242 Pay-to-Play: Costs of Organized Neurosurgery in the United States

INTRODUCTION: Organized neurosurgery offers innumerable opportunities for scientific exchange, networking, and continuing medical education. National, regional, state, and city-level societies and annual meetings have rapidly proliferated across neurosurgery, with journals following suit. METHODS: National, regional, and state neurosurgery societies were identified, and associated annual meetings were recorded. Top neurosurgery journals, as determined by reputation and impact factor, were selected. Data that was unavailable online was acquired via direct communication with the respective organization. ABNS board-certification costs were acquired and compared to board-certification costs in comparable specialties (orthopedics (Ortho), plastics surgery (PS), General surgery (GS), neurology (Neur)). Baseline academic engagement (BEA) was defined as two general society memberships, two annual meeting registrations, and respective board-certification. A CME credit-per-dollar value was created to measure relative financial value of CME. RESULTS: A total of 31 societies, 22 meetings, and 18 journals were identified. Society membership costs included AANS ($1,100), CNS ($990), Society for NeuroInterventional Surgery ($775), and Cervical Spine Research Society ($950). Meetings with the greatest registration fees included the Society of Neurological Surgeons ($1,800) and the Southern Neurosurgical Society ($1,000). Individual journal subscription costs included JNS ($636), Neurosurgery ($643), Spine ($1,188), and World Neurosurgery ($909). Neurosurgery had the greatest cost for BEA ($11,588; PS: $8,105, Ortho: $7,013; GS: $5,570; Neur: $4,640). Costs of non-traditional, online CME are significantly less compared to traditional, meeting-driven CME opportunities. CONCLUSIONS: Organized neurosurgery incurs major individual costs by way of society membership, annual meeting registration, and journal subscriptions. Rising costs for engagement are substantial and may not be sustainable when contrasted with unchanged CME reimbursement. Other sources of funding, such as increased CME or departmental funds, or increased industry affiliation for subsidization of costs may be advisable unless costs can be containted.