Child neurology in the 21st century
More than the sum of our RVUs
Citation Manager Formats
Make Comment
See Comments

Abstract
In September 2017, the Child Neurology Society (CNS) convened a special task force to review the practice of child neurology in the United States. This was deemed a necessity by our membership, as our colleagues expressed discouragement and burnout by the increase in workload without additional resources; reliance on work relative value units (wRVUs) as the sole basis of compensation; a push by administrators for providers to see more patients with less allotted time; and lack of administrative, educational, and research support. The CNS Task Force designed and distributed a survey to multiple academic divisions of various sizes, as well as to private practices. Our findings were strikingly similar across different practices, demonstrating high workloads, lack of resources, poor electronic medical record support, and high provider symptoms of fatigue and burnout. From the results, the CNS Task Force has concluded that wRVUs cannot be the sole basis of compensation for child neurology. We have also made several specific recommendations for alleviating the current situation, including innovative ways to fund child neurology as well as ways to enhance job satisfaction.
Glossary
- CNS=
- Child Neurology Society;
- FTE=
- full-time employees;
- IPOP=
- independent private organizations and practices;
- NP=
- nurse practitioners;
- RVU=
- relative value unit;
- wRVU=
- work relative value unit
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 57
- Received March 20, 2019.
- Accepted in final form October 29, 2019.
- © 2019 American Academy of Neurology
Disputes & Debates: Rapid online correspondence
- Author response: Child neurology in the 21st century: More than the sum of our RVUs
- Mary Zupanc, Pediatric Neurologist and Epilepsy Specialist, & Professor, Dept of Neurology and Pediatrics, Co-Medical Director, CHOC-Children’s Neuroscience Institute; Division Chief, UCI Pediatric Neurology (Irvine, CA)
Submitted September 15, 2020 - Author response: Child neurology in the 21st century: More than the sum of our RVUs
- Mary Zupanc, MD, Pediatric Neurologist and Epilepsy Specialist, & Professor, Dept of Neurology and Pediatrics, Co-Medical Director, CHOC-Children’s Neuroscience Institute; Division Chief, UCI Pediatric Neurology (Irvine, CA)
Submitted September 15, 2020 - Reader response: Child neurology in the 21st century: More than the sum of our RVUs
- Kendall B. Nash, Child Neurologist, UCSF Benioff Children's Hospital
- Nicholas S. Abend, Child Neurologist, Children's Hospital of Philadelphia
- Melissa L. Hutchinson, Child Neurologist, Nationwide Children’s Hospital
- Ricka D. Messer, Child Neurologist, Children’s Hospital Colorado
- Elizabeth M. Wells, Child Neurologist, Children's National
Submitted February 07, 2020 - Reader response: Child neurology in the 21st century: More than the sum of our RVUs
- Jan B. Wollack, Child Neurologist, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center
Submitted February 02, 2020
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.