Neurology as a Profession — An Overview

January 18, 2011


By Adrienne Foley

Neurologists, from those who practice general neurology to those who subspecialize, see the full gamut of diseases of the nervous system — specifically diseases involving the central, peripheral, and autonomic nervous systems — in patients ranging from newborns to old age. Once regarded as a diagnostic profession, the field of neurology today has evolved to one of broad intervention.

Jonathan Hosey, MD, a neurologist on staff at Geisinger Medical Center in Danville, Pa., says neurologists today do a bit of detective work beyond diagnosis. "Ours is a broad field," he says. "We're seeing patients who have challenging diagnostics, from migraines and epilepsy, to MS and Parkinson's." Fortunately, he says, with the explosion of technology and therapeutic interventions, the world of neurology has evolved from being basically a diagnostic field to one of intervention.

"Acute intervention of stroke, for example, has drastically changed the care of that disease," he says. "Historically, neurologists were regarded as just diagnostic technicians but that is no longer the case. We have as intense therapies as any other field in medicine."

How Do Neurologists Spend Their Day?

A neurologist essentially sees patients with diseases of the nervous system. "We also interact with the families, to educate them and help them understand what's going on with their family member," says Dr. Hosey.

Physicians specializing in neurology have a number of options for arranging their workday, including:

  • seeing patients with conditions ranging from migraine headaches to traumatic brain injury;
  • ordering diagnostic tests, including CT, PET and MRI among others;
  • reviewing test results;
  • consulting with other physicians to determine diagnosis and treatment plan;
  • conferring with patients, their families and friends. "Neurology is a very collaborative specialty in medicine," says Dr. Hosey. "For instance, with regard to stroke patients, a neurologist would work with emergency medicine doctors, neurosurgeons, family practitioners, and others. We work among each other and outside the specialty itself so there's an opportunity to keep learning through this collaboration."
  • working in inpatient settings, where Dr. Hosey says a neurologist typically sees patients with stroke, brain trauma, epilepsy, disorders that are crippling, and acute episodes of infection in the brain.
  • working in a group practice or outpatient setting. "Outpatient clinics treat those with less severe or chronic problems," says Dr. Hosey, who suggests that medical students get exposure in both inpatient and outpatient settings. "This will help them decide whether or not to go on to focus in specialized areas."

Because stroke is the third leading cause of death and the leading cause of serious, long-term disability in the United States, Dr. Hosey says many neurologists focus on stroke. "Acute stroke is hospital-based and neurologists also focus on chronic care and prevention of further stroke occurrences," he says.

Historically, Dr. Hosey says neurologists simply confirmed that a stroke had taken place. "Today, our focus is to not only identify stroke but to treat these diseases early on," he says. "We can't cure stroke and other neurological conditions but we can radically alter and make the life and longevity of the patients more robust than in the past."

Other chronic neurological specialties include multiple sclerosis, Parkinson's disease and Alzheimer's disease. "We have a significant aging population and we're no longer just seeing these patients at the end stages of these diseases. We are now looking at early identification of these problems."

Opportunities for Future of the Industry

In the next 10 to 20 years, Dr. Hosey anticipates a deficit of neurologists, due to the increased demands of the aging population. For physicians who are interested in either general or specialized neurology, Dr. Hosey says tremendous opportunity is available in all fields including research and current practice.

"The science of neurology is moving at an extremely rapid pace, some of the most rapid in the spectrum of medicine," he says. "We attribute that to the research and the interest in diseases that involve the brain and the nervous system."

If there's a black box in medicine, it's with neurology, adds Dr. Hosey. "It's a fascinating area if you're interested in medical science. There's so much we don't know so there's a lot of potential for great discovery. It's a profession that's always changing and experiencing new discoveries."

Dr. Hosey encourages all medical students to complete a rotation in clinical neurology. "Even if it's far away from what they want to do, participating in a neurology rotation provides a perspective on medicine they can't get in other specialties."