Monday, March 13, 2017

The three little neurologists

So I was recently talking to an inpatient about his back pain management, and trying to make sure he had outpatient follow-up.  I soon discovered that he was seeing THREE neurologists.

One neurologist was to monitor the size of a brain aneurysm.

One neurologist was for management of migraine headaches.

One neurologist was giving him his back pain medications.

Me: "Oh!  So the neurologist you're seeing for your pain meds can take over the care for your back pain!"

Patient: "No.  This neurologist only does sleep medicine, but just agreed to dispense the pain meds.  But she can't manage them."

I feel like sub-specialization may have gone too far.


  1. The problem with our healthcare system. Pt is paying probably $60+ because of this in copays AND people are probably not connecting the dots about how his meds are impacting pain/migraines etc.

  2. Meanwhile we have a need for neurologists and I can't get my husband in to see one for his migraines (and he has had a migrainous stroke!!)

    1. Yup - in my area it's so bad that really the only way you get in to see one is through the ER.

  3. As a stroke neurologist I would not want to do any of his headache or pain management. Actually I would just refer back to the pcp for serial imaging for his aneurysm as well. But I'm employed and not paid by the patient volume.

  4. I have been thru 4 neurologists and getting ready for a 5/6th one. One can't prescribe something so another one has to check me out to do it.

  5. I suppose I'm too optimistic if I hope that the Neuros are all working together in a reasonable way? The pain meds make me think not.