Job outlook for neurology

[HarveyCushing]

I came across this article, "Neurology in the next two decades", Walter G. Bradley, Neurology 2000;54:787–789. From my read of it, the author asserts that the supply of neurologist will be below demand by 2012 and the supply will continue to fall to 20% below demand by 2020. He attributes this to: "Factors influencing the demand for neurologists’ services include population growth and aging, economic growth, changes in managed care, technology and disease management, and interactions with other healthcare professions." He also makes the same claim for pediatric neurologist as well.

I am curious what you guys have to say about this. Would you say this is a fairly reliable assessment of the situation? Or is this some spin that the AAN might have had a part to play in? I have looked for more recent articles since this one is 8 years old. So if anyone knows of a more recent article or data please let me know or post it here. One interesting comment that the author mentioned about predicting the demand of neurologist in the future is:

"It has been said that the problem with forecasting is not with the projections, but with the fact that reality fails to keep up with the assumptions. Neurology workforce projections are highly dependent on future changes that are difficult to predict. These include the economic status of the United States; funding of healthcare by the government, especially for the 46 million uninsured; and funding of graduate medical education. Moreover, changes in technology and treatment may dramatically alter the need for neurologists."

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[buckley]

I dont know about the numbers, but it's easy to agree that the demand for neurologists would increase in the future for the reasons stated above. More than the numbers, I think it's a very exciting time to be a neurologist because the research is really growing. New drugs/treatments are being developed all over. It's pretty awesome even if you're not that into research.

 

[HarveyCushing]

If anyone has read or seen any numbers on the need of different sub-specialties within neurology I would be interested in hearing about that.

 

[DarthNeurology]

I think demand for neurologists will decrease.

 

[minstral]

Wow Darth your lack of knowledge is staggering...
Original Poster- ignore his post.

 

[AlternateSome1]

I think the relatively low pay of neurologists compared to other doctors is due to decreased demand, i.e. if demand was so great there would be more patients..

Yeesh...this seems speculative at best. While specialties may feel a bit of sway from supply and demand, mostly in geographic differences, pay is mainly a function of values that medicare has established for the type of work done (Relative Value Units, RVUs). Procedures that are deemed to require a lot of training, a lot of skill, high overhead, and are stressful are paid well. Seeing patients during office visits are paid less well. This is why those who do fellowships that allow more procedures are compensated better. Insurance companies generally make deals with offices to pay a percent of medicare rates...generally 110-140% of the medicare rate. A doctor may bill for whatever he or she wishes, but the insured only pay what they are contracted to pay. This normally leaves only a few (the rich "medical tourists" from other countries, and the uninsured) to pay the actual billed amount. However, procedures not covered by insurance plans can be profitable as patients have to pay the billed rate (derm, plastic surgery). Academic salaries are less influenced by RVUs, because these physicians tend to be paid a base rate, then obtain some compensation based on RVUs from their greatly reduced clinical duties.

Here are a few of the early articles that brought about this system.

Holahan, J., and Scanlon, W. 1978 Price Controls, Physician Fees, and Physician Incomes from Medicare and Medicaid. Publicaiton URI 21800 (April). Washington, D.C.: The Urban Institute.

Paying for Physician Services under Medicare and Medicaid
John Holahan, Jack Hadley, William Scanlon, Robert Lee and James Bluck
The Milbank Memorial Fund Quarterly. Health and Society, Vol. 57, No. 2 (Spring, 1979), pp. 183-211