CAN NEUROLOGISTS SURVIVE OR THRIVE WITH HEALTH-CARE REFORM

The economics of present-day health care and the politics of recent el ections will forever change the practice of neurology. Managed care, o utcomes research, limits on price and volume of services, diagnostic a nd treatment restraint, divestiture of ownership in health facilities, malpractice reform, increased use of preventive services, and adminis trative simplifications will all be part of the new practice of medici ne, and hence neurology. The challenge for neurologists will be to def ine cost-effective neurological services, put greater emphasis on the most prevalent and costly diseases of the nervous system, and convince primary care providers and patients of their value. Health care refor m is an opportunity and challenge for neurologists to improve patient access while achieving acceptable financing mechanisms.