Power: how to get it and how to use it for the future

Neurosurgeons represent 1% or less of all physicians; thus, as a group, the specialty has little power. In the 21st century, we will see a continuation of power becoming localized in large groups. Multinational corporations will have power as they will control large segments of their markets. It is for this reason that businesses merged in the 20th century and it is the reason this trend will continue in the 21st century. Governments will also become more powerful as can be seen in the trend in the United States toward socialism.

Physicians are, by nature, independent and individualistic. Neurosurgeons, in particular, do not work well in groups, as their specialty training encourages self-dependence. The solo practice of neurosurgery and medicine will disappear because of the huge amount of information that is being created every day in the “knowledge economy.” There is so much information that one neurosurgeon cannot know it all. Specialization will be inevitable. That means that group practice will be the mode of practice in the future.

The larger the groups, the more the power neurosurgeons will have against the power groups of government, industry, insurers, and other interests.

What neurosurgeons need to do is to unite behind a power base. The only way that this goal can be achieved is for neurosurgeons to become involved with their local, state, or national organizations. Neurosurgeons must become active politically in each of these groups to protect their interests against those who will use power against them. Neurosurgeons and other physicians must unite on ideals on which they can agree. Those ideals are based on the principle of “the patient is first.” This principle, which is unassailable, is the common ground on which all neurosurgeons and physicians can agree. It is a principle that puts all others who disagree in a position of being against the interests of the patient. Yes, the socialists will place the government and the state first, for economic reasons, but in the end, history shows that these socialistic solutions end in corruption with some benefiting and most losing. Power corrupts.

The physicians' greatest source of power is the patient, or every citizen. The power of patients is the largest power base in any country. People respect physicians, particularly those who are devoted to the patient's interests. Use the power of the patient. No politician has as large a power base as physicians do.

There is power in numbers, and those with power will be heard by the politicians who want to be elected. Even in dictatorships, those with power must be heard.

Thus, for the 21st century, power will be the key. Neurosurgeons must recognize this fact and change to accommodate to the new politics of the world. Power is and will be the key everywhere.