The growth of neurology in the United States has been spectacular. No country has more neurologists (over 9000) or more training programs (over 120). The quality resembles the American health care system itself, a spectrum of extremes.
To practice neurology requires only to have trained for a minimum of 3 years. Board certification is an option. Training programs are largely driven by service need, are usually funded by hospitals, and many have difficulty filling the positions with quality candidates, if at all.
Herndon1 and Menken2 agree that, for difficult cases, it may be appropriate that neurologists provide the principal care. Herndon argues further that subspecialists in neurology can provide the best care in close collaboration with the family physicians.
Health planners are fond of complex formulas—and simplistic solutions. Whether justified or not, the downsizing of specialties is on. This could be an opportunity for American neurology to improve
Hachinski V. Neurology: Increasing Quantity or Quality? Arch Neurol. 1995;52(2):208. doi:10.1001/archneur.1995.00540260114029
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