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June 15, 2021; 96 (24) Contemporary Issues

A Shortage of Neurologists – We Must Act Now

A Report From the AAN 2019 Transforming Leaders Program

View ORCID ProfileJennifer J. Majersik, Aiesha Ahmed, I-Hweii A. Chen, Holly Shill, Gregory P. Hanes, View ORCID ProfileVictoria S. Pelak, Jennifer L. Hopp, Antonio Omuro, Benzi Kluger, Thabele Leslie-Mazwi
First published April 30, 2021, DOI: https://doi.org/10.1212/WNL.0000000000012111
Jennifer J. Majersik
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Aiesha Ahmed
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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I-Hweii A. Chen
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Holly Shill
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Gregory P. Hanes
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Victoria S. Pelak
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Jennifer L. Hopp
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Antonio Omuro
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Benzi Kluger
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Thabele Leslie-Mazwi
From the Department of Neurology, Division of Vascular Neurology (J.J.M.), University of Utah, Salt Lake City; Departments of Neurology and Medicine (A.A.), Penn State Health, Hershey, PA; Department of Neurology, Division of Neuromuscular Medicine (I-H.A.C.), Medical University of South Carolina, Charleston; Barrow Neurological Institute (H.S.), University of Arizona College of Medicine–Phoenix; Sarasota Memorial Hospital (G.P.H.), FL; Departments of Neurology and Ophthalmology (V.S.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (J.L.H.), University of Maryland School of Medicine, Baltimore; Department of Neurology (A.O.), Yale School of Medicine, New Haven, CT; Departments of Neurology and Medicine (B.K.), University of Rochester Medical Center, NY; and Departments of Neurosurgery and Neurology (T.L.-M.), Massachusetts General Hospital, Boston.
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Full PDF
Citation
A Shortage of Neurologists – We Must Act Now
A Report From the AAN 2019 Transforming Leaders Program
Jennifer J. Majersik, Aiesha Ahmed, I-Hweii A. Chen, Holly Shill, Gregory P. Hanes, Victoria S. Pelak, Jennifer L. Hopp, Antonio Omuro, Benzi Kluger, Thabele Leslie-Mazwi
Neurology Jun 2021, 96 (24) 1122-1134; DOI: 10.1212/WNL.0000000000012111

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Abstract

In nearly every US state, a large mismatch exists between the need for neurologists and neurologic services and the availability of neurologists to provide these services. Patients with neurologic disorders are rising in prevalence and require access to high-level care to reduce disability. The current neurology mismatch reduces access to care, worsens patient outcomes, and erodes career satisfaction and quality of life for neurologists as they face increasingly insurmountable demands. As a community, we must address this mismatch in the demand and supply of neurologic care in an aggressive and sustained manner to ensure the future health of our patients and our specialty. The American Academy of Neurology has multiple ongoing initiatives to help reduce and resolve the existing mismatch. With the intent of raising awareness and widening the debate nationally, we present a strategic plan that the Academy could implement to coordinate and expand existing efforts. We characterize the suggested strategies as shaping the demand, enhancing the workforce, and advocating for neurologist value. The proposed framework is based on available data and expert opinion when data were lacking. Prioritization of strategies will vary by geography, practice setting, and local resources. The time to act is now to allow concerted effort and targeted interventions to avert this looming public health crisis.

Glossary

AAFP=
American Academy of Family Physicians;
AAN=
American Academy of Neurology;
ACP=
American College of Physicians;
APM=
alternative payment model;
APP=
advanced practice provider;
CME=
continuing medical education;
ECHO=
Extension for Community Healthcare Outcomes;
IMG=
international medical graduate;
PCP=
primary care provider;
SIGN=
Student Interest Group in Neurology;
TLP=
Transforming Leaders Program;
URM=
underrepresented minorities;
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.

  • Received August 10, 2020.
  • Accepted in final form March 4, 2021.
  • © 2021 American Academy of Neurology
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