TY - JOUR
T1 - Child neurology in the 21st century
T2 - More than the sum of our RVUs
AU - Zupanc, Mary L.
AU - Cohen, Bruce H.
AU - Kang, Peter B.
AU - Mandelbaum, David E.
AU - Mink, Jonathan
AU - Mintz, Mark
AU - Tilton, Ann
AU - Trescher, William
N1 - Funding Information:
M.L. Zupanc has research support for an investigator-initiated retrospective study on infantile spasms from Mallinckrodt and clinical research support for investigational drug study from Zogenix, both paid to her employer; is on the Speaker's Bureau for Mallinckrodt, Eisai Inc., Aquestive Therapeutics, and Greenwich Pharmaceuticals, and has received honoraria; and is on the editorial board for Pediatric Neurology. B.H. Cohen receives research support from Stealth Biotherapeutics, BioElectron Technologies, Reath Pharmaceuticals, and Horizon Pharmaceuticals, all paid to his employer; is a consultant for Stealth Biotherapeutics and Modis Pharmaceuticals; is an educational speaker and CPT Advisor for the AAN; and has received honoraria for his services. P.B. Kang is a consultant for AveXis for a clinical trial and a consultant for ChromaDex; is on the advisory board for Sarepta Therapeutics; and is a coeditor for Muscle and Nerve, coeditor for Pediatric EMG (textbook), and author for UpToDate. D.E. Mandelbaum is on the Scientific Advisory Board of Teva Pharmaceuticals; is on the editorial boards of Pediatric Neurology and Journal of Child Neurology; occasionally performs medical expert consultations; and performs locum tenens (CompHealth). J. Mink has received research support from Abeona Inc. and Beyond Batten Disease Foundation; has research funding from the NIH and has received institutional support from the University of Rochester for research; serves as Associate Editor of Neurology and Associate Editor of Continuum; receives royalties from Elsevier, Inc.; and serves as a consultant for Abide Inc., Censa Inc., TEVA Inc., Bluebird Bio, and Neurogene. M. Mintz has functioned as principal investigator for clinical trials research contracted through the Clinical Research Center of New Jersey (CRCN) sponsored by the following companies: Aquestive Therapeutics, Curemark, Eisai Inc., Impax Laboratories, Neurim Pharmaceuticals, Nuvelution Pharma Inc., PhenoSolve, Sunovion, and Teva; is a consultant to Philips-Electrical Geodesics contracted through the Center for Neurologic and Neurodevelopmental Health (CNNH) and is on the scientific advisory board of NeuroNeeds; serves on the editorial boards of the Journal of Child Neurology and Vision Development and Rehabilitation; has functioned as an expert witness in various litigation and mitigation cases, contracted through CNNH NeuroHealth; and is the Chief Medical Officer, Owner, and Founder of CNNH and CRCN, a board member of CNNH Management, Inc., and is President and Founder of NeurAbilities, a 501(3)c public charity. A. Tilton has worked with Ipsen Pharmaceutical on the development of a clinical study protocol and is a study investigator, with research support; is a consultant and educator for Eisai, Inc. and has received honoraria; and is a speaker on transitions of care for the Child Neurology Foundation. W. Trescher is an editor for the Journal of Pediatric Neurology. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
© American Academy of Neurology.
PY - 2020/1/14
Y1 - 2020/1/14
N2 - 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.
AB - 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=85077793212&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000008784
DO - 10.1212/WNL.0000000000008784
M3 - Review article
C2 - 31874925
AN - SCOPUS:85077793212
SN - 0028-3878
VL - 94
SP - 75
EP - 82
JO - Neurology
JF - Neurology
IS - 2
ER -