continuity of care

[scm]

howdy, im an ms3, I have neuro in a few months, up to this point I'm very interested in neuro. Just curious if people could offer some insight. It seems as though often as a neurologist, you would see patients as a referral/consult etc, make a diagnosis and potentially never see them again/send them off to rehab/for teatment etc (or maybe see them once every 6 months or something)...

What types of patients/problems do neurologists see with some regularity? i.e. will I have some people who are "my patients" and have some continuity with etc? i think this sorta thing would be important to me(if I'm doing outpatient)

much thanks
scm

---

Members don't see this ad.

 

[neurologist]

You will have more of "your" patients than you know what to do with. Remember: many (most) neurologic diseases are chronic and treatable but incurable. The things you will see most as a general outpatient-based neurologist are: headache (by far #1), epilepsy/seizures, peripheral neuropathy, back pain, vertigo, cerebrovascular disorders (stroke, etc), MS, movement disorders (parkinsons, etc).

How often you see a patient depends on a number of things. The first thing is the severity and natural history of the problem. Meningitis or a stroke is a big deal in the acute phase, and you might see them every day as an inpatient, but if the patient recovers well you might just see them once or twice in followup and then never again if they are doing OK. Patients with chronic problems that are prone to fluctuate or change over time (MS, migraine, epilepsy) can be seen on a scheduled basis (every six months or whatever) but may have periods where their problem gets out of control for some reason and require more frequent visits for a time. Others (the infamous "patient with 20 years of chronic low back pain") you will see once and be honest about not being able to do a d**n thing for and send them to physical therapy, etc, which may be of some help.

Another factor is what the referring physician wants you to do. Sometimes people are referred for a single visit with a very specific issue (confirm diagnosis, recommend medication changes, do an EEG, etc) and you see the patient, make your reccs to the referring doc, and that's that unless they want you to follow up. There are some primary docs who just aren't comfortable with doing neuro and want the patient to have regular neuro followup. The patient's insurance may have something to do with this too; some won't allow continued specialty evaluation.

Hope this helps.