As the population ages, South Carolina will need more brain doctors, experts say | Features

This spring, the University of South Carolina graduated five residents in neurology. Three plan to stay in the state.

As the first class of neurology residents to graduate from USC, these doctors will help narrow a critical gap between the number of neurologists in the state and patients who need them.

Experts say that gap will only become more severe as the state’s population ages. More neurologists will be needed to care for patients with conditions that are often tied to age, from stroke to Alzheimer’s and dementia.

USC is now one of two programs in the state producing neurologists, along with the Medical University of South Carolina. Sonal Mehta, a professor of neurology at USC and a leader within the S.C. Neurological Association, said specialists across the state are already stretched thin.

“We feel that we are unable to provide the quality of care and quantity of time that we’d like to,” Mehta said.

The Alzheimer’s Association recently released the results of a study that identified states struggling with a lack of neurologists. The study singled out South Carolina and four other states as having the greatest gap between neurologists and the number of people who will likely need them. South Carolina was by far the most populous of those states. The Palmetto State also had the third-highest rate of Alzheimer’s in the country in 2014, according to the Centers for Disease Control and Prevention. 

Neurocern, a software company that coordinates care plans for people with dementia, conducted the study.

The number of neurologists working in South Carolina, adjusted for the state’s population, is below the national average, although not by much, according to a recent report by the state’s Office for Healthcare Workforce. There were 162 neurologists in the state in 2015. Yet the state’s persisting problems with stroke and dementia and an aging population beg for a greater number of physicians with the specialty.

Ralph Sacco, president of the American Academy of Neurology, said about 2.6 percent of medical students will choose neurology. He and Mehta agreed medical schools need to increase all students’ exposure to neurology. Mehta said he hopes that exposure would improve the likelihood students would choose the field or at least equip them to treat neurological disorders.

“This is an opportunity to make them more capable and more confident in dealing with these conditions,” Mehta said.

Six out of ten neurologists experience burnout, according to the American Academy of Neurology. That fatigue, coupled with relatively low compensation compared with other specialties, makes recruitment a challenge.

To address the need for stroke specialists, MUSC recently began sharing its neurologists with Roper St. Francis this year. The agreement is part of a larger effort by MUSC to expand the capability of its neurologists to reach stroke patients across the state. Stoke patients and Alzheimer’s patients often share many of the same pre-existing conditions, including diabetes, tobacco use and obesity. The Palmetto State is part of the “stroke belt” and had the fourth-highest rate of deaths due to stroke in the country, according to the CDC.

Sacco said such contracts between hospitals are becoming more common as medical centers work to compensate for a shortage of neurologists. As is the case in many other fields of medicine, Sacco said he thinks telemedicine could open other possible solutions.

“It’s another way we can extend the reach of a neurologist,” he said.

Family doctors and nurses could help fill some of the gap, too. Beth Sulkowski, the vice president of communications and advocacy for the South Carolina chapter of the Alzheimer’s Association, said not every Alzheimer’s or dementia patient needs specialized care, and primary care doctors can be effective in diagnosing and treating the disease when equipped with the right tools.

But Mehta said primary care providers cannot be expected to keep up with the rapidly changing field.

“There is so much that is happening so quickly that even as a neurologist, it is practically impossible to keep up with it,” Mehta said. “I don’t think it would be fair to ask family doctors to take on the mantle of doing everything for these patients.”

Reach Mary Katherine Wildeman at 843-937-5594. Follow her on Twitter @mkwildeman.

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