Child neurology in the 21st century: More than the sum of our RVUs

Mary L Zupanc; Bruce H Cohen; Peter B Kang; David E Mandelbaum; Jonathan Mink; Mark Mintz; Ann Tilton; William Trescher

doi:10.1212/WNL.0000000000008784

Child neurology in the 21st century: More than the sum of our RVUs

Neurology. 2020 Jan 14;94(2):75-82. doi: 10.1212/WNL.0000000000008784. Epub 2019 Dec 24.

Authors

Mary L Zupanc¹, Bruce H Cohen², Peter B Kang², David E Mandelbaum², Jonathan Mink², Mark Mintz², Ann Tilton², William Trescher²

Affiliations

¹ From the Department of Pediatrics and Neurology (M.L.Z.), Division of Pediatric Neurology, Children's Hospital of Orange County, Orange, CA; Neurodevelopmental Science Center (B.H.C.), Akron Children's Hospital, OH; Department of Pediatrics, Neurology, and Molecular Genetics and Microbiology (P.B.K.), University of Florida, Gainesville; Department of Pediatrics and Neurology (D.E.M.), Alpert Medical School of Brown University, Providence, RI; Department of Neurology (J.M.), University of Rochester Medical Center (J.M.), NY; The Center for Neurological and Neurodevelopmental Health and the Clinical Research Center (M.M.), Voorhees Township, NJ; Department of Neurology and Pediatrics (A.T.), Louisiana State University, Baton Rouge; and Department of Pediatrics and Neurology (W.T.), Penn State University, Milton S. Hershey Medical Center. mzupanc@choc.org.
² From the Department of Pediatrics and Neurology (M.L.Z.), Division of Pediatric Neurology, Children's Hospital of Orange County, Orange, CA; Neurodevelopmental Science Center (B.H.C.), Akron Children's Hospital, OH; Department of Pediatrics, Neurology, and Molecular Genetics and Microbiology (P.B.K.), University of Florida, Gainesville; Department of Pediatrics and Neurology (D.E.M.), Alpert Medical School of Brown University, Providence, RI; Department of Neurology (J.M.), University of Rochester Medical Center (J.M.), NY; The Center for Neurological and Neurodevelopmental Health and the Clinical Research Center (M.M.), Voorhees Township, NJ; Department of Neurology and Pediatrics (A.T.), Louisiana State University, Baton Rouge; and Department of Pediatrics and Neurology (W.T.), Penn State University, Milton S. Hershey Medical Center.

PMID: 31874925
DOI: 10.1212/WNL.0000000000008784

Abstract

In September 2017, the Child Neurology Society (CNS) convened a special task force to review the practice of child neurology in the United States. This was deemed a necessity by our membership, as our colleagues expressed discouragement and burnout by the increase in workload without additional resources; reliance on work relative value units (wRVUs) as the sole basis of compensation; a push by administrators for providers to see more patients with less allotted time; and lack of administrative, educational, and research support. The CNS Task Force designed and distributed a survey to multiple academic divisions of various sizes, as well as to private practices. Our findings were strikingly similar across different practices, demonstrating high workloads, lack of resources, poor electronic medical record support, and high provider symptoms of fatigue and burnout. From the results, the CNS Task Force has concluded that wRVUs cannot be the sole basis of compensation for child neurology. We have also made several specific recommendations for alleviating the current situation, including innovative ways to fund child neurology as well as ways to enhance job satisfaction.

Publication types

Review

MeSH terms

Humans
Neurology / economics*
Pediatrics / economics*
Relative Value Scales*