Effect of Obamacare on Neurology

[rafman]

I'm an MS1 and I am really really interested in neurology (shadowed a pain med doc in undergrad, my preceptor is a neurologist and I am going to do research in a neurology lab next semester).

I was just curious how the impending Obamacare is going to affect the field of Neurology? Also in terms of salary and compensation (I'm already aware that neurology is on the lower spectrum of salary, but that really isn't that important to me)

Also, how important are pre-clinical grades (I'm doing ok, right in the middle of the class range)?

Thank you in advance for taking time out of your busy schedules to answer my questions

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[danielmd06]

I'm an MS1 and I am really really interested in neurology (shadowed a pain med doc in undergrad, my preceptor is a neurologist and I am going to do research in a neurology lab next semester).

I was just curious how the impending Obamacare is going to affect the field of Neurology? Also in terms of salary and compensation (I'm already aware that neurology is on the lower spectrum of salary, but that really isn't that important to me)

Also, how important are pre-clinical grades (I'm doing ok, right in the middle of the class range)?

Thank you in advance for taking time out of your busy schedules to answer my questions

http://forums.studentdoctor.net/showthread.php?t=929993&highlight=affordable+care+act+neurology

Sounds like you're okay for neurology so far. Keep in mind you need to do fair on the USMLE and that your performance on a neurology rotation in third and fourth years are considered much more important than the M1 or M2 grades.

 

[maw4bc]

This certainly changes the game:
http://www.aan.com/go/practice/coding

With this change coming Jan 1, 2013, a standard CTS would be making 65% less per patient, or $425. That is an astronomical decrease in NCS reimbursement.

I really hope AAN & AANEM can team together to stop this from happening.

 

[Mattchiavelli]

This certainly changes the game:
http://www.aan.com/go/practice/coding

With this change coming Jan 1, 2013, a standard CTS would be making 65% less per patient, or $425. That is an astronomical decrease in NCS reimbursement.

I really hope AAN & AANEM can team together to stop this from happening.

"The AAN worked with the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) and the American Academy of Physical Medicine and Rehabilitation (AAPM&R) to propose higher values for these services, and will continue to work with those societies to advocate for better reimbursement. We are committed to advocating on behalf of our members and helping our members prepare for these changes."

they are, apparently. Did you not read your own link?

 

[danielmd06]

I wonder if the AAN is going to do the same for sleep studies and the arguments regarding home testing?

They certainly should in my opinion (though I have a vested interest in that one). Neurology practices have very narrow profit margins as it is, and need all the help they van get to stay financially viable. Otherwise, the only way someone could practice neurology is going to be to work for an academic center or a large hosptial entity.

Very few future applicants are going to accept the rigors of extensive training, large debt, a difficult lifestyle, and tremendous legal risk for much less money than neurologists are making right now.

 

[maw4bc]

Otherwise, the only way someone could practice neurology is going to be to work for an academic center or a large hosptial entity.

I have spent my entire weekend crunching numbers and coming up with ways to keep my practice financially sustainable. I just don't see how I can do it. EMG/NCS was a huge part of my practice. This ruling is basically telling me that 65% of my revenue is GONE by Jan 1. To say I am gutted is an understatement. So disappointed. I feel most for the people that I employ to run my office, their financial situation is much worse than mine.

 

[rafman]

So I guess this means that most neurologists are going to join large hospital systems or academic medical center (shift away from private practice) or switch specialties in general? Either way I am really interested in this field, even if I'm making 90-100K. I just have to marry someone in Anesthesiology, surgery or rads

 

[DD214]

<Either way I am really interested in this field, even if I'm making 90-100K>

Spoken like a first year medical student. Neurology is a great field, but you will not feel the same way when you are actually practicing and getting 2AM calls from the about tPA with your license on the line.

 

[neurologist]

Well, if you believe our hospital administration, Obamacare and shift to "medical home" models is the end of the world for neurology and many other specialties, because there will be financial disincentives for primary care docs to make referrals (even within their own system, from what I gather.)

If you're a neurologist, and know full well that 99% of primary care MDs don't know jack **** about neurology and don't want to deal with neuro patients, you won't be losing any sleep over this. But you can still pretty much count on your salary going down for other reasons.

 

[FutureDO2016]

So did the changes go into effect on Jan 1st 2013?

 

[DD214]

They most certainly did for EMG. Add a 2% cut from Medicare due to sequestration and rumors of additional cuts to EEG reimbursement for 2014. Good times for neurology.

 

[Microglia]

Well that sounds unfortunate. Does anyone how how these changes have/will affect academic neurology? I'm interested in the physician scientist side of neuro and was curious.

 

[bustbones26]

Well that sounds unfortunate. Does anyone how how these changes have/will affect academic neurology? I'm interested in the physician scientist side of neuro and was curious.

I recently saw a guy that I was considering McArdle's versus CPT deficiency. Before I went out and shot gunned a bunch of genetic tests and muscle biopsy, I wanted to get the opinion of an academic neuromuscular neurologist. So I sent the guy to the "big university" doctor who told him to just come back and see me for an EMG

Since when do academic neuromuscular neurologists send patients back to the general neurologist for an EMG? Whenever they do not make money doing them anymore I suppose?