NEUROLOGISTS 1991 TO 1992

The American Academy of Neurology (AAN) membership survey was develope d to define and monitor changing trends in the demography and practice profile of US neurologists. All 11,300 AAN members received a Demogra phic Information Form (DIF) and 2,600 members also received a Practice Profile Form (PPF) to gather this information. Response rates were 75 % from the DIF group and 70% from those who received both. For respond ing members, age (median, 43 years), sex (83% male), race/ethnic origi n (85% white), and medical schools (22% international medical graduate s) are similar to those for other physicians in the United States. The ratio of neurologists to population ranges from a low of 1.3 per 100, 000 in Wyoming to a high of 11.0 per 100,000 in the District of Columb ia. One-fourth of neurologists complete at least one residency in addi tion to neurology and 39% complete a fellowship. Although nearly two-t hirds (63%) of neurologists have a full-time or clinical academic appo intment, 70% indicate patient care as their primary medical activity. The number of working hours and professional activities of neurologist s vary with practice type. Neurologists perform numerous neurodiagnost ic tests for reimbursement, particularly neurophysiologic studies and lumbar puncture. One-third of office-based neurologists have an owners hip interest in an imaging facility. The most common payment sources f or professional fees are commercial insurers (32%) and Medicare (29%), the latter reflecting the large proportion of disabled and elderly tr eated by neurologists. Office-based neurologists provide 5% charity ca re and write off an additional 13% of unpaid charges. The practice of neurology is constantly changing. This detailed description of the cur rent scope of practice allows neurologists to weigh the consequences a nd opportunities of the many proposed health reform plans and to advoc ate changes that benefit patients with neurologic illness and that enh ance the profession.