Table 2: MS patients seen per week for MS subspecialists versus Non-MS subspecialists/general neurologists.

MS subspecialistsNon-MS subspecialists and general neurologists
Mean number of MS patients seen per weekStandard deviation value for difference in means for number of MS patients seen by IV if MS subspecialist*Mean number of MS patients seen per weekStandard deviation value for difference in means for number of MS patients seen by IV if non-MS subspecialist or general neurologist*% seeing zero MS patients per week value for difference in %**

Total study population25.3316.513.473.3020.99
Subspecialty status
 Non-MS subspecialist 3.163.17 0.000323.90 0.003
 General neurologists4.433.4211.21
Practice arrangement
 Solo practice23.1910.55 0.57883.923.35 0.000112.20 0.000
 Neurology group25.8619.154.593.4611.57
 Multispecialty group28.8215.704.403.6016.67
 University based group24.8818.871.522.1254.10

Demographic characteristics
 44 years or less28.2719.25 0.22892.793.24 0.004729.03 0.026
 45 to 53 years24.7415.803.643.2319.01
 54 to 59 years22.1214.584.173.4615.25
 60 years or more30.1418.553.563.1715.93
 Male25.4217.46 0.92813.723.33 0.004218.60 0.055
 Yes24.6716.39 0.79823.783.44 0.374220.00 0.714
 No24.4419.11 3.363.2218.28
 Yes24.4419.11 0.79823.373.14 0.481118.07 0.694
Other race
 Yes3.504.15 0.570123.08 0.725
Hispanic or Latino
 Yes27.5010.41 0.37822.612.69 0.159825.00 0.485
Year began medical practice after completing medical training  
 1972 to 198533.0018.84 0.08163.853.49 0.002016.26 0.071
 1986 to 199322.2513.633.513.3322.33
 1994 to 200125.7316.043.923.2618.25
 2002 to 201123.2319.892.552.9929.03

Negative attitudes towards providing MS patient care
Care for MS patients takes too much time
 Yes26.5019.34 0.89103.643.26 0.392214.94 0.126
Insufficient reimbursement for time involved
 Yes28.8219.13 0.11574.153.33 0.005111.21 0.003
Lack of sufficient knowledge to feel comfortable caring for this patient population
 Yes0.901.47 0.000056.25 0.000
Lack of sufficient knowledge regarding newer disease-modifying drugs
 Yes25.00 0.59681.762.19 0.000033.90 0.009
Lack of special personnel (nurses, social workers, etc.)
 Yes25.5019.47 0.43653.233.04 0.640416.52 0.178
Little can be done to improve MS patients’ outcomes
 Yes1.00 0.33700.00 1.000
Seldom encounter MS patients
 Yes1.061.88 0.000048.57 0.000
MS patients are often difficult to treat
 Yes32.5019.94 0.32903.042.87 0.575016.67 0.439
MS patients often have multiple comorbidities
 Yes25.8514.34 0.69093.472.82 0.404110.00 0.015
Providing care to MS patients is not sustainable in my practice environment due to time or reimbursement constraints
 Yes28.7513.02 0.17643.603.30 0.736218.37 0.635

Positive attitudes towards providing MS patient care
Ability to improve patient outcomes and quality of life
 Yes25.1316.55 0.60743.943.26 0.000012.57 0.000
Dynamic area with evolving treatment options
 Yes25.9516.76 0.17794.403.37 0.000010.74 0.000
Care involving a multidisciplinary approach
 Yes27.9618.29 0.09524.023.43 0.028613.79 0.029
Research opportunities
 Yes27.4518.67 0.13644.113.23 0.062116.67 0.380
Personal connection to individuals with MS who are not your patients
 Yes30.6917.51 0.06764.163.22 0.140215.15 0.394
Enjoy interacting with MS patients
 Yes28.9217.98 0.00104.793.36 0.00006.94 0.000
Community of dedicated professional colleagues with which to interact
 Yes25.6317.73 0.87523.593.29 0.576620.00 0.786

Practice characteristics
Area in which you are practicing
 Within a major city (population greater than 250,000)27.2018.36 0.50612.923.07 0.001728.63 0.000
 Suburban or moderate-sized city (population 50,000 to 250,000)22.8614.013.913.4915.47
 Rural area or small city (population less than 50,000)22.8612.204.063.2410.29

Note: The sample excludes neurologists who have limited patient care responsibilities. Specifically, the sample excludes neurologists who provide direct patient care for less than 40 weeks per year and neurologists who do not have a clinical practice.
Wilcoxon-Mann-Whitney tests were calculated for independent variables with two categories. Kruskal Wallis tests were calculated for independent variables with three or more categories.
Chi-square tests or, as necessary due to small cell sizes, Fisher’s exact tests were performed.
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 patient 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 MS patient seen 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.”