Tareq and Michaele Salahi have stolen the media spotlight recently as a result of their White House party crashing, though their escapades failed to disrupt the festivities or pose any significant harm. Yet when it comes to crashing parties, maybe the government itself is the bigger culprit—intruding on physician's practice success. Medicare has retracted the consult codes on which so many specialists rely for reimbursement for their time and unique expertise, and there are concerns that efforts to neutralize the budgetary impact of healthcare reform could lead to additional financial detriment for physicians (and patients). Already CMS is focused on audits as a way to recoup overpayments and root out fraud, and expansions of audits are expected in the short- and long-term.

As a new decade dawns, the fiscal outlook for physicians is uncertain at best. Yet when it comes to clinical care, there is cause for optimism. From emerging medical therapies under FDA review to novel technologies that are enhancing patient care, neurologists are discovering new ways to enhance efficiency and optimize patient care. As our cover story describes, new apps for use on wireless devices are helping patients track their headaches and better communicate their experiences to patients. At the same time, as discussed on p. 30, electronic health records (EHRs) are finally entering prime time, helping to streamline documentation and billing, improving patient safety, and—for a change—providing practices an opportunity to increase Medicare reimbursements.

The close of this month marks the end of the decade that the British have termed “The Aughts.” While the term has not quite caught on in the US, maybe medical practitioners should think about a new era of “oughts,” determined to take the steps they ought to to ensure the success of their practices and the welfare of their patients in the new year and beyond. We thank you for your continued support of Practical Neurology and wish you a happy and successful new decade. Be assured that we'll continue to deliver information to help you enhance your practice of neurology.