The clinical responsibilities across the neurology department encompass a wide range of services tailored to each specialty. The collaborative and multidisciplinary framework ensures comprehensive care for patients with diverse neurological needs.
Patient Population and Services:
The department serves a diverse patient demographic, addressing conditions including movement disorders, cognitive impairments, neuromuscular diseases, cerebrovascular diseases, and pediatric neurological conditions. The high-volume program includes specialized clinics for ALS, epilepsy, Parkinson’s, and stroke, among others.
Services and Procedures:
Critical Care: 100% Critical Care Intensivist
Call Coverage by Specialty
Neurology:
General Neurology Call: Rotating schedule shared among faculty, typically involving coverage for inpatient consults and urgent outpatient needs.
Telestroke Call: Faculty provide virtual stroke consultations, usually 5–6 calls per month, depending on the pool of participants.
Memory:
Call responsibilities are minimal, primarily involving consultation for inpatient memory-related cases. Memory specialists typically focus on outpatient care.
Movement Disorder:
Movement specialists have limited call duties, focusing on outpatient follow-ups and urgent care needs for Parkinson’s and related disorders.
Memory-related on-call duties are rare and typically handled during regular clinic hours.
Muscular Neurology:
Call duties include managing neuromuscular emergencies, such as myasthenic crises, and interpreting urgent EMG results. These responsibilities are shared among neuromuscular faculty.
Stroke:
Stroke Service Call: Covered in 7-day inpatient blocks, including both general stroke and telestroke services.
Telestroke Call: Physicians typically manage multiple cases remotely during on-call periods.
Pediatric Neurology:
Pediatric neurologists provide on-call coverage for inpatient cases, epilepsy monitoring units, and emergency consultations. Clinic schedules are reduced during on-call weeks to accommodate these responsibilities.
Epilepsy Call Coverage and Clinical Workflow:
Epilepsy physicians rotate between EEG services including the Epilepsy Monitoring Unit (EMU), ICU EEG monitoring, inpatient EEG studies, and outpatient EEG interpretation. The current rotation involves one physician covering the EMU while the other covers ICU and inpatient EEGs. Weekend responsibilities alternate weekly between physicians, with the on-call physician managing EEG studies and surgical epilepsy cases over the weekend.
Though on-call duties include after-hours responsibilities, overnight hospital presence is almost never required. Physicians manage issues remotely via laptop, and well-trained neurology residents are typically the first line of support overnight. The department does not require epilepsy faculty to take general neurology call but does involve them in weekly resident continuity clinics in a supervisory role.
The ideal staffing model includes four dedicated EEG physicians, allowing for more manageable rotations and at least one physician off EEG duty each week. This would enhance flexibility and reduce burnout, ensuring balanced workloads and continuity of care.
Technology and EMR Systems:
The facility is equipped with advanced diagnostic tools, including epilepsy monitoring units and state-of-the-art imaging. The practice uses an integrated Epic electronic medical record (EMR) system to streamline documentation and patient management.
Research and Teaching Opportunities:
Clinical research is a cornerstone of the department, with active trials in areas such as ALS, Parkinson’s, stroke, and dementia. Physicians also contribute to resident and fellow education, enhancing academic engagement.
Support Services:
The department benefits from robust support services, including physician assistants, advanced practice providers, and a medical illustrator for educational content. Integrated care teams provide access to physical therapy, speech therapy, and specialized coordinators for surgical and non-surgical interventions.