Movement Disorder And Private Practice

[MKKJ20]

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I am very interested in pursuing a career in Movement Disorders. I find the whole field very fascinating. However, I am not interested in pursing a career in academic medicine. I would like to be in private practice. I just wanted to know if it is possible to be successful in Private Practice as a Movement Disorder specialist. Or is this field strictly an academic field? Any input would be greatly appreciated.

 

[neurolddoc]

While I am not a Movement Disorder specialist, there are people in my area who practice the subspecialty. From an economic point of view, you would have some procedures in the form of Botox. I think many of the movement people also do clinical trials but that takes a big commitment of resources and is not something you can just dabble in. Some also do DBS programming but I don't know how much volume that would generate. You could always do some EMG to pay the bills.

 

[BrainBuff]

I would say the field is strictly academic. Most neurologists in private practice try to handle everything they can, and what they do not feel comfortable with, they end up referring to a university practice for the most part. A private multispecialty neurology group may require its own Movement Disorder guy, but those are very rare.

I am very familiar with some very large cities and the trend for practitioners is to protect their turf. You do your EEGs, your EMGs and your NCVs and even some vascular studies. You only refer some one out if you have no clue, or require a second opinion for the likes of ALS, surgical Epilepsy, or a tough MS case, Dystonia etc.

 

[oruen]

this is certainly possible, i know a former resident doing this currently. he is joining a large nonacademic group, he will see _mostly_ MD, do DBS, botox etc, in a fairly large city/hospital. he'll essentially be the MD guy in that group but see some general neuro as well. more and more neuro residents are going into fellowships which are not just helpful for academia anymore...in well populated areas, larger groups of neurogists are actively recruiting people with this expertise. just take a look at the ads in the green journal. it's possible, with movement disorders it may be less common currently, and less lucrative potantially than EMG etc, but this person i know is being paid very well. as the required knowledge base for each field continues to grow, and as there are more neurologists available out in the community, the demand for private subspecialists will grow. in fact, i think patients will demand it in some instances-i.e. wouldn't you rather go to a MD doc if you had Parkinson's or MS doc if you had MS? there will still be a demand for general neurologists in many underserved areas as well.

 

[MKKJ20]

thank you for all the replies;

just one more quick question; I understand that often times, DBS placement requires a movement disorder neurologist to map the brain in the OR. is this something that is seen also in private practice?

 

[BrainBuff]

Movement disorders neurologists do not get involved with intraoperative monitoring. You are referring to Neurophysiologists which emphasize EMG, Evoked Responses, EEG, in their fellowships. I know of some fellowships that are somewhat combined.

And yes, as a neurophysiologist if you develop a relationship with a surgical team involved in that type of surgery, you will do the monitoring. But again, very few private surgeons are doing those procedures. We go back to the fact, that all the sophisticated stuff remains strictly academic.