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Interview with Sandra F. Olson, MD, FAAN: AAN President 2003−2005

Sandra F. Olson, MD, FAAN
AAN President 2003−2005

Sunday, April 23, 2017
Boston Entertainment and Convention Center
Boston, MA

Tim Streeter, AAN staff, Interviewer 

(c) 2017 by the American Academy of Neurology. All rights reserved. No part of this work may be reproduced or transmitted by any means, electronic or mechanical, including photocopy and recording or by any information storage and retrieval system, without permission in writing from the American Academy of Neurology.

TS: Hello, my name is Tim Streeter, and I am very fortunate this afternoon to be with Dr. Sandy Olson, who was the president of the Academy from 2003 to 2005. Thank you for coming down, Dr. Olson.

SO: Thank you for asking me.

TS:   The first question, probably the easiest one, why did you become a neurologist? When did you decide that you wanted to go that route?

SO: My first year in medical school. We had neural anatomy. And it fascinated me, and during the course we had some patient demonstrations of different neurological disorders and correlated with the anatomy, etcetera. I remember one especially was a person with Friedreich's ataxia and it just fascinated me. Why? What causes it? What's the issue? I just never gave up that interest.

        I liked medical school. I liked the subjects in general because I like medicine, but on the other hand it was always I really decided that I was going to become a neurologist and just stayed with it.

TS:   Now, you entered medical school at Northwestern in 1959?

SO: That's correct.

TS:   You were one of only four women in your class. Is that correct?

SO: That's correct.

TS:   Do you think that something has been lost in the neurology profession, and medicine as well, by either gender ‘roles’ or outright gender discrimination of the time?

SO: Well, perhaps so. I don't know if Northwestern at that time had a quota of women or not. I do know that by large, the classes before and after me had just a few women. As I said, I just don't know but I was put on the admissions committee at Northwestern I believe in 1970, and frankly we just didn't get that many applications. There wasn't the pipeline, and we did find out that when the women applied they tended to be better candidates but there just weren't a lot of them. In a way, I think that women at that time just didn't think about going into medicine nearly as much as they do now. Now, as we know, about 50 percent of students are women.

        In a way, yes, I'm giving a long answer to a short question. I think that there is something that was lost, but again the remedy at that time just didn't seem to be there.

TS:   I was really surprised. I was hoping that Dr. Rowland was going to be here [former President Lewis P. "Bud" Rowland, MD, FAAN, passed away shortly before the 2017 Annual Meeting]. I really wanted to interview him, and he had done an interview a few years ago. I read the transcript and he talked about how there was a quota of the number of Jewish people that medical schools would take. I was stunned by that, and it seems that it took a long time for the education part of our society to come around to both that and accepting more women.

SO: Yes. I was aware that at Northwestern it wasn't overtly mentioned, but there was a subtle implication that there was a Jewish quota and that, I know, disappeared. Because when I was on the admissions committee we didn't pay any attention to that, race, anything. So, I can speak to that but I was surprised at that too when I found out.

        Because I guess I just hadn't thought about it, and where I had worked as a technician in surgery, so many of the doctors were Jewish. You know, that’s just the way it was and you didn't think about it.

TS:   When you became a member of the academy in 1966, what were your expectations and what were your needs then as a young neurologist?

SO: Well, I was a resident at the time and I was told, I guess, by some of my professors, “You just join the Academy of Neurology. That is your organization and they will do a lot for you.” Of course, we got the journal, which is an excellent journal which I enjoyed reading, and at that time as a resident I didn't think so much of member benefits. It's just that I wanted to be a member of my professional organization, and that because I knew that they would do things for me when I needed them because to whom else was I going to turn? I actually belonged to many organizations for that very reason, for different levels of resources and things like that that I knew would help me.

TS:   Now, one of your first committee assignments was the Practice Committee?

SO: That's correct. I was on the Practice Committee, which I thoroughly enjoyed. It was really fun working on the different aspects of neurological practice. I was on a Computer Subcommittee, I was on the Medical Legal Subcommittee, and it just was very stimulating to learn about these different things I really didn't know much about at the time. Even though I was in practice with a group, but the various aspects of being in practice and what the needs were and so it was a great experience. I really liked it and liked the people and enjoyed it.

TS:   Did you find that you were usually the only woman on these committees?

SO: No, no. I wasn't. I'm thinking back on the Practice Committee, and there was somebody else. I can't put my finger on it right now, but I just don't remember who it was but no, I was not the only woman.

TS:   What motivated you to get involved in leadership activities?

SO: Well, again I enjoy working in the committees toward a goal. Toward a purpose. Accomplishing something and accomplishing something for the betterment of the profession, for the betterment of neurologists. I just enjoyed always being involved and again working for the things that I thought were important.

TS:   You were heavily involved in your county and state neurological societies. You were with the AMA as a representative. Did those activities help prepare you for leadership?

SO: My first, I was involved with the Chicago Neurological and I was the president of that, true but I was also involved with the Chicago Medical Society. I eventually became president of that society and Fred Schwartz was our CEO of the Chicago Medical Society, and he was a great mentor. He taught me so much about organizational work, and so then same with Illinois and I was a delegate to the AMA. These all really helped prepare me because I learned the roles I think, between the staff and the volunteers and the leadership in the various organizations and they're different roles. They're different jobs to do, so to speak, and so through the years I think that clarified things for me which in turn has helped me very much with the Academy.

TS:   Did you have any particular mentors within the Academy?

SO: Yes, I did.

TS:   Who were those?

SO: Ken Viste. Ken Viste, as you know, he was the president of the Academy and Ken mentored me. He told me he wanted to see me as president of the Academy someday, and I think he really put forth some effort for that. He appointed me as chair of the 50th Anniversary Committee, as you know, and I worked on that and enjoyed that a lot. Working closely with the staff, especially Pat Vendor and Mike who's no longer part of the staff. And we just had a great time putting that together. That was a lot of fun.

TS:   He was a special man. Several of the past presidents have mentioned him.

SO: Ken was very special. Ken was at Northwestern. Ken went through our residency program at Northwestern in a wheelchair and he did very well. He's very well respected and can never ask for anything special. He did his job just like everybody else. Ken was special. He had true grit, let's put it that way, and he was a great friend. He was a great friend, and I still miss Ken a lot.

TS:   He was a marvelous advocate for the academy and for neurologists. We have pictures of him in Washington in his wheelchair. Nothing seemed to stop the man.

SO: It didn't. No, he loved the Academy. I mean, he really had a special love for the Academy, and Northwestern, and the University of Illinois. Ken was accepted to the University of Illinois when some other schools didn't accept him so he was very—he loved the University of Illinois, and I think he was very generous to them as they were very nice to him.

        I don't know this, but I think he really tried to repay them and respect them. I think in his love for the Academy he wanted to do everything he could to promote the Academy. To promote it amongst the members, to promote it to the outside. And so, as I said, that special quality or special qualities of his really shone through.

TS:   Dr. Casino told me a story when I interviewed him last week, when Dr. Viste was at the Mayo with his final illness, and Dr. Casino made an effort to visit him daily. And the last day before he passed, Dr. Viste looked up to him and he said, “Take care of the Academy.”

SO: Yes. I just heard that story and it epitomizes Ken. I couldn't say it any better.

TS:   You became in 2003, the first woman president of the Academy. Why you and why then?

SO: It's interesting. I've asked myself the same questions. I think me, because again I had been very active, I had been on the committees. I was involved with the different aspects of the Academy, and I think at that time they thought that I was worthy to be the president and was nominated and became the president. I don't like to think that it was just because I was a woman, and they looked around and said, “Jeez Louise! It's about time we have a woman. Whom can we nominate?” If it were that, I wouldn't want to do it of course. At that time, I sort of felt like I was the right person at the right time. I was the woman, yes, but I just happened to be somebody who had been working with the Academy and involved in that and that was the time.

TS:   You had the right skill set.

SO: Well, I like to think so.

TS:   Yes.

SO: I guess they thought so too.

TS:   As a member of the staff I would say we thought so too.

SO: Well, thank you.

TS:   You have a reputation of being the consummate advocate for neurology. Where does that passion come from?

SO: It's because I love the profession, and I think it's the greatest profession. I think it's the greatest area of medicine. It was for me. I never knew anything else other than being a neurologist, and I just like to spread the word. I like to exhibit that passion to the young people, to the students and the residents that I've dealt with through the years. And to recruit them into neurology because I just think it's so rewarding. As I said, I wouldn't do anything else.

TS:   During your term, the State Affairs Committee was created. Previously, it had just been Legislative Affairs that had covered both federal and state issues. Do you recall why there was that decision to split?

SO: No, I really don't. I don't.

TS:   Was there a lot of activity going on within the Academy at the state level?

SO: There were some states that were very active because they had issues in their state that they addressed. California was one, there was the EMG issue. Michigan was another one where they thought that unqualified people were trying to do these tests and they were right.

        As a result, I think the neurologists rallied in the state to work with the legislature to pass legislation and avert legislation that would compromise the value to patients. I think that was kind of a natural rise; they had an issue and so they became organized and powerful. I think the Academy would probably recognize that at the time that, “Hey, this is really important and we have to support our state societies.”

TS:   In 2003, the Academy launched two big advocacy programs: Neurology on the Hill and the Palatucci Advocacy Leadership Forum. The Palatucci Forum has remained at about 30 participants for a very intense weekend, but Neurology on the Hill has just grown. The last one had over 200 members attend, 216 I think it was. How important are these activities to not only the Academy, but to the members who participate in them?

SO: I think they're very important, and I think that is shown by the fact that more and more people want to participate in Neurology on the Hill. I've participated; I participated in the last one. I was a Palatucci fellow, and I think that as the Academy realized that we had to grow leaders. And that we had to become very active in advocating for neurology in our patients, that this just caught on. And I also think that people have also felt threats and they want to do something about it.

        And so, they, like you, said, they went to the Hill, we went to the Hill and presented our cases to the Congress people. And really tried to make the point of neurology, and what the needs were, and why they needed neurologists and needed us. As I said, that's something that has really caught on.

TS:   It's something that, with a limited staff, there's only so much that can be done. And so, to harness the passion of the members makes the Academy even more effective, doesn't it?

SO: Yes, it does and the Congress people that I have talked to, they want to know what the patients are saying or what the patients think. “What do you hear from you patients?” I was asked that very bluntly when I met with Dan Rostenkowski quite a few years ago. He said, “What are they saying out there?” I was almost taken aback by his directness and bluntness. But that's what they want to hear and we are the ones that have those stories to tell. I think the stories, the individual stories, really make an impact on them rather than giving them sometimes just, “Well, X amount said this and X say—.” But let me give you an illustration and that makes a difference.

TS:   They also see that those are voters too, don't they?

SO: Oh, of course. In fact, they want to talk to the voters in their districts and that, "Don't come from California and expect to speak to somebody in Illinois." I mean, sorry, they want to hear from the folks in Illinois and so that's very true.

TS:   One of the big controversies both scientific and nationally during your term was the issue of federal funding for stem cell research, and the Academy took a stand in favor of that. Was that a difficult decision for the board to make?

SO: As I remember back, that became a position paper and that of course went through the usual channels and was vetted. I remember the discussion, there was a discussion at the board level but I don't remember that it was that difficult to make the decision to vote for it. I don't believe it was unanimous. Again, I'm going back in my memory but it was a very thoughtful decision. It was well vetted both at the committee level which discussed it and developed the paper, and it was well discussed at the board level. I think the decision was made very deliberately and very carefully, and also knowing that it would be somewhat controversial with some people. But yet, we thought it was the right thing to do.

TS:   We did get some comments I recall from some members who were not happy with that decision. When Obamacare was proposed and being debated in Congress, the Academy didn't take a firm position on that.

SO: No.

TS:   It didn't take a firm position on the ACHA or AHCA which was recently proposed by the Trump administration. But we came up with a set of health care reform principles. Is there a point, in your experience, where the Academy really has to take a firm stand and say, “This is right” or “This is wrong,” even though it's going to alienate some of our members?

SO: That's a difficult question or a difficult stand to take for an organization. As you know, the AMA came out and endorsed Obamacare which caused a big controversy. And I think in the long run there were a lot of people involved perhaps in the decision making who were not happy with it. But I can’t speak to it, I wasn't on the board so I really don't know. It's just sort of what you hear, and I think again those decisions are often driven by a few people who feel very passionate about one thing or the other.

        As far as the Academy taking a stand on that, that would be up to the board and to the leadership if they thought it was the right thing to do. But again, you have a great diversity of opinions with regards to these issues. Great diversity and as you know they're often very polarized. Some people think there should clearly be a single payer government run system, ala England and other countries. There are other people that wouldn't want the government doing anything about health care. I feel it's kind of in-between in some way, and to me the best solution has not yet been worked out, but that's just my personal opinion. Hopefully it will be. Hopefully it will evolve and everybody will get the care they deserve, and physicians will be able to take care of people. And get fairly reimbursed for it, which is always something neurology has kind of being advocating because we're such a cognitive specialty. It’s easy to measure that an operation has been done and the gall bladder has been removed. That's pretty black and white. It's not so easy in neurology to recognize that a half an hour that you spend with an Alzheimer’s patient and their family is really going to deliver any goods. You can't measure that, and so that's where it's a little different with neurology.

TS:   You can't cure them, but you can help improve their quality of life.

SO: Right, and there are things that we can cure. I mean you can get an epileptic under complete control, and eventually get them off their meds. Is that a cure? Well, yes. You can take a migraine patient who is really suffering and get them on the right medications and improve their quality of life immensely. Those are joyous things. There are other folks like a Parkinson patient; you can get them up and walking and let them go to the bathroom when they have to. That's a big deal for some of these folks and the same with an MS patient. 

        Again, you feel a great sense of accomplishment when you see that and when you have the patients tell you, “Well, now I can walk down the street.”

TS:   It's hard to quantify, isn't it for the CMS or insurance providers?

SO: That's right. It is. It's very hard to quantify.

TS:   When the Academy looked at business administrators within neurology, it realized that there was an opportunity there to reach out and invite them in as members. Were you part of that decision, or did you encourage that?

SO: No, I wasn't part of the decision. It just came about and as I remember correctly, it just was we felt there was a need there. And that these folks should be included, and should be educated so that they really realize kind of what neurology was about other than just the business side. That's basically all I can remember about that when it developed.

TS:   As the reporting became more complicated there was more work, wasn't there, for not only for neurologists, but the business administrators as well?

SO: Absolutely. Doctors had to hire people to just fill out the forms, whereas 20 years ago or 30 years ago they didn't. And the forms got more and more complicated. It's good to be educated on all those things.

TS:   In the practice area during your period as president, the Academy established some several significant guidelines on epilepsy. There was a lot of advocacy to improve patient access to anti-epilepsy drugs. Now, the past couple of years there's been a very strong focus on concussion, sports concussion. How does the Academy determine when to put its full weight behind a specific disorder? Stroke was a big one for a number of years in the 90s. Does that feed off of what's happening in the general society? Or does the Academy take the initiative and say, “Hey look at this. This is a problem?”

SO: With regard to concussion, I remember that about over 10 years ago, I personally felt that we should devote a lot of time to concussion. We didn't at the time; it didn't take on, but yet because there was more and more evidence of concussion: the sequelae of it, traumatic brain injury and that. We saw that in the veterans returning. How they were affected by that, and that that's a serious public health problem. It really wasn't addressed as much as it should have been, especially in the young athletes—the football players, the soccer players now, the cheerleaders—and what problems have developed because of the serious nature of the concussions. As you know, now we're getting so much press about it from the professional football players that are suffering now from dementia from concussion. I think it just became very widely known, and that it was more widespread and that somebody had to deal with it. I think neurology is the specialty that should deal with it because it's the brain. And who knows the brain better that neurologists?

TS:   Exactly. Turning to education, the Academy began helping educate members on maintenance of certification requirements that were established by the ABPN, and we developed the tools and resources to help them. Is this a good example of the value of Academy membership?

SO: Absolutely, because as you know that Continuing Certification (CC), the CC process and that has become very involved. It's become rather onerous for physicians. They resent it and they don't like it, and so the fact that their professional organization is educating them, giving them the tools for it, I think is extremely important. I think it's a great use of our resources, and that again demonstrates the value of the organization to the individual physician.

TS:   The Academy made a very strong effort to connect with residents; they provided 155 resident scholarships, and appointed 14 residents to different Academy committees. Why was that important?

SO: Well, I feel it's very important to get the young people involved because it's going to be their organization. They should have a say in how things are going to be developed and how it should evolve. When I became president, I made a conscious effort to appoint residents to the appropriate committees. I felt that that clearly should be done, and that we should really get the residents interested in working in the Academy and doing things in the Academy. It has again evolved, there are more and more involved and I think that's only going to provide benefits to the Academy in the long run.

TS:   Is there a sense that, you know, “Well, back in my day it blah, blah, blah and—”

SO: “We always did it that way.”

TS:   Right, and then the younger residents, “Well you don't understand what it is now.” Is there that chasm that you try to bring together when you have residents on a committee?

SO: Absolutely. I think the residents are very sophisticated. And they see what goes on certainly in their training program with their mentors. And they're attending and that there're things they like and things they don't like, and the things they think are detrimental perhaps to them and should be changed and we've got to hear that. We've got to hear all the voices and the different viewpoints. Because again, it's going to be their organization and they should help develop it and take charge of it.

TS:   I want to ask you about the Annual Meeting: the 50th anniversary Annual Meeting in particular. You headed up the Planning Committee for that, didn't you?

SO: Correct.

TS:   That was a pretty big occasion, wasn't it?

SO: Oh, it was. It was exciting because 50 years, we wanted to make a really big splash and let the members see some of the past history and what was going on. Oh, yeah. We had some giveaways; like there was a blue or black champagne glass. I still have some of those, and we had a big cake in the one of the halls and passed out champagne and pieces of the cake. The book that you mentioned that we put together. Yeah, that was really we wanted to make it a big celebration and we did our best. We left something behind; there's a garden—

TS:   Yes, that's right.

SO: There's a garden in Minneapolis or St. Paul, I don't remember; a century garden. That was Steve Ringel’s idea.

TS:   Oh, really?

SO: Yes. He had the idea of leaving something behind, and we settled on the garden so, yes.

TS:   At that time, Frank Forrester was the only survivor of the Four Horsemen who helped found the Academy. Did you know him?

SO: Well, I met him and knew him; we took some pictures. My husband took some pictures with him. I remember he came with his wife to a meeting or something like that. I can't say that I knew him well, but I did meet him and I met him several TSes and he was always very gracious to me. He was a very gracious man.

TS:   He seemed like a very warm man.

SO: He was. I remember just his kind words, and that he was a positive man too. He was upbeat and he was charming.

TS:   Did you have a chance to meet Dr. Baker?

SO: I did.

TS:   Dr. Sahs?

SO: I met Dr. Baker once in Washington, DC, actually, at an American Neurological Association meeting that I went to. I just met him, that's all. I didn't meet Dr. Sahs or Dr. Krinker. They were deceased, I think at the time.

TS:   The Annual Meeting in 2003 was the first to be held off the mainland; it was in Hawaii. Was that a big risk for the Academy?

SO: Yes, I think we thought that it was going to be a bit risky. Because people would grumble about going so far off the mainland, and that sort of thing and that it would be so very expensive. Well, it turned out to be a very well-attended meeting, a very well-received meeting, and I think people really enjoyed it. Yes, it was quite a distance for a lot of people. Now, the people from Asia were able to come to it more easily than some of the other meetings in the US in the mainland. The other thing that surprised me which the staff told me, that actually some of the food was cheaper in Hawaii.

TS:   Pineapple?

SO: Yes, probably pineapple but the juices and things they said were actually—a gallon of orange juice was less than a gallon of orange juice in the mainland in some of the cities. New York, I'm sure, was one they were thinking about. Again, I don't have the facts to back that up or anything like that, but I was just told that. The airfare, of course, was more expensive for a lot of the people, but as I remember people by and large really enjoyed it.

TS:   There was a record number of abstracts submitted at that point.

SO: That's right.

TS:   Yes, it was over 2,500. That shows there were some many people who were willing to come.

SO: People were voting with their feet.

TS:   Yes.

SO:  Not literally, obviously, because they had to get there over the water.

TS:   Looking at science and research, did you invite Dr. Kandel, the Nobel Laureate to become the Presidential Lecturer in 2004?

SO: Yes, I did. Dr. Pedley gave me his name, and said if I was looking for somebody he thought that he would be an excellent choice. I took Dr. Pedley’s advice and I was very happy I did.

TS:   Are the Nobel Laureates very esteemed within the neurology community?

SO: I would say so. Dr. Prusiner, again, was another and yes, he was very esteemed. I remember when he gave his talk, and I think he's given some other talks on one thing or another but he was. Yes, he was. 

TS:   He's at this meeting too.

SO: Is he here too?

TS:   Yes.

SO: Yes, he comes to the meetings.

TS:   Let's talk about the Academy's relationship with NINDS. We've been helping them identify reviewers for clinical research grants at that time and consulting on future research gaps. Is that an important relationship for the Academy?

SO: Very important because again, we have the members who are doing the work that can be helpful to the folks at NINDS and reviewers and that sort of thing. As you know, Walter Koroshetz, one of our own, now is head of NINDS so I think we have a very good relationship and a strong relationship with NINDS.

TS:   Do you have any concerns about the pipeline of people becoming interested in neurology going through the education process, becoming practicing neurologists or researchers? We're looking at a deficit of something like 20 percent below what we need.

SO: Yeah, I'm definitely very concerned about it because as you know one in six people will be affected by neurological disease in one way or another. And as the aging population comes along there're going to be more and more neurological problems that need addressing by neurologists. Yes, I'm very concerned about it. And it's hard because young people nowadays coming out with their tremendous debt, they look to ways to pay that off. And you don't think necessarily of neurology as being the most lucrative specialty in the world. And so, you can understand why they want to go into the things they’re going to give them better remuneration.

        But again, you have to have a passion for neurology, I think. We try to instill that in the young people; that's something that I touched on before, that I want to see folks come in who really want to do it, who really want to help people with these disorders in any way they can.

TS:   The Academy does a lot of outreach to the public. The Quality of Life book series began while you were president, and there was the Brain Matters website that was developed for the public, and education brochures distributed. Can you talk about the need for patient education and the Academy's role?

SO:  I think it's very important that patients be educated about their disorder whatever it is. And in neurology, as you know, it's often very complicated and people don't understand pathways and that sort of thing necessarily. To educate them about the effects, what they can do about it. They can take charge of their illness, and that makes them a much better patient and makes them better as far as their disorder is concerned. And they can help their doctor.

        You know, the doctor-patient relationship is a contract. It's very important because there's two sides to it. We can do so much as physicians, but if the patient understands and can work back with us, they're better off in the long run. I really think these our educational efforts for the public have paid off. I have used them, and I have found patients very, very grateful to get something so that they can understand and then they can ask questions.

TS:   They can also share with their family or their caretakers.

SO: That's exactly right. They can share, and their family can understand better how to deal with an Alzheimer's patient. And why they have the problems they do, and the best way to deal with them.

TS:   You served on the board for the foundation, the AAN Foundation. During that period in the 2000's, there were a number of different executive directors. What were the challenges of the foundation during that period?

SO: First of all, one of the challenges was getting the members to know and understand the foundation and what it would do and to support it. Because it was something out there that wasn't really clear in everybody's mind. It took a while for that to coalesce in people's minds. It took a while for it to coalesce, period. and to really develop a purpose. And we ended up at Susan Spencer's suggestion for the clinical research training fellowships and again, I think that really helped. This was the purpose of raising money in the foundation, and at first that wasn't clear. What're we raising money for? What're we going to do with it?

        Now, again I think people have a much better idea and what they're doing. As you know, this has been an immensely successful program to support these young researchers, so many have then gone on to get the NIH grants and some of them have become shining stars in our profession. I can think of one from Northwestern that I've known very well and he was a resident. It's just a terrific feeling to see them go along and achieve their goals. Yes, the foundation, I think, is really, now, it's grown up.

TS:   It's distributed over $20 million to support researchers. That is something, isn't it?

SO: It's a brilliant something. From nothing to that, in that period of time, it's good.

TS:   The Academy adopted its second strategic plan in 2003. Can you talk about the importance of strategic planning for the organization?

SO: Yes. I think it's very important. I think to have a clear pathway of what you're going to do and when in the future, what your goals are, is very good. I can't imagine living without it now that I think about. You know where you're going; you have an aim rather than just sort of floundering around saying, “Well, let's do this. Let's do that. Let's do something else.” The bottom-line is that it's extremely important, and I applaud Steve Sergey who worked on that and cleverly saw that as a purpose.

TS:   At the same time, the Academy has to be nimble and not just reactive but pro-active, particularly with regards to advocacy activities, and seeing what's coming through Congress or through CMS, and to try and head that off or promote something.

SO: You have to be flexible. You have to be able to see where's there's a need and try to fulfill it or fill it. Fill the need. I think the Academy has really grown in that, we have the strategic plan but as things come up we are able to swing in to that direction and devote resources. CC is a good example of that that was seen as something that we needed to address for the members and was done and is being done.

TS:   Were there discussions during your term about creating the PAC.

SO: Yes, I'm rather proud of the fact that I introduced the idea of the PAC when I was president at one of the business meetings in, I believe it was in ‘04. Several people had said to me, “You know, we need a PAC; we've got to get into Congress. We have to be able to go see these people.”

        I was familiar with the PAC, and recognized that and I agreed. In a meeting, I introduced the idea, "We're going to talk about. No vote, but we want to hear what the resident members have to say about it." We had a big discussion about it; there were pros and cons and so it went fine and, "Thank you, we've heard about it.” Like I said, we didn't make a decision about it. The decision obviously would go to the board; it's for the board to make.

        Eventually the decision was made. I don't believe it was made at first at the board level. On the other hand, the PAC has been wildly successful and we can demonstrate that, which in turn makes the members want to contribute to it because the see the PAC as doing something for them. The idea of, what's in it for me? You can understand that attitude and again I think we've demonstrated that there's something in it for you and we're going to do it.

TS:   Were the cons the basic attitude that this is pay for play, we're getting sucked into the system and—

SO: "It's dirty and we don't worry about that. We just don't do that as neurologists." Well, interestingly, when you started to look at who else had the PAC and they were very successful, we were behind the curve. It was decided, “Look, you've got to be in there playing with the big boys.” And so, we adopted the PAC.

TS:   The budget when you were president was $25 million; today it's more than double that amount. We've got 32,000 members. What accounts for that growth?

SO: I think the Academy's demonstrating its worth, and it tangible now to the members, not that it wasn't before. It was, but I think people just want to be involved in a society and they support the Academy and that just leads to the growth. I think the staff also—we have just a marvelous staff led by Cathy Rydell, who's just been, in my opinion, phenomenal. She's a good friend of mine; she's taught me a lot. I think Cathy has brought this enthusiasm, and has again made an outreach and that has paid off in a lot of ways.

        I don't quite know why we have so many more members because I don't know if there's that many more neurologists. I think maybe people are just more aware, and of course there's the international group, too, who want to belong because they get something from the society. It's something that I don't quite know why, but I think it's got to be because we're demonstrating that we're worth something.

TS:   We've also established a member category for advanced practice providers [APPs], and so we're bringing in more people who work closely with neurologists as business managers.

SO: Yes. There's that too. Those folks are seeing now that it's a good thing to belong to. We have in the United States, we have what, 90 some percent of the neurologists belong. With the APPs, as you said, I don't know what that number is off the top of my head.

TS:   I think it's close to a thousand.

SO: Yeah, up to [32,000 total AAN members]. Again, that's kind of interesting.

TS:   Yes. One of the things that you did as president working with the board of course, was to provide an incentive bonus for the staff.

SO: Yes. That was an issue that came up, and I think it was a very good thing, too. I think that the staff likes it very much, and it helps them reach their goals. It helps them see what they've done, and it's a tangible way that they see their worth being valued. I think that's what it's for and what it's good for.

TS:   I will tell you that we do appreciate it very much.

SO: I'm glad. Well, as I said it wasn't just my decision.

TS:   Just a couple of final questions here. A two-year term as president is very short in the scheme of things. Were things that you were very proud of accomplishing and something that you wish you had more time to work on?

SO: Yes. Well I mentioned that I was proud of introducing the idea of the PAC to the members. The other thing that I was proud of was getting the residents on the committees and bringing that idea forward. I think people hadn't necessarily thought of it before; I wanted a resident on the board. That's never done, but I've felt that it would be very good to have a resident on the board. As you've seen, that has grown.

        Getting the residents aware of the Academy; I think that was just one aspect of that that, “Hey, I can be involved. I can have a voice.” I was proud of both of those things really. There were other things too that we did, but you do it concert with other people in the board. You work together; it's a team.

TS:   Right. What was your favorite part of being president?

SO: Oh, gee! I think working with the people, with the membership and with the staff. Great people; I just enjoyed that so much. Accomplishing things and moving forward, that to me was quite a highlight. I also liked meeting the members. When we went to the various cities and things like that and the various meetings and etcetera. Meeting with different folks and hearing what they had to say. I think that's very enriching, and one can take that back to an organization and get some new ideas, some new aspects of things.

TS:   One final question; what advice would you give to a young Academy member who wanted to get more involved?

SO: Okay. First of all, you can apply to be on a committee, and put your name in for a committee you think you would like being on and where you could make a contribution. That's wide open and or you can make it known to the powers that be or whatever; lobby for yourself a little bit. Study the issues; see where you want to go.

        It's very important when you're on a committee to (A) show up, and (B) do the homework. People have asked me so many times, “Well, what's the secret, Dr. Olson?” First of all, you have to show up and second of all you have to be aware of what it is. And if you don't like that committee and what they're doing, well, okay, shift gears. Speak up, you don't have to go along with what everybody says.

        It's very disheartening to be on a committee and have a member who never says anything, never contributes, never has an opinion, or asks a question. You want to say, “Why are you here?” That's a negative aspect of things. There's so many positive aspects, so young folks sign up. We send out that email, join.

TS:   Simple enough, isn't it?

SO: Join. Come to the meetings.

TS:   Our time has run out. I want to thank you so much for taking the time to come down here to share your thoughts and recollections of your term as president as a very important leader of the Academy and neurology in general.

SO: Thank you, it's been my pleasure.