If long waiting lists were not an indicator of a neurologist shortage, a study published in “Neurology” confirms it. The study estimates the U.S. neurologist shortage will increase from 11% to 19% by 2025. The demand for neurologists at that time will be 21,440, but only about 18,060 will be available.
Neurologists are in demand due to increases in aging baby-boomers experiencing dementia and an increase in patients with Alzheimer’s and Parkinson’s disease. The demand continues to grow each day due to changes in health care laws. Even today, setting an appointment with a neurologist requires long wait times, averaging 24 to 45 days.
How the Affordable Care Act affects Physician Shortages
The Association of American Medical Colleges states that the shortage is a result of “an aging physician workforce, 15 million people eligible for Medicare and 32 million newly insured patients through the Affordable Care Act.”
The sudden increase in insured patients through the Patient Protection and Affordable Care Act (PPACA) increased the number patients suffering from neurological diseases and disorders. Those that previously could not afford health care can now be treated. This expanded coverage through the health care reform is advantageous to patients; however, the supply and demand for neurologists can no longer be met. To make things worse, many neurologists are not accepting new Medicaid patients due to low reimbursement rates.
As more patients use the new coverage to unearth chronic neurological issues, the wait times for highly trained neurologists will increase. Not only will neurologists in private practices become overbooked, but also those in larger multi-doctor practices will not be able to see all of the patients requiring neurological treatment.
Does the High Cost of Medical Schooling Influence Medical Students Choosing a Specialty?
In addition, there is a low attraction by medical students to the neurology profession. Many students are disenchanted with neurology because of the low reimbursement rates from insurance companies. When students are choosing a specialty to spend the next eight to ten years training in, many are considering the outlook of long-term financial implications.
Most medical schools tuition average between $22,800 to $42,472 per year and by the time the student is done, their debt load is tremendous. The average salary for a neurologist is $202,930 per year. With the overwhelming student loan debt and an annual salary less than other specialties, many new graduates may want lean towards a specialty that will pay much more and receive higher reimbursements than what is allowed through insurance or Medicare.
Unfortunately, one in six people suffer from a neurological disease. The increase in population growth and aging will only serve to spotlight the fact that the demand outweighs the growth. With dementia and stroke also being on the rise, the wait times will continue to increase.
The consequence of the shortage of neurologists in the United States will include patients that fall through the cracks in the system. Patients may become frustrated and give up seeking treatment for their neurological disease or disorder. At the other end of the spectrum, neurologists trying to meet the demand may overbook and find themselves giving patients rushed and substandard care. In the field of neurology, this can be a dangerous endeavor. Patients require and deserve the best treatment possible. However, this may not be possible until the future supply and demand of neurologists is met again with highly trained specialists.
The Official Journal of the American Academy of Neurology http://www.neurology.org/content/early/2013/04/17/WNL.0b013e318294b1cf.abstract