The 1992-1993 Annual Report of the American Board of Psychiatry and Neurology Inc1 is of special interest and importance for neurologists. Of the eight Neurology Directors of the Board, all eight practice in teaching and referral centers and six are training program directors as well. None of them represents the community practice of neurology. Of the most recent cohort of certified neurologists, however, most have located their practices in the community, as is the case for the great majority of practicing neurologists in the United States.1
This is not a mere "town and gown" issue. Neurologists in community practice spend about half their time treating patients with headaches, backaches, and epilepsy, and nearly one fourth of their patients have ill-defined symptoms and psychosocial problems.2 By way of contrast, neurologic patients in teaching hospitals are a selected group of those with acute, complex, and esoteric problems that are