Survey of current neurohospitalist practice

Likosky, David; Josephson, S. Andrew; Coleman, Mary; Freeman, W. David; Biller, José

doi:10.1212/cpj.0b013e318278be3e

Cited by 8 publications

(21 citation statements)

References 4 publications

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“…This is less than the proportion of neurologists (60%) and internal medicine hospitalists (52%) and US physicians in general (54%) who report at least one symptom of burnout; however, it is comparable to US physicians intending to reduce their clinical hours (24%) or intending to leave current practice in 2 years (32%). 9,12,19,20 Of note, this survey includes a younger subspecialty sample than prior surveys, 2,3 and age of 40 years or less was not associated with burnout. The factors most commonly reported as contributing to self-report of having experienced or concern for burnout include clinical schedule and patient census, echoing observations within neurology in general.…”

Section: Discussionmentioning

confidence: 72%

Neurohospitalist Practice, Perspectives, and Burnout

Probasco

Greene

Harrison

et al. 2018

The Neurohospitalist

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Background and Purpose: Neurohospitalist neurology is a fast-growing subspecialty with a variety of practice settings featuring neurohospitalist models of care. Since inception, the subspecialty has responded to new challenges in resident training, hospital reimbursement, practice, and burnout. Methods: To characterize neurohospitalists' current practice and perspectives, we surveyed the neurohospitalists and trainees affiliated with the Neurohospitalist Society using an electronic survey distributed through the society listserv. Results: Of 501 individuals surveyed by e-mail, 119 began the survey (23.8% response rate), with 88.2% self-identifying as neurohospitalists. Most neurohospitalists (63%) are 10 years or less out of training, devoting 70% of their professional time to inpatient clinical activities while also performing administrative or teaching activities. Only 38% are employed by an academic department. Call schedules are common, with 75% of neurohospitalists participating in a hospital or emergency call schedule, while 55% provide telemedicine services. The majority (97%) of neurohospitalists primarily care for adults, most commonly treating patients with cerebrovascular disease, seizures, and delirium/encephalopathy. The majority (87%) are overall pleased with their work, but 36% report having experienced burnout. Conclusions: Neurohospitalists are a diverse group of neurologists primarily practicing in the inpatient setting while performing a variety of additional activities. They provide a wide array of clinical expertise for acute neurological diseases and neurological emergencies that require hospitalization, including stroke, seizure, and encephalopathy. Neurohospitalists in general are very pleased with their work, while burnout, as in neurology and other areas of medicine, remains a concern.

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Section: Discussionmentioning

confidence: 72%

Neurohospitalist Practice, Perspectives, and Burnout

Probasco

Greene

Harrison

et al. 2018

The Neurohospitalist

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“…The majority of neurohospitalist programs are built around a consulting model, although some have an admitting service. 5 This decision to consult or primarily manage patients is multifactorial, but often consultation is chosen in hospitalist models with the support of strong internal medicine hospitalists, where the neurohospitalist can focus on the neurologic disease while the hospitalist provides the support in other necessary areas of care. A cooperative model helps address the progressively increasing acuity and complexity of inpatients.…”

Section: Primary Versus Consultative Managementmentioning

confidence: 99%

“…These neurologists, whose primary focus is the care of inpatients, are a diverse group, including many new graduates as well as many who have left outpatient or combined outpatient and inpatient practices. 4,5 Despite this large work force of neurohospitalists nationally, the optimal practice model has not yet been established.…”

mentioning

confidence: 99%

Models of Inpatient Neurologic Care

Likosky

Aragon

2015

Semin Neurol

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The rapid ascension of the neurohospitalist model has been a response to national pressures implemented around local practicalities. As such, there is no uniform or ideal neurohospitalist model; there remains tremendous variation nationally. Over time, several dominant models have emerged, each of which raises distinct issues, both clinical and financial. As the field continues to grow, neurohospitalists in both hospital-owned and private practices are developing models that are reshaping the practice of inpatient neurology. A thoughtful approach to developing and maintaining programs is critical to success.

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“…6,8 Conditions commonly encountered by neurohospitalists include stroke, encephalitis (both infectious and immune mediated), refractory seizures, and generally patients that tend to have higher acuity, requiring greater care coordination and more complex medical decision making. 5,6,8 The coordination of patient care transitions from the inpatient to outpatient settings, models of practice, measures of care quality, neurological disease and treatment, and resident education are among the natural interests of neurohospitalists. 5,6 There is an ongoing discussion regarding the necessity of neurohospitalist-specific training, and the core features and standards for a potential fellowship or advanced specialist practice training program and the distinction of such training from other neurology fellowship training are yet to be defined.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 There is an ongoing discussion regarding the necessity of neurohospitalist-specific training, and the core features and standards for a potential fellowship or advanced specialist practice training program and the distinction of such training from other neurology fellowship training are yet to be defined. 5,6,8,9 Here, we present a national survey of department chairs and residency program directors of Accreditation Council for Graduate Medical Education (ACGME)-certified adult neurology training programs. We surveyed academic departments, as they are most likely to be involved in the development of neurohospitalist-specific training programs.…”

Section: Introductionmentioning

confidence: 99%

Neurohospitalists: Perceived Need and Training Requirements in Academic Neurology

Probasco¹,

George

Dorsey³

et al. 2013

The Neurohospitalist

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Background and Purpose: We sought to determine the current practices and plans for departmental hiring of neurohospitalists at academic medical centers and to identify the core features of a neurohospitalist training program. Methods: We surveyed department chairs or residency program directors at 123 Accreditation Council for Graduate Medical Education (ACGME)-accredited US adult neurology training programs. Results: Sixty-three(51% response rate) responded, 76% of whom were program directors. In all, 24 (38%) academic neurology departments reported employing neurohospitalists, and an additional 10 departments have plans to hire neurohospitalists in the next year. In all, 4 academic neurology departments have created a neurohospitalist training program, and 10 have plans to create a training program within the next 2 years. Hospitals were the most frequent source of funding for established and planned programs (93% of those reporting). Most (n ¼ 39; 65%) respondents felt that neurohospitalist neurology should be an ACGME-accredited fellowship. The highest priority neurohospitalist training elements among respondents included stroke, epilepsy, and consult neurology as well as patient safety and cost-effective inpatient care. The most important procedural skills for a neurohospitalist, as identified by respondents, include performance of brain death evaluations, lumbar punctures, and electroencephalogram interpretation. Conclusions: Neurohospitalists have emerged as subspecialists within neurology, growing both in number and in scope of responsibilities in practice. Neurohospitalists are in demand among academic departments, with many departments developing their existing presence or establishing a new presence in the field. A neurohospitalist training program may encompass training in stroke, epilepsy, and consult neurology with additional focus on patient safety and cost-effective care.

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Survey of current neurohospitalist practice

Cited by 8 publications

References 4 publications

Neurohospitalist Practice, Perspectives, and Burnout

Neurohospitalist Practice, Perspectives, and Burnout

Models of Inpatient Neurologic Care

Neurohospitalists: Perceived Need and Training Requirements in Academic Neurology

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