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Paul C. Bucy

Board remarked, one would have thought that this (to them) small Journal was the most important thing they do. For many years the Journal of Neurosurgery ended each year with a balance of income over expenses. This was not a profit as the Journal is truly a not-for-profit venture. As a result of these annual fiscal accumulations the Journal gradually built up a sizable surplus. This is unusual in the operation of scientific and medical publications. In fact, many of them have to be subsidized. This accumulation of funds steadily progressed because those who

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M. Stephen Mahaley Jr., Curtis Mettlin, Nachimuthu Natarajan, Edward R. Laws Jr. and Barbara B. Peace

respect to size and type of sponsorship, although there was not necessarily a geographic representation of population distribution. Thirteen percent were classified as governmental, non-federal institutions; 5.2% were governmental, federal institutions; 79.3% were nongovernmental, not-for-profit institutions; and 2.6% were nongovernmental, for-profit institutions. Thirty-one percent of the hospitals had less than 300 beds, 41.2% had 300 to 499 beds, and 27.3% had 500 or more beds. Of the patients included in the survey, 16.4% were from hospitals with less than 300 beds

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David A. Herz

. 3, 7 Some physicians have intentionally testified for profit repeatedly. These individuals rely on such behavior to generate income, replacing their clinical practice. There is now a developing trend whereby the definition of an expert witness has been legislated into law. This has occurred in at least 11 states 3 and should continue in the process of reforming state tort (civil wrong) laws. The problem of the dishonest or less than expert witness will persist, however, until the courts and state legislatures progressively adopt realistic definitions. Until

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The Journal of Neurosurgery

Its origin and development

Paul C. Bucy

. This was not a profit as the Journal is truly a not-for-profit venture. As a result of these annual fiscal accumulations the Journal gradually built up a sizable surplus. This is unusual in the operation of scientific and medical publications. In fact, many of them have to be subsidized. This accumulation of funds steadily progressed because those who served the Journal — Dr. Eisenhardt and the members of the Editorial Board — did so largely at their own expense. For years Dr. Eisenhardt was paid an inadequate remuneration. She has never spoken of this to

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In times of change learners inherit the earth

The 1997 presidential address

J. Charles Rich

does not react to what is going on around him, he anticipates it. Neurosurgeons who are learners will also be adept at anticipating what is going on around them and where they will have to be. Foresight is especially needed as we deal with attempts by others to standardize what we do. Our four-person neurosurgical group works with a successful not-for-profit organization named Intermountain Health Care, Incorporated, which owns 24 hospitals in a four-state area. They have collected an enormous amount of data and assessed everything about us: operating room time

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prayer continues to guide us: … . In Thine Eternal Providence Thou hast chosen me to watch over the life and health of Thy creature … . Inspire me with love for my art and for Thy creatures. Do not allow thirst for profit, ambition for renown and admiration, to interfere with my profession, for these are the enemies of truth and love for mankind … . Today's chief of neurosurgery should continue to practice with the same devotion to the patient and dedication to teaching and research as those proclaimed in the Hippocratic oath and Maimonides' prayer

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Martin H. Weiss

important? Some patient advocates might agree with this premise, but corporate America does not; and they pay the bills, and they also have the greatest influence in Congress. One recent ray of optimism in this arena is the move by corporations and other purchasers of healthcare to negotiate directly with physicians and physician groups in an effort to eliminate the administrative overhead built into for-profit intermediaries. Hopefully, this will begin to restore financial viability to those providing health services rather than to those manipulating them. What are the

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Jennifer R. Voorhees, Aaron A. Cohen-Gadol, Edward R. Laws and Dennis D. Spencer

understand, Cushing compared himself to one who can drive an automobile very well but does not need to understand the principles behind gas engine combustion. The goal of Cushing's letter was to convey the importance of collaboration between the surgeon and manufacturer. Liebel's response conveyed a similar sense of purpose and an affirmation of their collaboration. In his own admonishment for profit-driven work in the medical field, Liebel wrote, We have never for one moment let commercial expediency interfere in any way with bringing out new improvements as fast as

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Shivanand P. Lad, Chirag G. Patil, Eleonora Maries Lad and Maxwell Boakye

.91  female 43,437 (78.21) 5.3 22,994 49.44 1.23 39.71 1.56 42.28 15.03 payer  Medicare 46,124 (83.04) 5.3 23,165 49.01 1.47 39.82 1.58 42.34 14.58  Medicaid 3,999 (7.20) 6.2 27,260 52.75 1.87 36.45 2.43 42.01 16.88  private insurance 4,689 (8.44) 5.9 34,494 41.34 1.68 54.83 3.28 24.62 15.39 owner of hospital  government 5,891 (10.61) 5.6 23,256 42.76 1.83 43.26 2.58 37.67 14.13  private, not-for-profit 42,039 (75.69) 5.5 24,360 50.08 1.58 40

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Neurosurgery and spine: a vital synergy

Chairperson Address, 2007 Annual Meeting of Section of Disorders of Spine and Peripheral Nerves

Charles L. Branch Jr.

under pressure for funding or reimbursement. Advocacy is: when neurosurgeons participate and lead in the development of guidelines of care or best practices so that the government or for-profit healthcare insurors will not withhold payment for effective care or impose ill-conceived payment for performance programs. Advocacy is: when neurosurgical spine surgeons support and direct injury and disease prevention programs in their communities. When they actively volunteer and serve in local, regional, and national political, professional, or elected offices as servant