Advocacy Tops Agenda for New AAN President

Fran Lowry

May 19, 2011

May 19, 2011 — Bruce Sigsbee, MD, FAAN, 1 of 3 general neurologists working in a small group practice in Rockport, Maine, has been elected the 32nd president of the American Academy of Neurology (AAN).

"It is a privilege and honor to serve as president of this esteemed group of neurologists with a rich history of promoting the highest quality patient-centered neurologic care," Dr. Sigsbee said in a statement released by the AAN.

Dr. Sigsbee is a graduate of Dartmouth College and Dartmouth Medical School, Hanover, New Hampshire. He completed his neurology training at New York Hospital Cornell Medical School in Manhattan and received a master's degree in business from Husson College in Bangor, Maine.

He currently serves as chair of the AAN Health Reform Task Force and is a member of the AAN Medical Economics and Management Subcommittee and the AAN Executive Board. He also served as AAN treasurer.

"Dr. Sigsbee has made extraordinary contributions to the field of neurology, including his persistence in lobbying for healthcare reform, benefitting neurology patients and neurologists alike," Catherine M. Rydell, CAE, executive director and chief executive officer of the AAN, said in a statement. "His strong sense of leadership and his wealth of experience leading AAN committees position him well to lead the organization."

In His Father's Footsteps

The son of a general physician, Dr. Sigsbee grew up in western Massachusetts. His brother and sister are also physicians.

Dr. Bruce Sigsbee

"My father was a true GP," Dr. Sigsbee tells Medscape Medical News. "He was great at it; he really had a good attitude, and so all 3 of us, myself, my brother, and sister, all became physicians."

His interest in neurology was sparked in the first semester of medical school. "We had neuroanatomy, and they talked about clinical correlations. My interest and curiosity were piqued, and I've never lost that interest in the specialty."

Asked what he hopes to accomplish during his 2-year tenure as AAN president, Dr. Sigsbee told Medscape Medical News he had 3 major initiatives in mind.

At the top of the list is improving the academy's advocacy efforts.

"We've gotten much smarter about how to represent neurologic interests in Washington, but we need to get even smarter and continue to work effectively to make certain that the specialty is considered as healthcare reform goes forward," he said in an interview.

We've gotten much smarter about how to represent neurologic interests in Washington, but we need to get even smarter...

"It's likely that we're going to see changes substantially beyond what have already been suggested as the government tries to address the deficit and its many other considerations," he said. "The only way they can effectively deal with the deficit is to address entitlements, and obviously Medicare and Medicaid are important parts of that."

Dr. Sigsbee, who is no stranger to Capitol Hill, said it is very difficult "navigating the landmines that are in Washington."

The AAN has hired 2 additional staff to help bolster their efforts at ensuring that people have access to quality neurology care. The need for such access will only become greater as the US population ages.

"We need to let the people in Washington understand how their policies will affect neurologists and their patients. The baby boomers are going to be confronting disorders of the elderly, which to a large extent are neurologic in nature, such as dementia, Parkinson's and other movement disorders, and stroke," he said. "There really is not only a current need but a huge future need for folks who have the expertise and ability to really care for this population."

Second on his agenda is to identify and hopefully remove barriers to becoming a researcher in neurology.

"There is good evidence that the ability of young neurologists to go into research careers is challenged at this point," he said. Their number has been static over the last 10 to 15 years.

"I am working with other organizations, such as the Child Neurology Society and the American Neurological Association, to identify those barriers and find ways to overcome them so that the road to becoming a researcher is not as difficult," he said.

Last but not least, Dr. Sigsbee wants to ensure that the AAN is an effective home for general neurologists, that it meets their needs for educational, career, or practice support.

General neurology has become extremely complex, he said. "It's perhaps more difficult than subspecialties because of the rapidly changing nature of our understanding of neurologic disease and treatments — a general neurologist has to be very familiar with a wide spectrum of disorders and treatments," he pointed out. "It is very important that the academy support people who are trying to stay current and take good care of patients."

Adequate Compensation Still a Challenge

One of the biggest challenges facing the field of neurology right now is the issue of compensation for services. Right now, neurology is one of the poorest compensated specialties, Dr. Sigsbee said.

For a number of years, when we went to Washington, they confused us with neurosurgeons. They would say, 'Oh, you operate — you make a million dollars a year, why are you here?'

"For a number of years, when we went to Washington, they confused us with neurosurgeons. They would say, 'Oh, you operate — you make a million dollars a year, why are you here?,'" he said. "They don't do that anymore, but it was very frustrating."

The problem is that incentives are much greater for the procedural specialties than for those that provide direct patient care, and this makes it difficult to recruit new physicians into the specialty, he said.

New medical graduates, more often than not burdened with medical school debt, are tending to opt for the specialties that pay more, he noted.

"Right now, there's very good evidence that the well-compensated specialties are having no trouble attracting graduating US medical school student seniors. Yet the primary care, neurology, psychiatry, and rheumatology specialties are having difficulty," he said.

This, despite the fact that the field of neurology is "exploding" with exciting new discoveries and insights about treatments for disease.

"It's a very exciting field to be in right now, and it will be for the next 30 or 40 years," Dr. Sigsbee said. "It's really a shame that because of high medical school debt or other barriers that young physicians are electing to go into other specialties that are much better compensated."


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