Factors Associated with Neurologists’ Provision of MS Patient Care

Table 1

Descriptive statistics for study populations.

	MS subspecialists^†		Non-MS subspecialists and general neurologists
	Number	%	Number	%
Total study population	87	15.18	486	84.82
Subspecialty status:
Non-MS subspecialist	—	—	364	75.83
General neurologists	—	—	116	24.17
Practice arrangement:
Solo practice	16	18.39	123	25.31
Neurology group	29	33.33	121	24.90
Multispecialty group	11	12.64	48	9.88
University based group	17	19.54	61	12.55
Other^‡	5	5.75	56	11.52
Unknown	9	10.34	77	15.84
Demographic characteristics
Age:
44 years or less	16	18.60	124	26.05
45 to 53 years	31	36.05	121	25.42
54 to 59 years	25	29.07	118	24.79
60 years or more	14	16.28	113	23.74
Sex:
Male	61	70.11	344	71.07
Female	26	29.89	140	28.93
White:
Yes	67	88.16	305	76.63
No	9	11.84	93	23.37
Asian:
Yes	9	11.84	83	20.85
No	67	88.16	315	79.15
Other race:
Yes	0	0.00	13	3.27
No	76	100.00	385	96.73
Hispanic or Latino:
Yes	4	5.41	24	6.25
No	70	94.59	360	93.75
Year began medical practice after completing medical training:
1972 to 1985	15	17.24	123	25.84
1986 to 1993	32	36.78	103	21.64
1994 to 2001	27	31.03	126	26.47
2002 to 2011	13	14.94	124	26.05
Limiting attitudes towards providing MS patient care
Care for MS patients takes too much time:
Yes	36	41.38	87	17.90
No	51	58.62	399	82.10
Insufficient reimbursement for time involved:
Yes	39	44.83	116	23.87
No	48	55.17	370	76.13
Lack of sufficient knowledge to feel comfortable caring for this patient population:
Yes	0	0.00	32	6.58
No	87	100.00	454	93.42
Lack of sufficient knowledge regarding newer disease-modifying drugs:
Yes	1	1.15	59	12.14
No	86	98.85	427	87.86
Lack of special personnel (nurses, social workers, etc.):
Yes	24	27.59	115	23.66
No	63	72.41	371	76.34
Little can be done to improve MS patients’ outcomes:
Yes	0	0.00	2	0.41
No	87	100.00	484	99.59
Seldom encounter MS patients:
Yes	0	0.00	70	14.40
No	87	100.00	416	85.60
MS patients are often difficult to treat:
Yes	6	6.90	48	9.88
No	81	93.10	438	90.12
MS patients often have multiple comorbidities:
Yes	20	22.99	70	14.40
No	67	77.01	416	85.60
Providing care to MS patients is not sustainable in my practice environment due to time or reimbursement constraints:
Yes	8	9.20	49	10.08
No	79	90.80	437	89.92
Positive attitudes towards providing MS patient care
Ability to improve patient outcomes and quality of life:
Yes	81	93.10	382	78.60
No	6	6.90	104	21.40
Dynamic area with evolving treatment options:
Yes	77	88.51	270	55.56
No	10	11.49	216	44.44
Care involving a multidisciplinary approach:
Yes	52	59.77	116	23.87
No	35	40.23	370	76.13
Research opportunities:
Yes	54	62.07	60	12.35
No	33	37.93	426	87.65
Personal connection to individuals with MS who are not your patients:
Yes	16	18.39	33	6.79
No	71	81.61	453	93.21
Enjoy interacting with MS patients:
Yes	62	71.26	173	35.60
No	25	28.74	313	64.40
Community of dedicated professional colleagues with which to interact:
Yes	43	49.43	100	20.58
No	44	50.57	386	79.42
Practice characteristics
Area in which you are practicing:
Within a major city (population greater than; 250,000)	50	58.14	234	48.45
Suburban or moderate-sized city (population 50,000; to 250,000)	29	33.72	181	37.47
Rural area or small city (population less than 50,000)	7	8.14	68	14.08

†MS subspecialists answered “Yes, and I chose a fellowship in MS” to question “Did you consider a fellowship in MS as subspecialty training?” and, on average, saw at least one MS patients per week. Respondents who did not complete an MS fellowship were categorized as MS subspecialists if indicated that they saw, on average, more than 12 patients per week.
‡The “other” category includes neurologists who responded “staff-model HMO,” “government hospital or clinic,” or “other public or private hospital or clinic setting” to question “Indicate in which practice arrangement you spend the majority of your clinical time.”