Neurologic practice and care have been modified in many important ways during the past 30 years, to adapt to the explosion of new information and new technology. Moreover, of great influence on the matrix of care are the effects that result from major social and demographic changes in our society. For example, the aging of the population has increased the burden of chronic illness, such as arthritis, cardiovascular disorders, and Alzheimer's disease. Changes in the financing of care have resulted in fewer hospital admissions of much sicker patients, and a concomitant increase in the volume of ambulatory care.1 Attitudes about health care have changed, fueled in part by the escalation of expenditures, estimated to be $550 billion in 1988, or nearly 12% of the US gross national product.2 A respected economist suggested in 1986 that some reduction of physician services may be socially beneficial, even if it decreases
Menken M. The Changing Paradigm of Neurologic Practice and Care: Implications for the Undergraduate Curriculum. Arch Neurol. 1990;47(3):334–336. doi:10.1001/archneur.1990.00530030112026
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