This article describes practice and payment trends among neurologists. Data from the 2012 Practice and Payment Trends survey were compared to results from the 2010 Medical Economics survey. Both ...surveys were sent to a random sample of 1,000 US practicing neurologists, with a response rate of 32%. Since 2010, there has been an 8% increase in the percent of neurologists working in academic medical centers. Nearly half of neurologists reported working for a hospital-affiliated practice. Wait times have increased 40% for a new patient visit. Only 19% of neurologists indicated procedures as the primary focus of their practice. New delivery models have not yet gained traction with neurologists but the majority (>80%) of neurologists currently use electronic health records in their practice.
Electrical impedance myography (EIM) is a new bioimpedance‐based technique for neuromuscular disease assessment. Past work has focused on EIM in the evaluation of diffuse diseases (such as myopathy). ...In this study, the method's most basic form, linear‐EIM, was used for the assessment of restricted radiculopathic disease. Ten normal subjects and 10 patients with unilateral cervical or lumbosacral radiculopathy, diagnosed by electromyography and clinical criteria, were enrolled. Linear‐EIM was performed bilaterally on all individuals, and comparisons with the major outcome variable, θavg, were made. In normal subjects, side‐to‐side differences in θavg averaged 0.64% and were no greater than 15.9% in magnitude. In the 10 patients with radiculopathy, θavgwas consistently lower in the affected extremity, with a mean side‐to‐side difference of 15.3%, but ranging as low as 72.3%; there was a tendency for muscles with more prominent chronic neurogenic change to show greater relative reductions in θavg. These findings support the potential utility of EIM in assessment of localized neuromuscular disease. Muscle Nerve, 2005
Part 1 of this series focused on factors influencing payment for patient care services. In Part 2, we review compensation models for nonpatient activity such as medical legal reviews, committee ...participation, and collaboration with the pharmaceutical industry. Compensation to neurologists in private practice is commonly in the form of guaranteed salary and bonuses. Salary for neurologists in academic medicine has changed considerably over the past 3 decades, from small departments with faculty supported by grants and volunteer faculty, to large departments with faculty split between those with research grant support and those focusing on patient care and teaching. Compensation models in academic medicine range from straight salary without bonus to straight salary with personal or shared bonus and salary based on relative value units.
The tipping point for electronic health records (EHR) has been reached and universal adoption in the United States is now inevitable. Neurologists will want to choose their electronic health record ...prudently. Careful selection, contracting, planning, and training are essential to successful implementation. Neurologists need to examine their workflow carefully and make adjustments to ensure that efficiency is increased. Neurologists will want to achieve a significant return on investment and qualify for all applicable financial incentives from payers, including CMS. EHRs are not just record-keeping tools but play an important role in quality improvement, evidence-based medicine, pay for performance, patient education, bio-surveillance, data warehousing, and data exchange.
Part 1 of this series focused on factors influencing payment for patient care services and Part 2 described compensation plans for neurologists in private practice and in academic medicine. In Part ...3, we review how hospital salary support and appointments to Veterans Administration hospitals contribute to the salary structure of neurologists. We also discuss neurohospitalist care and ways neurologists can potentially increase compensation from on-call pay, telemedicine, and the use of new transitional care and complex chronic care codes. We conclude with an emphasis on the important role of neurologists as team players in a health care system that will rely on efficient coordination of care among many health care workers.
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