Introduction: Since 1991, we identified at least 14 job discrimination lawsuits in neurosurgery in the continental US. They caught the attention of the media in fascinating ways.

Methods: We mailed and delivered questionnaires to neurosurgeons on and off for a period of 14 and a half years. A paid subscription to Public Access to Courts Electronic Records is useful to search the federal courts. We reviewed records (Newspapers, Court Dockets) via electronic search for the following terms: “neurosurgery; harassment; discrimination; settlement; lawsuit; minority; female.”

Results: We found cases litigated in the media easy through exams of newspapers websites as Awad vs Lillehei, and complaints in Boston. Docket Case # 95-CV-2227, is Chandler's lawsuit against James and Jon Robertson on 95. While in Boston, Arthur Day received 2 work discrimination lawsuits in Federal Court from females of Indian decent. These were Tuli, and Soni v. Day, BWH, et al. Day also received three discriminations complaints through the Massachusetts Commission Against Discrimination within a 3 year period. The third complaint against Day from Narayanan received a settlement. Soni also filed a lawsuit against Chin, Boston Medical Center, alleging retaliation from Chin against Soni because Soni lawsuit against Day will bring retaliation by the ACGME to Boston Univ. not granting a residency. Tuli obtained a trial verdict of $1,620,003.00 sustained by Appellate Court. Period of 1990-2000 shows 2 discrimination cases, 8 cases for the period of 2000-2010, and incomplete analysis shows at least 3 cases after 2010.

Conclusions: The percentage of African Americans and Hispanics Neurosurgeons are grossly less than 3 %. Women constitute 6% of ABNS-certified practicing neurosurgeons but now 51 % of graduating medical students. We recommend that the neurosurgical profession support the promotion of minorities to leadership positions. This will result in the normalization of the workforce and patient care.

Patient Care: Elimination of racial tension in the work environment through the implementation of the suggested Committee to eradicate litigation between other measurements will improve physician cordial communication ending in better patient care and the joint effective solutions to decrease or eliminate human errors that can jeopardize patient care.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Realize the importance of keeping a job environment of mutual respect with empathy and consideration of other physicians racial, gender, or ethnic groups. 2) Discuss, in small groups those aspects that arise conflicts between different racial or ethnic groups and how to delineate amicable solutions to the disagreements. 3) Identify an effective ways of individual personal communication as an early treatment of individual personal communication for a successful eradication of conflicts originating discriminatory based problems.

References: "Diversity in Medical Education – Facts and Figures 2012” – AAMC Report “Diversity in the Physician Workforce – Facts and Figures 2010” – AAMC Report “Health Policy Research Institute - The Surgical Workforce in the United States: Profile and Recent Trends.” American College of Surgeons and Association of American Medical Colleges 2010 Report “Ensuring an Adequate Neurosurgical Workforce for the 21st Century” – December 19, 2012 report to the Institute of Medicine “Walking Out on the Boys,” Book, Conley, Frances. K (1998) New York: Farrar, Straus, and Giroux Court Dockets; Legal Complaints; Court Pleadings; Documentation of Settlement or Trial Verdicts; Newspapers Clips Women in neurosurgery: inequality redux"" JNS online June 2018