Neurologists‐1991 to 1992

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Abstract
The American Academy of Neurology (AAN) membership survey was developed to define and monitor changing trends in the demography and practice profile of US neurologists. All 11,300 AAN members received a Demographic 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 responding members, age (median, 43 years), sex (83% male), race/ethnic origin (85% white), and medical schools (22% international medical graduates) 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 Columbia. One-fourth of neurologists complete at least one residency in addition to neurology and 39% complete a fellowship. Although nearly two-thirds (63%) of neurologists have a full-time or clinical academic appointment, 70% indicate patient care as their primary medical activity. The number of working hours and professional activities of neurologists vary with practice type. Neurologists perform numerous neurodiagnostic tests for reimbursement, particularly neurophysiology studies and lumbar puncture. One-third of office-based neurologists'have an ownership interest in an imaging facility. The most common payment sources for professional fees are commercial insurers (32%) and Medicare (29%), the latter reflecting the large proportion of disabled and elderly treated by neurologists. Office-based neurologists provide 5% charity care and write off an additional 13% of unpaid charges. The practice of neurology is constantly changing. This detailed description of the current scope of practice allows neurologists to weigh the consequences and opportunities of the many proposed health reform plans and to advocate changes that benefit patients with neurologic illness and that enhance the profession.

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