Neurology departments within hospitals and the overall practice of neurology have progressed a lot over the years, in both subspecialties and diagnostic tools. In a new-school/old-school combination, biotechnologies coupled with stable neurological philosophies are transforming today's neurologists. Paul Bendheim, MD, is the founder and CEO of BrainSavers, a private company that has developed evidence-based brain-aging programs and products to help maintain brain fitness and reduce age-related neurological impairments, including memory loss and Alzheimer's disease. Dr. Bendheim shares some points on the qualities of neurologists that leading hospitals should strive to have in their neurological departments.
1. Excellent bedside care. Dr. Bendheim says neurology has traditionally been an intensive bedside specialty, and as a classical neurologist, he thinks bedside care is a staple because hours may be required to patiently examining someone's brain condition. "Excellent bedside care starts with the fact of realizing the patient and his or her family might be terrified, and you must be a caring individual," Dr. Bendheim says. He also believes bedside and overall medical care is generally improved if a hospital is connected to an academic department, as a patient can receive two or three looks from medical students, house officers and attendings for the price of one.
2. Diligent attitude. Because so much time may be required observing the patient and monitoring hours of a patient's brain activity, neurologists, like all physicians in healthcare, must be willing to have the diligence and patience to see a case through, Dr. Bendheim says. It is not uncommon for neurologists to be the last stop in a difficult diagnostic problem. "To be a neurologist, a physician, everything else has to be secondary," Dr. Bendheim says. "You have to be willing to leave dinner to take care of the patient. It comes down to that philosophy. If you're responsible for someone's life, there are no excuses for the time you have to put in for proper treatment of your patient."
3. Openness to new diagnostic tests and therapies. Neurologists have not had the types of diagnostic tests at their disposal that are revenue centers for other departments, but that has begun to change in the last few years, Dr. Bendheim says. Stroke care and interventional neurology therapies, physiological monitoring, deep brain stimulation for movement disorders and infusion centers for multiple sclerosis and auto-immune neuromuscular disorders all offer profit margins as well as state-of-the-science advanced care in a hospital's neurology department. "We pride ourselves on our diagnostic skills, but now we've become therapists as well," he says. Incorporating neuroradiology is also key because CT, PET and MRI scans offer images of the brain that have revolutionized the diagnosis and treatment of some neurological disorders, something that was hard to imagine 30 years ago, he says.
4. Balance of workflow. In a perfect world, neurologists would apply their best diagnostic skills regardless of fee schedules, Dr. Bendheim says. "But we have to practice in the real world," he says. "There has to be a balance struck between the time at the bedside and the need to generate sufficient revenues for the department."
5. Top-notch training of residents and fellows. "Ensure the next generation of neurologists gets the best training," Dr. Bendheim says. "And keep absolutely abreast of the state-of-the-art in diagnoses and treatments." As mentioned, deep brain stimulation and infusion therapies are up-and-coming treatments, but even older discoveries are requiring updated and enhanced training. Dr. Bendheim says treating neurological cases with monoclonal antibody therapy — a revolutionary approach to diagnosis and therapy discovered in the mid-1970s — is still very much relevant today. MS, Alzheimer's and cancer are all seeing MABs in use or under development as therapies will be increasingly employed in other diseases in the near future, he says.
Learn more about BrainSavers.
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1. Excellent bedside care. Dr. Bendheim says neurology has traditionally been an intensive bedside specialty, and as a classical neurologist, he thinks bedside care is a staple because hours may be required to patiently examining someone's brain condition. "Excellent bedside care starts with the fact of realizing the patient and his or her family might be terrified, and you must be a caring individual," Dr. Bendheim says. He also believes bedside and overall medical care is generally improved if a hospital is connected to an academic department, as a patient can receive two or three looks from medical students, house officers and attendings for the price of one.
2. Diligent attitude. Because so much time may be required observing the patient and monitoring hours of a patient's brain activity, neurologists, like all physicians in healthcare, must be willing to have the diligence and patience to see a case through, Dr. Bendheim says. It is not uncommon for neurologists to be the last stop in a difficult diagnostic problem. "To be a neurologist, a physician, everything else has to be secondary," Dr. Bendheim says. "You have to be willing to leave dinner to take care of the patient. It comes down to that philosophy. If you're responsible for someone's life, there are no excuses for the time you have to put in for proper treatment of your patient."
3. Openness to new diagnostic tests and therapies. Neurologists have not had the types of diagnostic tests at their disposal that are revenue centers for other departments, but that has begun to change in the last few years, Dr. Bendheim says. Stroke care and interventional neurology therapies, physiological monitoring, deep brain stimulation for movement disorders and infusion centers for multiple sclerosis and auto-immune neuromuscular disorders all offer profit margins as well as state-of-the-science advanced care in a hospital's neurology department. "We pride ourselves on our diagnostic skills, but now we've become therapists as well," he says. Incorporating neuroradiology is also key because CT, PET and MRI scans offer images of the brain that have revolutionized the diagnosis and treatment of some neurological disorders, something that was hard to imagine 30 years ago, he says.
4. Balance of workflow. In a perfect world, neurologists would apply their best diagnostic skills regardless of fee schedules, Dr. Bendheim says. "But we have to practice in the real world," he says. "There has to be a balance struck between the time at the bedside and the need to generate sufficient revenues for the department."
5. Top-notch training of residents and fellows. "Ensure the next generation of neurologists gets the best training," Dr. Bendheim says. "And keep absolutely abreast of the state-of-the-art in diagnoses and treatments." As mentioned, deep brain stimulation and infusion therapies are up-and-coming treatments, but even older discoveries are requiring updated and enhanced training. Dr. Bendheim says treating neurological cases with monoclonal antibody therapy — a revolutionary approach to diagnosis and therapy discovered in the mid-1970s — is still very much relevant today. MS, Alzheimer's and cancer are all seeing MABs in use or under development as therapies will be increasingly employed in other diseases in the near future, he says.
Learn more about BrainSavers.
Related Articles on Neurology:
How Facebook Helped One Neurosurgeon Diagnose and Treat a Comatose Patient: Q&A With Dr. Kamal Thapar of Sacred Heart Hospital
Pennsylvania's Lehigh Valley, Phoebe Ministries Form Teleneurology Partnership
15 Statistics on Physician-Generated Revenue in 2010