Institute of Neurological Disorders and Stroke in 1968.

While the AAN enjoyed a close relationship with the NINDS in its early years, the institute’s increasing budget drew greater congressional scrutiny, and its mandate and the collaborative associations with the Academy and other neurology organizations became more codified and bureaucratic. The Academy helped the NINDS secure congressional support for the Decade of the Brain in the 1990s. Though the NINDS budget stands at $2.8 billion for the 2023 fiscal year (out of an NIH budget of $47.76 billion), the Academy continues to monitor appropriations closely and advocates for increases that will help spur progress in neurologic research.

Member Needs Require Legislative Focus

While Baker continued to be a significant influence in Washington, the growth of practicing neurologists and the introduction of Medicare and Medicaid in the 1960s helped lead the Academy to establish the Practice Committee, with legislative affairs as part of its portfolio.

“A.B. was our most outstanding political figure in the very early days,” recalled Herbert Rosenbaum, MD, FAAN, first chair of the Practice Committee, in 2008. “However, Jack Segerson, Ed Davis, and I also donated much of our time to advocacy affairs on behalf of the Academy. When you’re only one percent of the physician population, getting your share of the pie takes a great deal of effort and sweat. However, we did make out fairly well. I clearly recall personally testifying before a House subcommittee in the middle 1960s in an effort to promote clinical neurologists to be considered primary care physicians

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