The death of the physician-scientist?

As third- and fourth-generation physicians, we have a profound respect for the medical profession and a sense of the arc of medical history. In COVID-19, we are facing an acute global pandemic, a public health challenge not seen since the time of our great-grandfathers. But even they would be shocked by another threat to the practice of medicine in New York and across the country: misguided and short-sighted government policies that are going to deter the next generation from joining medicine and may well bring to an end the era of the physician-scientist.

As viewers of the Netflix series “Lenox Hill” know, the neurosurgery department at Lenox Hill Hospital takes care of critically ill patients who suffer from painful and life-threatening neurologic conditions such as traumatic brain injury, brain tumors, debilitating degenerative spine disorders and stroke. We also perform cutting-edge clinical research developing treatments for some of the most aggressive and deadly forms of brain tumors — ones considered by many other hospitals to be untreatable.

We believe deeply in the vital, lifesaving work of the clinicians and researchers in our neurosurgery department and others like it across the state and country. Unfortunately, the combination of a deadly pandemic and shortsighted policy decisions threaten the continued efforts of the clinician-scientist, physicians who combine patient care with medical research.

COVID-19 has had a devastating impact on our health-care system across the board. Here in New York City and other hard-hit areas, physicians shifted their attention to the treatment of COVID cases, canceling or deferring most of the non-emergency procedures that are the financial lifeblood of a hospital system. Nationwide, at the height of the pandemic, our hospitals were facing a net revenue decline of $1.44 billion per day due to COVID-19.

Unfortunately, unless Congress acts, this impact will be compounded next year by new rules recently announced by the Centers of Medicare & Medicaid Services that will cut overall payments to surgeons treating Medicare patients by up to 9%. This will have a devastating trickle-down effect, with fewer resources available to support research, training and innovation. In addition, it may negatively impact Medicare beneficiaries’ access to care when they need it most.

Hospitals are businesses, whether we like it or not, and some of the greatest stressors in our jobs happen outside of the operating room. The byzantine payment process, insurance red tape and laborious data entry requirements all affect our ability to do what is most important.

Everything we do daily — from brain surgery to obstetrics and gynecology, to emergency room and trauma care — will feel the impact of Medicare payment cuts that devastate a business model that already operates on narrow profit margins of around 1%.

But what troubles us most is the longterm implications for medical research and innovation. Research funding is being squeezed from all sides right now. NIH funding is a tiny fraction of overall health care spending in this country, and the economic downturn resulting from this pandemic is sure to reduce the capacity for philanthropic giving to offset any shortfalls.

A recent analysis predicted that total nationwide research funding will drop by 20-40% due to COVID-19. Financing research will become even more dependent on shrinking clinical revenue, and reducing payments to surgeons by nearly 10% will make that nearly impossible.

There is still a narrow window to prevent this from happening. America’s surgeons need Congress to act this year by passing legislation that will avert these devastating cuts.

Now is the time to increase funding for health care and medical research, not to cut it. Now is the time to plant the seeds that will bring us the next generation of medical innovation, not to salt the earth. It is time for Congress to stand with our health care heroes, not undercut them.

Langer is chair of the department of neurosurgery at Lenox Hill Hospital and professor of Neurosurgery and Radiology at the Zucker School of Medicine at Hofstra/Northwell. Boockvar is vice-chair of the department ofnNeurosurgery and director of the Brain Tumor and Pituitary/ Neuroendocrine Center at Lenox Hill Hospital.