n Commentary | From the Desk of the President
My Phone Rings from Time to Time
Michael H. Heggeness, MD, PhD
Baylor College of Medicine
My phone rings from time to time. More often I receive an email. The
general format is: “Now that you are president of NASS, what are you going to do
about (pick one): tort reform, SGR, coverage for procedure X, Obamacare, PODs,
global warming, or the stability of the euro?
These requests are usually (but not
always) over advocacy issues having to do
with physician reimbursement in one form
or another. The questions are sometimes
rather obviously biased and self-serving,
sometimes grand and glorious, usually
quite worthy, and often very insightful.
Such issues are indeed part of the NASS
mission to foster “the highest quality ethi-
cal, value-based and evidence-based spine
care through education, research and
Yes, reimbursement issues and national
health policy bear significantly on our mis-
sion. For a spine care specialist to be paid
fairly for the effort expended in delivering
care is important. At the moment, my in-
stitution nets approximately $30 an hour
when I see Medicare patients in my office.
The crisis is not “brewing,” as the media
would say. It is upon us.
At the moment, I feel that I am reason-
ably compensated for the work I do, con-
sidering the effort that went into my career.
That effort included two decades of straight
As and increasing debt in high school, col-
lege, grad school, postdoctoral fellowship
and medical school. Formal schooling was
followed by a stint in the salt mines (six
years of residency and fellowship). Now,
I face the daily technical challenge of de-
compressing spinal nerves. With this work
in mind, an honest spine surgeon can still
earn a fair (academic) wage. Unfortunately,
this is extremely unlikely to remain true
for much longer. It is certainly no longer
true for most of our members who are not
Unfortunately, while NASS is a large
and successful professional medical association, there are real limits to what we
can accomplish in the politically roiled and
partisan national arena. The total membership of the society is now over 7,000. Of
these, 5,900 reside in the United States and
could presumably cast votes in federal, state
or local elections.
As a nonprofit professional medical association, we can only devote, at most, 10%
of our annual funds toward advocacy issues.
Our separately funded political action committee (SpinePAC: www.spine.org/forms.
BackThePAC.htm) also regularly solicits
contributions. SpinePAC can and does use
all donated funds for advocacy. My sincere
thanks go to all who have donated. If you
are reading this and have not donated,
please give this strong consideration. Our
advocacy volunteers are extraordinarily
hard working, well informed and dedicated.
Yes, the remarkable members who devote
time to advocacy (and all other NASS activities) are not paid for their time and effort.
They deserve our thanks.