Ok, so I admit I don't know much about the practice of neurology, but I have a few questions.
Cliff Huxtable? Shouldn't you be on the OBGYN forum?
😉
How feasible is having a neurology private practice?
Very. Solo practice seems to be fading out but you can certainly still be in a group practice. These range in size from 2 to 20+. Most larger groups cover multiple hospitals and office locations. Larger groups also usually allow you to have more of a "subspecialist" role if you want.
What types of cases do you see and what do you do in private practice?
"Bread and butter" neurology is headache, stroke, and seizure. Mostly headache. And lots of other pain complaints (neuropathy, back pain, etc).
DO NOT go into neurology if you can't handle a lot of pain patients. Even if you subspecialize, it will be a big part of what you see. Beyond that, lots of "weak and dizzy" old ladies; "altered mental status" consults in the hospital; smattering of other stuff like MS, vertigo, dementia, movement disorders. Sleep stuff is becoming bigger. Every once in a great while you get a zebra like Huntington disease or prion disease, limbic encephalitis, etc.
Most people in private practice (and academics) do both inpatient and outpatient practice, but, as with internal medicine, there is starting to be a move toward hospitalists. And neuro-intensive care is a growing area as well, if you like the inpatient environment.
It helps (the bottom line) to be able to do one of the following procedures (at least nowadays; this may change as the healthcare environment changes): EMG, EEG, sleep, pain.
How is the lifestyle? The pay? The hours?
Lifestyle's not bad. Hours are variable depending on your practice setting. My official hours are 8-5, some days I'm there longer, some days not. Call is variable depending on size of group. As for pay, I'm not starving. Many neurologists in private or (non-academic) hospital practice make >$200K, more if they do lots of procedures as noted above. After health care is "reformed," who knows?
How difficult is it to go into neuroradiology from neurology as opposed to radiology?
Don't waste your time with this line of questioning. While there is a growing field of "interventional neurology," it is
not the same thing as neuroradiology. If your goal is to sit around reading MRIs and CTs all day, you need to do a rads residency.
What are some of the more popular neurology subspecialties that lend themselves well to private practice?
Depends what you mean by "lend themselves well." If you mean "make money for the practice," it's neurophysiology (EMG/EEG), sleep and interventional pain. Maybe stroke. Other specialties that are frequently looked for by employers but not necessarily big moneymakers are headache, MS, epilepsy, maybe movement disorders.
(I would like to be in a private practice instead of working for a hospital.)
Most private practice jobs require some hospital work. Pure outpatient practice is rare.
Lastly, any overall tips/suggestions for a MSIII thinking about Neurology?
Think about the patients you will be seeing. Neurologists see patients with brain disease. The brain is the organ of behavior. Thus, many of your patients will not be playing with a full deck. Many have associated psychiatric conditions (depression, anxiety, etc) or other cognitive problems (dementia, various encephalopathies) that make it all that much harder to treat their other problems. This can be a source of great frustration to both patient and physician. If you can't deal with this, stay away.
As I noted above, pain is a big part of neuro, especially outpatient private practice. If you don't like that, again, stay away.
Neuro has a reputation for being unable to fix anything. That's true to an extent. Don't go into neuro expecting to "cure" much. The goal in most cases is to minimize symtpoms and maximize function. This is often not what the patient wants to hear, so if you don't like not being able to make a quick fix, don't do neuro.
Most med schools make you spend your neuro rotation on the inpatient service where all you see is stroke. Try to get away and do some time in an outpatient setting, if possible with a private practice doc, so you can see what they really do day to day.
Good luck.
