Over the past several decades, the field of Neurology has evolved significantly. Along with many other specialties, an increasing amount of Neurological care has been moved to an outpatient setting in an effort to reduce costs. As the demand for Neurological care has grown, many outpatient Neurologists have become stretched thin seeing a high volume of patients in an office setting. Many of these Neurologists have in turn ceased to take emergency call due to increasing demands and diminishing returns. Unfortunately, the decline in outpatient Neurologists willing to take emergency call has not lessened the overwhelming number of patients that continue to present to emergency departments with neurological emergencies. As a solution to this issue, the field of Neurohospitalist medicine has gained popularity.
The factors that gave rise to Neurohospitalist medicine are also contributing to the swell in demand. As the population continues to age, the demand for in hospital Neurological care will continue to increase. With escalating numbers of neurologically ill patients in emergency departments (including those admitted for other health issues but also have neurological illnesses), many hospitals are increasing the number of Neurohospitalists they have on staff. Additionally, these physicians are also functioning as part of an inpatient team, often working on quality improvement initiatives and improving transitions of care. Some studies have also found that Neurohospitalists can decrease the length of stay of Stroke patients, as well as improve overall quality of care for patients.
While more hospitals and health systems are eager to bring on Neurohospitalists, the supply may not meet the demand. Neurology, like many other specialties, is experiencing a physician shortage that is only going to grow with time. To make matters worse, fewer medical residents are choosing neurology over other specialties than in the past. These factors are making it increasingly difficult to fill neurology positions across the country.
While outpatient Neurology opportunities are becoming increasingly difficult to fill, the situation with Neurohospitalist positions is even more difficult. While many newly trained Neurologists enjoy the exposure to a variety of patients with neurologic diseases, many prefer outpatient practices with better schedules, the ability to establish patient relationships, and the option to control the number of patients seen on a daily basis. Also making Neurohospitalist positions hard to fill is the compensation – while medicine Hospitalists enjoy higher compensation than their outpatient counterparts, the same cannot be said about Neurohospitalists. In order to successfully recruit a Neruohospitalist, it is essential for employers to make themselves aware of the latest recruitment trends and utilize all of the resources at their disposal.