Distribution of neurologists and neurosurgeons in India and its relevance to the adoption of telemedicine

Abstract

Majority of Indians have no access to centres of neurological excellence in the country. A detailed analysis of 3666 members of the Neurological Society of India and the Indian Academy of Neurology revealed that not a single member lived in a geographical area covering 934.8 million people. 30.09% live in the four major metropolitan cities, 29.54% in the state capitals, 30.58% in Tier 2 cities, 7.12% in tier 3 cities and 2.67% in rural areas covering a population of 84.59 million. Building additional neurological centres cannot be the only answer, given the acute shortage of funds and trained personnel. In 1999, the author among others, foresaw that it could be possible, to extend the reach of urban specialists to suburban and rural India, by virtual means. The neurological community has been slow to use Information and Communication Technology (ICT) as an integral part of their health care delivery system. This article analyses the distribution of neurologists and neurosurgeons in India and suggests that providing additional virtual neurological care can be the only answer to offset the lop sided distribution of clinical care givers in neurosciences. In this article, the authors' considerable experience in introducing and developing telehealth in India over the last 15 years is being shared with specific emphasis on its relevance to neurosciences. A review of the global literature on telemedicine and neurosciences will substantiate the plea that telemedicine must be deployed by neurologists and neurosurgeons in India to extend their reach to patients particularly those residing in rural areas.

Management of Patients with Neurotrauma by Trauma Surgeons: Need of the Hour

“…5,6 Scarcity of neurosurgeons get compounded by the fact that more than 80% of India's specialist doctors live in urban India. 7 A study by Neurological Society of India found that there was not a single neurosciences specialist living in a geographical area covering nearly 934.88 million people. 7 Therefore, patients of neurotrauma often have to travel hundreds of kilometers to have an expert opinion and management thereof; needless to say, golden hour of trauma is surely lost in this time.…”

“…7 A study by Neurological Society of India found that there was not a single neurosciences specialist living in a geographical area covering nearly 934.88 million people. 7 Therefore, patients of neurotrauma often have to travel hundreds of kilometers to have an expert opinion and management thereof; needless to say, golden hour of trauma is surely lost in this time. 7 Scarcity of neurosurgeons is not limited to developing world; it is a problem in developed world too.…”

“…7 Therefore, patients of neurotrauma often have to travel hundreds of kilometers to have an expert opinion and management thereof; needless to say, golden hour of trauma is surely lost in this time. 7 Scarcity of neurosurgeons is not limited to developing world; it is a problem in developed world too. It is a scarcely available resource even in the United States, where only 20% of population has direct access to a specialist, with one neurosurgeon per 70,000 population.…”

Image quality in telehealth: challenges in developing countries

“…Other determinants that have an impact on the adoption of telehealth in India and Pakistan include accessibility to healthcare professionals, the quality and reliability of the ICT infrastructure within a region, the shortage of healthcare professionals in rural and remote locations, patient education regarding the benefits of telehealth, patient demographics and technology safety and awareness [3,[26][27][28][29][30][31]21,[42][43][44]32,45,46]. This research focuses on one specific determinant, the quality of images transmitted within the telehealth environment in India and Pakistan, as it is evident, from a review of the literature that scant studies have been undertaken on this topic.…”

Evolving Role of Telemedicine in Health Care Delivery in India

“…The role of ICT in the field of neurology, especially in stroke care and management of epilepsy has been recently emphasized in several studies [36][37][38][39]. Presently, there is a severe shortage of trained neurologists and stroke care specialists, particular in the rural areas in India [36].…”