Neurologists collaborate with PCPs to improve brain health

SAN DIEGO — Facing a workforce shortage and higher patient volumes, neurologists are looking for ways to collaborate with primary care providers to improve outcomes, according to speakers at the American Academy of Neurology Annual Meeting.

A study published earlier this year in Neurology showed the average wait time between a referral and neurology visit was more than a month among older adults, with longer wait times for those with serious neurodegenerative conditions like multiple sclerosis, epilepsy and Parkinson’s disease.

In this video, Mary A. O’Neal, MD, FAAN, chief of general neurology at Brigham and Women’s Hospital, and Ratna K. Bhavaraju-Sanka, MD, FAAN, vice chair of clinical at UT Health San Antonio, discuss their efforts to address the lack of access to neurological care by partnering with primary care.

At her institution, O’Neal said most patients are referred to neurology for headache. So, she surveyed PCPs to gauge their knowledge in headache management and determine what support they need to care for these patients.

“Very interestingly, they wanted something embedded in our EMR,” O’Neal said. “They wanted what we call a SmartRX set about migraine medication treatments. So, that’s what we did.”

Meanwhile, Bhavaraju-Sanka said she found it beneficial to embed neurologists into primary care clinics.

“Primary care is very … comfortable managing some of these neurological disorders, but patients want to see neurologists,” Bhavaraju-Sanka said. “If they see us as a team working in the same building and sharing the same office, they trust us as a team. Thus, primary care can reduce the number of referrals, and we can see more complicated patients. At the same time, we can educate primary care in their offices on neurological examination red flags.”

The pair shared their experiences with fellow neurologists at the AAN meeting, but their next steps are to seek input from primary care stakeholders.

“We truly are partners in crime,” O’Neal said.

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Mary A. O’Neal, MD, FAAN, chief of general neurology at Brigham and Women’s Hospital, and Ratna K. Bhavaraju-Sanka, MD, FAAN, vice chair of clinical at UT Health San Antonio, can be reached at neurology@healio.com.