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February 1995

Neurology Should Not Become a Consulting Specialty

Author Affiliations

From the Department of Neurology, Good Samaritan Hospital, Portland, Ore.

Arch Neurol. 1995;52(2):205-206. doi:10.1001/archneur.1995.00540260111027

Historically, neurology developed as a consulting specialty. Until the 1940s and early 1950s, there was very little that could be done for most of the major neurologic diseases beyond making a diagnosis and providing a prognosis. Whether the neurologist was dealing with meningitis, a degenerative disease, stroke, poliomyelitis, or multiple sclerosis, treatment was limited. A general physician could provide analgesics for headache or anticonvulsants for epilepsy about as well as a neurologist. While there were treatments for some neurologic disorders, few were effective and specialized knowledge for administration was rarely required. A humorous definition of a neurologist current in the 1950s was "a specialist in the differential diagnosis of incurable disease." The prevailing mode of operation was what Labe Scheinberg has characterized as "diagnose, adios."

In the first half of this century, research on neurologic disorders was limited to a few major centers and was done largely by neurosurgeons and

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