Letter from the Chair

July 10, 2012

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The first year of my Chairmanship has seen a number of exciting new developments as well as a persistent challenge.

In my first letter, I noted we need to encourage ourselves and our colleagues in the section to sit for the UCNS Geriatric Neurology Certification Examination. Second, we needed to have our own training programs UCNS approved so we could sustain our important mission. While our training programs are slowly increasing in number, there remain too few. In fact, we had hoped five programs would be available by June 1st, but this goal was not realized. Moreover, less than expected applications to sit for the Geriatric Neurology Certification Examination were received this year. As an immediate consequence, the 2013 Certification Examination has been cancelled.

In times of fiscal restraint, it is not surprising the Certification Programs have been slow to initiate and that individuals are hesitant to seek Certification. Establishing a program and establishing certification are both time consuming and expensive. Our aging population, however, needs our help and attention. With the ever increasing complexity of medical education, three year neurology programs are not currently sufficient to fully understand the neurological needs of our older patients. Fellowship training is therefore critical to successful care delivery to some of the neediest of our patients. In addition, possible changes in future health care reimbursement may offer advantages to those specially trained. Therefore, during the next year, I will make increasing our training and the number of individuals sitting for the Certification Examination a priority of the Section.

Special thanks go out the Dr. Honig, Education Workgroup leader, for his efforts to encourage applicants for Geriatric Neurology Certification as well as his help in developing new programs for training.

The new year has brought new involvement of members. Special thanks to Dr. Henderson for coordinating the 2012 Councilor election. Dr. Henderson noted that his goal was to make sure the process is transparent and democratic, and further noted there was a good response for nominees this year. Dr. Tiffany Chow was selected as the new Councilor and will be responsible for overseeing the geriatric neurology webpage. Dr. Chow will replace Dr. Arvanitakis who just completed three years of service as Webpage master. Special thanks to Zoe for all the wonderful work she did!

The new year also brought us new initiatives. The NAPA strategic plan was officially announced. In addition, at the recent State of Alzheimer's Therapeutics program, Dr. Francis Collins announced new research monies specifically dedicated to Alzheimer's disease genetic discovery and treatment. Links to information about these new initiatives is posted on the website.

Dr. Foster continues to pursue an ambitious agenda in the Practice Workgroup. At the section meeting, he provided a brief statement of what geriatric neurologist is, and the challenges of having a clinical geriatric neurology practice.

He will also note the difficulties of residents completing training and choosing geriatric neurology in part due to lack of vision of what that involves or whether it is real career choice. The Practice Workgroup is currently working on informational literature to facilitate adequate reimbursement for services. As part of the Practice Workgroup, there has been further discussion of how we define a Geriatric Neurologist. A formal modification to the strategic plan reflecting our newer definition will be forthcoming shortly.

In addition, Dr. Douglas Scharre continues to focus his role on legislative issues, and will initiate review of the strategic plan as it relates to legislative issues in light of the potential new healthcare act. He will also liaison with the National Alzheimer's Association and reach out to Maria Carrillo to discuss issues regarding cognitive neurologists overall and how they might help educate primary care physicians.

Finally, on the scientific front, Dr. Foster and Dr. Knopman have submitted a proposal for a course on Amyloid Imaging at the 2013 meeting. The content of this course will be posted on the Website should it be chosen for presentation.

Thanks to all the Geriatric Neurology Section Members for their continued support and active participation. I hope 2012–2013 will be another exciting year for the Section!

Charles S. DeCarli, MD, FAAN