Workforce Gap Analysis in the Field of Headache Medicine in the United States

Dhaem, Olivia Begasse de; Burch, Rebecca; Rosen, Noah; Stein, Ken; Loder, Elizabeth; Shapiro, Robert E.

doi:10.1111/head.13752

Cited by 22 publications

(25 citation statements)

References 10 publications

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“…This, in turn, should attract more doctors to be trained in headache medicine and increase access for patients to specialty care. There is a major national shortage, and an uneven geographic distribution, of headache specialty doctors 57 . This may reflect the pervasiveness of migraine’s perceived “legitimacy deficit” among doctors 6 .…”

Section: National Institutes Of Health (Nih) Neglect Of Migraine and mentioning

confidence: 99%

What Will it Take to Move the Needle for Headache Disorders? An Advocacy Perspective

Shapiro

2020

Headache

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Discrimination toward people living with migraine and other headache disorders is widespread and socially accepted. Stigma toward these diseases is both a manifestation of these discriminatory attitudes and a sustainer of them. For those living with migraine and headache disorders, stigma limits the full expression of their lives, as well as the likelihood of receiving health care to reduce the burden. In the past decade, public advocacy organizations have emerged in the United States and internationally to counter the consequences of this stigma. These organizations have raised public awareness of these diseases, corrected misconceptions, and empowered millions of people affected by them. The Alliance for Headache Disorders Advocacy has focused on addressing the structural stigma inherent in discriminatory policies of employers, government agencies, and public institutions. While notable progress has been made, there is considerable work left to be done to increase resources and equity for people living with headache disorders.

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Section: National Institutes Of Health (Nih) Neglect Of Migraine and mentioning

confidence: 99%

What Will it Take to Move the Needle for Headache Disorders? An Advocacy Perspective

Shapiro

2020

Headache

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“…As a result, many providers feel uncomfortable managing headache disorders 4,5 . Furthermore, with only 707 board‐certified headache medicine specialists in the United States currently, there is a large gap between the number of providers specially trained to treat patients with migraine and other headache disorders and the vast number of patients with these conditions 6 . Early education and exposure to headache medicine in training is crucial to recruiting more physicians to practice within this subspecialty, and to caring for those with headache disorders.…”

Section: Introductionmentioning

confidence: 99%

The current state of headache medicine education in the United States and Canada: An observational, survey‐based study of neurology clerkship directors and curriculum deans

et al. 2021

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Objective To investigate the current headache medicine education paradigm in allopathic and osteopathic medical schools in the United States and Canada. Background There is a disparity in the number of clinicians specially trained to treat patients with headache disorders and the number of people who have them. Early education and exposure to headache medicine is crucial to address this disparity. However, the current state of headache education within medical schools across the United States and Canada is unknown. Methods The authors created a medical student headache education survey, which is a 20‐question REDCap survey that was distributed via email to the neurology clerkship director, curriculum dean, or similar role at each US and Canadian MD or DO conferring medical school. The email listserv was created using the American Academy of Neurology Clerkship Directory, the Association of American Medical Colleges Organization Directory, the American Association of College of Osteopathic Medicine Organization Directory, manual searches of the institutions' websites, and phone calls and emails to administrators as needed. Results Of the 249 individuals contacted, 78 completed the survey, yielding a response rate of 31.3%. Of those responses, 84.6% of respondents (66/78) reported that their institution has at least one mandatory session on headache disorders. Many of these sessions (72.7% (48/78)) occurred during preclinical training, and 74.2% (49/78) occurred as part of the clinical curricula. Of respondents, 44.9% (39/78) reported that their institutions coordinate headache education across training levels (i.e., from preclinical to clinical), and only 17.9% (14/78) coordinate across clinical rotations. The most common topics covered were headache red flags, migraine, pharmacologic management, and differentiating primary versus secondary headache. 65.4% of respondents (51/78) felt that the preclinical headache curriculum prepares their students for the clinical experience, and 55.1% (43/78) felt that medical students were learning enough about headache medicine at their institution. Barriers to educating medical students about headache included insufficient time during courses, lack of administrative support in curricula development, lack of available resources, and lack of student interest. Case‐based learning modules and online lectures were the most desired educational materials to improve medical student headache education at their institution. Conclusions The majority of medical schools report incorporating headache medicine education into preclinical or clinical curricula and cover a range of topics in headache medicine. Yet there remains a lack of consistency, with some reporting limited headache education, citing barriers such as lack of administrative support and available educational resources. There is also variation in what is being taught at the medical student level. Future projects should aim to address said barriers, with the goal of providing a standardized headache medicine curriculum...

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“…In 2010, headache disorders were, in fact, the most common diagnoses made on initial visits to general neurologists (19%) 2 and, today, approximately one-third of patients presenting to general neurology clinics have headache as a primary symptom. 3 On the inpatient side, headache is estimated to be the fourth most common chief complaint and is responsible for approximately 3% of all emergency room visits. 4 Perhaps even more notable is that 5 to 9 million primary care visits each year in the United States are for headache.…”

Section: Section 1: Epidemiology and Introductionmentioning

confidence: 99%

“…For 6 million of these patients, the condition is chronic (>15 headache days per month 10 ), yet only 2.9 million of them are followed up in a headache clinic. 3 Economically, the burden exacted by migraine currently estimates around $11 billion in direct medical costs (from medications, emergency department visits, hospitalizations, physician services, laboratory and diagnostic services, and management of treatment side effects) and at least another $11 billion in indirect costs from disability (mainly due to loss of productivity in the workplace for migraine sufferers). 11,12 Recent studies have continued to show that this already very large health problem is getting bigger, rather than smaller.…”

Section: Section 1: Epidemiology and Introductionmentioning

confidence: 99%

Approach to Headache

Bobker

Safdieh

2021

Semin Neurol

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There is a very high prevalence of headache in both outpatient and inpatient settings, in the United States and worldwide, due to an abundance of possible causes. Having a practical and systematic approach to evaluating and treating headache is, therefore, key to making the correct diagnosis, or possibly overlapping diagnoses. Taking a thorough and methodical headache history is the mainstay for diagnosis of both primary and secondary headache disorders. Evaluation and workup should include a complete neurological examination, consideration of neuroimaging in specific limited situations, and serum or spinal fluid analysis if indicated. Adopting a diagnostic approach to headache ensures that cannot-miss, or potentially fatal, headache syndromes are not overlooked, while resource-intensive tests are performed only on an as-needed basis.

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Workforce Gap Analysis in the Field of Headache Medicine in the United States

Cited by 22 publications

References 10 publications

What Will it Take to Move the Needle for Headache Disorders? An Advocacy Perspective

What Will it Take to Move the Needle for Headache Disorders? An Advocacy Perspective

The current state of headache medicine education in the United States and Canada: An observational, survey‐based study of neurology clerkship directors and curriculum deans

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