Timothy MDall, Health Economist, IHS Healthare & Pharmatim.dall@ihs.com
Tim Dall, Washington DC; Oksana Drogan, Atlanta, GA
Submitted February 19, 2014
We thank Drs. Racette and Holtzman for their comments. We produced national and state level projections of supply and demand for neurologists through 2025. National estimates of supply reflect that some neurologists are engaged in non-patient activities such as teaching, research, and administration. [1] As we noted, a 2010 Practice Profile Survey by the American Academy of Neurology reported that 73% of professional time goes to patient care and the rest going to administrative responsibilities (10%), research (9%), teaching (3%), and other activities (3%). The national average was 42.3 hours per week engaged in patient care (in addition to time spent for other professional activities), and we defined one clinical FTE as 42.3 hours of professional time.
When projecting state level supply and demand, we made the simple assumption that the proportion of professional time spent in non-patient activities is constant across states. To the extent that neurologists in a particular state average more (less) than the national average time spent in non-patient care activities, then our supply estimates will overstate (understate) total supply in that state. The projections also take into consideration that demands on neurologist professional time include non-patient care activities. State level demand projections are driven by FTE clinical demand projections that account for the characteristics of the population and applying national patterns of case use and delivery. So that demand and supply are in the same metric for comparison, the simplifying assumption is made that state-level demand for non-patient care activities is a constant proportion of total demand for neurologist time. Therefore, the state- level supply estimates and projections reflect active supply (not clinical FTEs) and the demand projections reflect total professional time for patient care and non-patient care activities.
While our estimates of supply and demand for each state are best estimates given the data available from national sources, the comments by Drs. Racette and Holtzman highlight that workforce analysts and neurologists in a particular state or community are best positioned to have a clear understanding of the workforce situation in the state or community in which they work.
1. Dall TM, Storm MV, Chakrabarti R, et al. Supply and demand analysis of the current and future US neurology workforce. Neurology 2013; 81: 470-478.
For disclosures, please contact the editorial office at journal@neurology.org.
We thank Drs. Racette and Holtzman for their comments. We produced national and state level projections of supply and demand for neurologists through 2025. National estimates of supply reflect that some neurologists are engaged in non-patient activities such as teaching, research, and administration. [1] As we noted, a 2010 Practice Profile Survey by the American Academy of Neurology reported that 73% of professional time goes to patient care and the rest going to administrative responsibilities (10%), research (9%), teaching (3%), and other activities (3%). The national average was 42.3 hours per week engaged in patient care (in addition to time spent for other professional activities), and we defined one clinical FTE as 42.3 hours of professional time.
When projecting state level supply and demand, we made the simple assumption that the proportion of professional time spent in non-patient activities is constant across states. To the extent that neurologists in a particular state average more (less) than the national average time spent in non-patient care activities, then our supply estimates will overstate (understate) total supply in that state. The projections also take into consideration that demands on neurologist professional time include non-patient care activities. State level demand projections are driven by FTE clinical demand projections that account for the characteristics of the population and applying national patterns of case use and delivery. So that demand and supply are in the same metric for comparison, the simplifying assumption is made that state-level demand for non-patient care activities is a constant proportion of total demand for neurologist time. Therefore, the state- level supply estimates and projections reflect active supply (not clinical FTEs) and the demand projections reflect total professional time for patient care and non-patient care activities.
While our estimates of supply and demand for each state are best estimates given the data available from national sources, the comments by Drs. Racette and Holtzman highlight that workforce analysts and neurologists in a particular state or community are best positioned to have a clear understanding of the workforce situation in the state or community in which they work.
1. Dall TM, Storm MV, Chakrabarti R, et al. Supply and demand analysis of the current and future US neurology workforce. Neurology 2013; 81: 470-478.
For disclosures, please contact the editorial office at journal@neurology.org.