<P>17 AANnews • September 2014 Public Policy AAN-trained Advocates Work Together for Success Recently, an audiology bill before the Pennsylvania legislature caught the eagle eye of Partha Thirumala, MD, MS, FACNS, a clinical associate professor at the University of Pittsburgh Medical Center and president of the Pennsylvania Neurological Society. Amid more than two dozen pages in the bill was a four-line passage regarding neurophysiologic intraoperative monitoring (IONM) that could have had a significant impact on how medicine is practiced in Pennsylvania. It could have affected many patients receiving neurosurgery, orthopedic surgery, and ENT surgery. The legislation, if passed without any amendment, would have allowed audiologists to independently interpret IONM data collected in the operating room in the state of Pennsylvania, said Thirumala, who is a 2013 graduate of the AANs Palatucci Advocacy Leadership Forum. Continuous, real-time IONM monitoring and interpretation requires expertise in comprehensive medical school education followed by understanding the principles and practice of neurological disorders and the application of clinical neurophysiology. The training for audiologists was inconsistent across the state, which leads them to be inadequately trained. If they were allowed to independently perform real-time IONM services, it would have led to inconsistent interpretation of IONM data and in some instances lead to devastating neurological complications like stroke and paraplegia. Fortunately, Thirumala was up to the task. The Palatucci Forum training gave me the necessary education as well a mentor, Dr. Donn Dexter, to guide me after the training. The education involved creating an action plan with a specific timetable under which this can be implemented. We also received training in how to interact with conventional and social media outlets. Thirumala contacted fellow neurologists in Pennsylvania to educate them on the bill. An ad hoc team formed to connect with other state specialty organizations so they could understand the ramifications of the proposal. They coordinated with the Pennsylvania Medical Society and enlisted its lobbyists to advocate on their behalf. Physicians provided testimony on IONM to the states House Health Committee and educated other legislators and staff through multiple calls, teleconferences, and other events. The amendment requires an audiologist to be supervised by physicians. This still allows audiologists to perform IONM but does not allow them to interpret. The addition to the bill (in italics) was small but significant: Practice of audiology. The application of principles, methods, and procedures related to disorders of the auditory and vestibular systems. Areas of audiology practice include the following… (13) administration of electro- physiologic measures of neural function, including, but not limited to, sensory and motor- evoked potentials, preoperative and postoperative evaluation of neural function, neurophysiologic intraoperative monitoring of the central nervous system, spinal cord and cranial nerve function, provided that an audiologist shall not perform neurophysiologic intraoperative monitoring except upon delegation from and under the overall direction of a physician, and the audiologist shall be certified by the board under section 8.1; Gov. Tom Corbett signed the bill into law in July. The overall effect of the advocacy effort may be larger than just the bill. I think it also sent a message to many that neurologists in Pennsylvania are not as quiet and passive as they might have thought, said Brad C. Klein, MD, MBA, who practices in Willow Grove and participated in the push to fix the bill. Klein is a member of the AAN Practice Management & Technology Subcommittee and a graduate of the 2006 Palatucci Forum. • Apply by September 21 to Change Your Life Applications for the 2015 Palatucci Advocacy Leadership Forum close on September 21. If you want to change something in your practice, institution, or community—and have your life changed in the process—visit AAN.com/view/2015palf today for more information. The Forum will be held January 15 to 18 at the Omni Amelia Island Plantation near Jacksonville, FL. • Partha Thirumala, MD, MS, FACNS Brad C. 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