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Reasons behind a shortage of specialists in neurology in the United States

Overwhelming Shortage of Specialists in Neurology: Nine Reasons Why

Overall Shortage of Physicians

Today, the United States faces a shortage of physicians, which is projected to worsen significantly over the next decade. For example, the Association of American Medical Colleges projects a shortfall of 37,800 and 124,000 physicians by 2034.  The ramifications of the deficit are clear: an impending crisis in which our healthcare system will not be able to deliver adequate medical care to all who need it.

Significant Shortage of Neurologists

The severity of the shortfall varies by specialty. The field of neurology has already been hit especially hard. A near-perfect storm has resulted in a significant gap between the demand for neurologists and the supply of neurologists to provide the required care.

The American Academy of Neurology (AAN) characterized the shortage of neurologists in the U.S. as a “grave threat.” The current and projected neurology mismatch in supply and demand has harmful consequences: reduced and delayed access to high-quality care, worsened patient outcomes, and eroded career satisfaction for neurologists.

Statistics on the Shortfall

Based on scientific modeling in 2012, the National Center Health Workforce Analysis projected a 73% increase in the national shortfall in neurologists needed to meet the national demand by 2025. In 2025, the need for neurologists is projected to exceed the supply by 19%.

A 2020 study of Medicare enrollees revealed that only 24% of people with a neurologic condition were seen by a neurologist. The same study highlighted regional differences in the availability of neurologists. While the prevalence of neurologic disorders is consistent across the U.S., the distribution of neurologists is not. The magnitude of regional differences is striking. For example, access to neurologists was available to 27% of those seeking it in urban areas but only 21% in rural areas.

We hear from our MS community about the personal effect of the shortage. For example, many BeCare MS Link users tell us of traveling over four hours to see a qualified neurologist, and others report waiting more than a year for their next office visit.

Increased Need for Neurologists and Specialists in Neurology

So why the increased demand for neurologists? 

  1. The population is simply getting older. Every country is experiencing “population aging,” with a more significant proportion of older people.  Source. Advances in medicine have helped people live longer.

For the U.S., the baby boomers are the driving force of America’s aging. As the large post-World War II generation ages, the population skews older. At the turn of this century, 13% of the population was 65 and older. By 2030, 21 percent of people            will be 65+; by 2060, nearly one in four Americans will be 65 and older. Source.

  1. Increasing age is the most critical risk factor for most neurologic diseases. Neurologic disorders are rising in prevalence. For example, the prevalence of dementia, stroke, and Parkinson’s Disease has increased globally two to threefold from 1990 to 2016. Source.
  2. Improved patient outcomes in neurology have contributed to the increased number of surviving neurologic patients. The success of innovative treatments and pharmaceutical advancements for conditions such as multiple sclerosis, migraines, and epilepsy have created more work. Ongoing access to specialized care will be needed to reduce disability, especially for MS patients. Source.
  3. Increased referrals to neurologists and neurology clinics that don’t warrant neurologic intervention. Because over half of patients with neurologic complaints are not seen by neurologists, a lack of training about neurologic diseases and a lack of experience conducting a neurologic exam by non-neurologists ultimately results in more unnecessary referrals.

The Supply: The Number of Neurologists

With demand growing, the supply of neurologists is not expanding to meet demand. Here’s why.

  1. Many working neurologists will also be reaching retirement age along with the rest of the Baby Boomers. This demographic reality factors into 2025’s projected 19% shortfall.
  2. Some argue that neurology has an image problem. This is not a new problem. In 1994, the JAMA Neurology Journal reported that half of medical students experience “Neurophobia”– the fear of neural sciences and clinical neurology. The disconnect may start with how neurology is taught. Medical students and residents often perceive the field as the most complicated medical specialty. BMC Medical Education attributes these perceived difficulties to the complexity of neuroanatomy, limited patient exposure, and insufficient teaching. Source
  3. There’s a misperception about the rewards of neurology. Many potential neurologists believe there is little to offer patients with neurologic conditions. On the contrary, especially with the advances in treatment mentioned earlier, neurologists can make a long-lasting and life-changing impact on their patients’ lives. Unfortunately, these misperceptions about the field of neurology are prevalent globally. To attract more medical students to choose the field of neurology, Japan produced a 15-minute promotional video to convince medical students about the rewards of being a neurologist. Source.
  4. Compensation is another supply determent. In 2021 the Medscape Neurologist Compensation Report, the average neurologist’s salary ranked in the bottom third of all medical specialties.
  5. Burnout is an issue. According to a 2021 report from Medscape, neurology is one of the specialties experiencing the most significant degree of burnout, with 53% of neurologist respondents saying they are burned out, depressed, or both.

Solutions to Supply-Demand Discrepancy

These facts may convey more gloom than necessary for our healthcare system and those dealing with neurologic disorders. On the positive side, many initiatives are underway to address the discrepancy between the supply and demand of neurologists.

Among the possible solutions is building the pipeline of neurologists through education, mentoring, federal funding, and increased compensation.  Additionally, educating the referral base will reduce the number of unwarranted referrals and mitigate demand. Finally, one of the most significant impacts on addressing the staffing shortages will be the increasing adoption of remote patient care and digital health tools.

Lessons for Patients: How BeCare Link Can Help

BeCare Link was founded because of the healthcare challenges our society faces. Our mission is to help patients with neurologic issues become their own health advocates and to supply all clinicians with the tools needed to treat patients more efficiently and effectively.  (Read about the inspiration for BeCare Link here). With BeCare MS Link and BeCare Neuro Link (coming soon), you can monitor the status of your neurologic condition, whether it’s Multiple Sclerosis or another neurologic disorder.

The BeCare Neuro Link App can help you assess your neurologic health if you are afraid that you may have inherited a neurologic condition or notice something just isn’t right with your nervous system, even if you don’t have a diagnosis of a neurologic disorder. Then, you can take an active role in your healthcare by sharing the quantitative data generated by the app with your physician at your office or during telehealth visits. If you detect a change, our apps can help quantify the change, which by sharing with your physician, can guide your care more quickly and accurately. 

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