Responding to change: the challenge of the 1990s

✓ In 1995, neurosurgery in the United States is facing challenges and threats never before imagined. In its attempts to respond as a relatively small specialty, the neurosurgical community can no longer afford to remain a house divided. Neurosurgical unity has now become a critical matter. In particular, our neurosurgical leadership must minimize duplication of efforts and efficiently allocate its resources. Most importantly, it must unify its energies in directing the numerous joint American Association of Neurological Surgeons/Congress of Neurological Surgeons activities, as well as serving as a direct liaison with the emerging representative assembly under the Joint Council of State Neurosurgical Societies. The unification of the neurosurgical leadership will clearly enhance our ability to deal with all of our present challenges and future changes, but more importantly it will permit our specialty to truly speak with one voice.