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March 1990

The Changing Paradigm of Neurologic Practice and Care: Implications for the Undergraduate Curriculum

Author Affiliations

From the Department of Neurology, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick.

Arch Neurol. 1990;47(3):334-336. doi:10.1001/archneur.1990.00530030112026

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

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