Typical Week in Neuro

[318038]

Hey guys, I've been following this forum for awhile and thought I would post. I am very interested in neurology at this point based primarily on how much I loved the nervous system block in our school. I was just wondering what they typical week of a general neurologist is in both private practice and academia? Mostly inpatient or outpatient? Which are the most common diseases seen and can you see progress in these patients? What are the hours like? What does the future of the field look like and lastly what do you wish you could change about the way the field operates?

I know this seems like too many questions but these answers seem surprisingly difficult to track down. Any information would be greatly appreciated, thanks!

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[95439]

Hey guys, I've been following this forum for awhile and thought I would post. I am very interested in neurology at this point based primarily on how much I loved the nervous system block in our school. I was just wondering what they typical week of a general neurologist is in both private practice and academia? Mostly inpatient or outpatient? Which are the most common diseases seen and can you see progress in these patients? What are the hours like? What does the future of the field look like and lastly what do you wish you could change about the way the field operates?

I know this seems like too many questions but these answers seem surprisingly difficult to track down. Any information would be greatly appreciated, thanks!

Hey, I'm just a 4th year medical student, but I'm on my 4th month of neurology rotations now, and I can answer some of your questions:
1) Most common diseases seen in outpatient = Headache, seizures, multiple sclerosis, neuropathies, movement disorders (i.e. Parkinson's), dementias...and much much more. Yes, you can definitely see progress in your patients (if you're good). Neurology today is not neurology of 20 years ago. There are a lot more treatments, and the field and it's research are rapidly evolving, moreso than any other field of medicine IMHO.
2) The future of neurology is BRIGHT! It's the last frontier of medicine, and there is so much research going on right now. I personally feel Alzheimer's and Multiple Sclerosis will have effective treatments within the next ten years or so..(there are already remedies for these diseases, which are much more effective than past treatments, but it is still progressing)
3) I personally wish at the hospital, that neurologists had more of a say over which patients they're expected to consult. Today I got my 2nd 'gout' consult, and the first one was at a different hospital. But it's a minor drawback to be in such an amazing field.

Neurology is amazing...it's going to be the 'next cardiology' in terms of treatments and innovations over the next 50 years, and is the most fascinating field of medicine if you love the brain and behavior! Hope that helps some..

 

[318038]

Hey, I'm just a 4th year medical student, but I'm on my 4th month of neurology rotations now, and I can answer some of your questions:
1) Most common diseases seen in outpatient = Headache, seizures, multiple sclerosis, neuropathies, movement disorders (i.e. Parkinson's), dementias...and much much more. Yes, you can definitely see progress in your patients (if you're good). Neurology today is not neurology of 20 years ago. There are a lot more treatments, and the field and it's research are rapidly evolving, moreso than any other field of medicine IMHO.
2) The future of neurology is BRIGHT! It's the last frontier of medicine, and there is so much research going on right now. I personally feel Alzheimer's and Multiple Sclerosis will have effective treatments within the next ten years or so..(there are already remedies for these diseases, which are much more effective than past treatments, but it is still progressing)
3) I personally wish at the hospital, that neurologists had more of a say over which patients they're expected to consult. Today I got my 2nd 'gout' consult, and the first one was at a different hospital. But it's a minor drawback to be in such an amazing field.

Neurology is amazing...it's going to be the 'next cardiology' in terms of treatments and innovations over the next 50 years, and is the most fascinating field of medicine if you love the brain and behavior! Hope that helps some..

Wow, that was an extremely informative post. Thanks so much for the info! Where would you like to go for neuro residency? I had so many concerns about the field and it seems to get so much negativity from individuals in other areas of medicine for no real reason.

 

[Moosecakes]

Great post blue! Subscribing to read further posts.

 

[95439]

Wow, that was an extremely informative post. Thanks so much for the info! Where would you like to go for neuro residency? I had so many concerns about the field and it seems to get so much negativity from individuals in other areas of medicine for no real reason.

Haha...you're more than welcome! I don't really like to disclose where I want to go for residency, but I interviewed at alot of places, and will find out on Thursday (then I'll pry post on here to see if there's anyone else going).
Yeah, it's funny how much criticism you'll hear about neurology, but really, you'll hear criticism about any field other than the one that the doctor you're talking to is in. It's insecurity if you ask me...talk to neurologists, they usually don't badmouth other medical specialties, and are very happy doing what they do.
Just keep your mind open while you go thru medical school...start to form a 'top 3 specialties' when you start rotations, and then go from there. Obviously I'm biased, but I do think Neurology is the best field by far. I'm working 21 days in a row in it right now, am completely lazy, and I love it! Normally I'd kill myself if I had to spend that much time in the hospital but I love being a neurological detective...
Feel free to ask me any specific questions you may have along the way, and good luck!

 

[medsRus]

Haha...you're more than welcome! I don't really like to disclose where I want to go for residency, but I interviewed at alot of places, and will find out on Thursday (then I'll pry post on here to see if there's anyone else going).
Yeah, it's funny how much criticism you'll hear about neurology, but really, you'll hear criticism about any field other than the one that the doctor you're talking to is in. It's insecurity if you ask me...talk to neurologists, they usually don't badmouth other medical specialties, and are very happy doing what they do.
Just keep your mind open while you go thru medical school...start to form a 'top 3 specialties' when you start rotations, and then go from there. Obviously I'm biased, but I do think Neurology is the best field by far. I'm working 21 days in a row in it right now, am completely lazy, and I love it! Normally I'd kill myself if I had to spend that much time in the hospital but I love being a neurological detective...
Feel free to ask me any specific questions you may have along the way, and good luck!

What were some of your favorite places that you've visited on the interview trail?

 

[WhyMD]

Bblue, what do you think of the new policy of no pay for consults and less pay for diagnostic tests as how that will affect your future income significantly? Or is it that you are so excited about this field that you don't care about these rather practical issues?

I am as excited about neurology as you. But I don't like to work big part of every day for free.

I posted a new thread about this as well, since I really want to know the solution to these new ridiculous policies that I didn't have the chance to oppose. I wonder how physicians especially thinking neurologists allowed this to happen to themselves.

 

[95439]

Bblue, what do you think of the new policy of no pay for consults and less pay for diagnostic tests as how that will affect your future income significantly? Or is it that you are so excited about this field that you don't care about these rather practical issues?

I am as excited about neurology as you. But I don't like to work big part of every day for free.

I posted a new thread about this as well, since I really want to know the solution to these new ridiculous policies that I didn't have the chance to oppose. I wonder how physicians especially thinking neurologists allowed this to happen to themselves.

In all honesty, I have not heard about this, and am a little skeptical. I've heard a few rumblings about the 'end of the world' for neurologists and for doctors, in general. And I like to wait to see if it will actually come true before I react...where did you get this information?
Medsrus...I liked all the residencies I visited that didn't have lebanese residents

 

[medsRus]

In all honesty, I have not heard about this, and am a little skeptical. I've heard a few rumblings about the 'end of the world' for neurologists and for doctors, in general. And I like to wait to see if it will actually come true before I react...where did you get this information?
Medsrus...I liked all the residencies I visited that didn't have lebanese residents

Keep the racial tension in this forum low, blue, after all its nearing match day.

 

[WhyMD]

In all honesty, I have not heard about this, and am a little skeptical. I've heard a few rumblings about the 'end of the world' for neurologists and for doctors, in general. And I like to wait to see if it will actually come true before I react...where did you get this information?

Not picking on you at all but your uninformed status and suspicious reaction are precisely the reason why these things are allowed to happen above our bowed heads.

I heard it from attendings and verified it here in one of the forums (gen surg?). It's not, "it will happen." It already has happened and I want to know how Neurologists are coping with it.

I've also read that at least for gen surg they have ways to go around it and end up with the same or minimally higher (1%) reimbursement in the end. But I don't know if that's true for neurologists as well given very little interventional treatment arsenals. You know what I mean?

I love neurology. But if pay is too low, it sucks the joy out of it especially if family and babies are on the way. There is no way denying it. One practical solution maybe marrying another doc.

 

[WhyMD]

repeat post.

 

[95439]

Not picking on you at all but your uninformed status and suspicious reaction are precisely the reason why these things are allowed to happen above our bowed heads.

I heard it from attendings and verified it here in one of the forums (gen surg?). It's not, "it will happen." It already has happened and I want to know how Neurologists are coping with it.

I've also read that at least for gen surg they have ways to go around it and end up with the same or minimally higher (1%) reimbursement in the end. But I don't know if that's true for neurologists as well given very little interventional treatment arsenals. You know what I mean?

I love neurology. But if pay is too low, it sucks the joy out of it especially if family and babies are on the way. There is no way denying it. One practical solution maybe marrying another doc.

I'm pretty tight with the neurologist I'm working with right now, and the man knows EVERYTHING about neurology...I'll ask him tomorrow about the 'decrease in pay for consults', and I'll bet you that he says 'what are you talking about?'...I've heard so many theories and rumors on what will happen with the new medical plan, and so much of it is heresay and personal opinion. Of course if that's true it would effect pretty much every specialty, not just neurology...so I'd take that into account too ;o) If you feel the future of medicine is primary care....go for it!

And Medsrus..just playing with ya man. Calm down

 

[WhyMD]

I'm pretty tight with the neurologist I'm working with right now, and the man knows EVERYTHING about neurology...I'll ask him tomorrow about the 'decrease in pay for consults', and I'll bet you that he says 'what are you talking about?'...I've heard so many theories and rumors on what will happen with the new medical plan, and so much of it is heresay and personal opinion. Of course if that's true it would effect pretty much every specialty, not just neurology...so I'd take that into account too ;o) If you feel the future of medicine is primary care....go for it!

Um...it's not a "decrease in pay for consults," but NO pay [zero] for consults and decreased pay for diagnostic tests (EMG, ECG etc). Yes, it will affect most specialties but neuro is hit the most for obvious reasons.

attendings in academic centers seem to be not so well informed about these things. But do come back and tell us what you heard.

 

[bluntdissector]

Not picking on you at all but your uninformed status and suspicious reaction are precisely the reason why these things are allowed to happen above our bowed heads.

I heard it from attendings and verified it here in one of the forums (gen surg?). It's not, "it will happen." It already has happened and I want to know how Neurologists are coping with it.

I've also read that at least for gen surg they have ways to go around it and end up with the same or minimally higher (1%) reimbursement in the end. But I don't know if that's true for neurologists as well given very little interventional treatment arsenals. You know what I mean?

I love neurology. But if pay is too low, it sucks the joy out of it especially if family and babies are on the way. There is no way denying it. One practical solution maybe marrying another doc.

Care to share some links? I tried to get info, but could only get info on Medicare paying less for consults:
http://www.bnncpa.com/services/healthcare/2010ChangestoMedicare.asp

 

[318038]

Not to be rude but it seems as though every thread turns into a salary cut debate. Let's focus on the career and the money will surely come along as I have yet to see a doctor who goes hungry.

 

[AlwaysSearching]

Um...it's not a "decrease in pay for consults," but NO pay [zero] for consults and decreased pay for diagnostic tests (EMG, ECG etc). Yes, it will affect most specialties but neuro is hit the most for obvious reasons.

attendings in academic centers seem to be not so well informed about these things. But do come back and tell us what you heard.

It's not "zero" pay for consults either, it's the elimination of the consultation code used for billing. Consults will still happen and still be reimbursed, but will have to be tweaked to be billed under different codes. From what I've read, it sounds like the tweak may require a more thorough H&P, but shouldn't that always be included in consults anyway? It also looks (from the link provided above) like telemedicine consults are specifically being spared, which bodes well for stroke centers (and patients).

 

[95439]

Um...it's not a "decrease in pay for consults," but NO pay [zero] for consults and decreased pay for diagnostic tests (EMG, ECG etc). Yes, it will affect most specialties but neuro is hit the most for obvious reasons.

attendings in academic centers seem to be not so well informed about these things. But do come back and tell us what you heard.

Mikan is right, this is getting way off topic, especially when you started another thread with the same topic, but I'm going to put it in writing right here, before I even find out the answer (I forgot to ask my attending today)...THIS IS NOT TRUE. How would that be possible? "Yeah, I'll take your possible MS patient, but no, I don't expect to be reimbursed. All my work is pro-bono". It's just not possible. I could see the possible need to 'tweak' the H&P to get paid, but there is no way that you could be expected to do your job for free. Most of neurology is consults. I doubt it and will eat my words if I find out it's true..

 

[typhoonegator]

Um...it's not a "decrease in pay for consults," but NO pay [zero] for consults and decreased pay for diagnostic tests (EMG, ECG etc). Yes, it will affect most specialties but neuro is hit the most for obvious reasons.

attendings in academic centers seem to be not so well informed about these things. But do come back and tell us what you heard.

Do not hijack this thread. You already created another thread to discuss this exact topic. The topic of this thread is the typical week for neurologists. People interested in fee-for-service issues can visit the other thread, or one of the several prior threads in existence discussing this issue.

 

[95439]

Mikan is right, this is getting way off topic, especially when you started another thread with the same topic, but I'm going to put it in writing right here, before I even find out the answer (I forgot to ask my attending today)...THIS IS NOT TRUE. How would that be possible? "Yeah, I'll take your possible MS patient, but no, I don't expect to be reimbursed. All my work is pro-bono". It's just not possible. I could see the possible need to 'tweak' the H&P to get paid, but there is no way that you could be expected to do your job for free. Most of neurology is consults. I doubt it and will eat my words if I find out it's true..

Last comment - talked to my preceptor and I'm eating my words lol...it is true. Supposedly they're trying to push doctors into more primary care fields. But he said this happens every 10 years or so and soon the pendulum will swing back to the specialists. Also, it's not as bad as it sounds. I'm not going to go into details but it's really not supposed to have that big of an impact on your salary...

 

[WhyMD]

Do not hijack this thread. You already created another thread to discuss this exact topic. The topic of this thread is the typical week for neurologists. People interested in fee-for-service issues can visit the other thread, or one of the several prior threads in existence discussing this issue.

Relax, bro. And read my very first post here. I clearly notified that I've created a thread for the subject. The reason why I responded to this thread was not so much discuss the topic but to bring home the point that excitement and love for the field as expressed by BBlue could also encompass a care for its well-being (respect, development, compensation, expansion).

And BBlue, thanks for getting back with what you learned. We will see how much impact this new policy is having. I don't know how this will push "doctors into more primary care" although it may push more med students to primary care.

Again, if we truly care about Neurology, let's protect it, further advance it, make it into the top choice for more med students.

Lastly, I share the same excitement and love of neurology as BBlue. It's the whole reason why I initially applied to med school and why I returned to med school. There is nothing more fascinating and adventuresome than this field because there are so many unknown uncharted territories beyond mere proteins and chemicals that current scientists are so preoccupied with finding that magic pill. I don't believe the magic will be in a form of a pill but something else entirely different beyond the profit-blinded pharma.