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June 1994

Trends in the Practice of Neurology: Responding to Health System Reform

Arch Neurol. 1994;51(6):543-544. doi:10.1001/archneur.1994.00540180021008

As we approach the end of a millennium, many neurologists and other physicians question where we are going in health care, where we want to go, and how to reconcile the former with the latter. For example, at the recent XVth World Congress of Neurology, September 1993, under the rubric "Preparing Neurologists for the 21st Century," molecular genetics, neuroimmunology, and brain mapping were highlighted as spheres of neuroscience that would likely experience rapid growth and development in the future. It is not my intention here to underscore such emerging advances in clinical neuroscience, in part because there are excellent reviews of this topic.1,2 There is no doubt that progress in neurogenetics, molecular biology, and other basic sciences will result in effective treatment of neurologic disorders that have long been viewed as more or less untreatable.3 Instead, I will focus this discussion on trends in the changing environment of