Stroke Call in the United States: Challenges and Opportunities in Vascular Neurology

OBJECTIVE: To determine the current status and perceptions of the stroke call workforce in the US. BACKGROUND: In 2014, the Stroke Practice Resources Workgroup was created by the AAN Stroke and Vascular Neurology (VN) Section to identify challenges to the recruitment and retention of vascular neurologists and provide recommendations to reduce the number of unfilled VN fellowship training positions and shortage of VN specialists. In 2015, only 52% of eligible diplomates in VN were re-certified and in 2016, 34% of VN fellowship training programs had unfilled positions. DESIGN/METHODS: In January 2016, we conducted a cross-sectional analysis of responses to 10 survey questions addressing stroke call concerns that was distributed by email to a sample of 900 neurologists likely to provide stroke call. RESULTS: Eighty-five percent of the respondents indicated their institution provided stroke call services of which 42% were dedicated stroke call. Forty-one percent of the respondents felt there was a stroke call workforce shortage at their institution. Mean number of days spent on call each month was 9.3 (± 5.6); 21% of respondents who took call were dissatisfied with their current job. General neurologists were more likely to report “spending too much time on stroke call” (42% vs. 27%, p=0.02), and 46% indicated that stroke call duties contributed to their personal feeling of “burnout”. Stroke physicians (VN, neurohospitalists, telestroke providers) and general neurologists had similar perceptions regarding the stroke workforce. Responses to an open-ended question revealed displeasure about compensation received, burnout concerns and combining stroke call with telestroke responsibilities. CONCLUSIONS: Correcting a perceived discontent about stroke call may improve fellowship recruitment, retention and the overall supply of Vascular Neurology specialists. Study Supported by: AAN Stroke and Vascular Neurology Section Stroke Practice Resources Workgroup: Edgar Kenton MD, Chair; Writing Group Antonio Culebras MD, Pierre Fayad MD, Larry Goldstein MD, Brian Kaskie MD, Helmi Lutsep MD, Larry Wechsler MD; for additional Workgroup, Jose Biller MD, Irene Katzan MD, James Stevens MD, David Wang MD, Nellie Adams. Disclosure: Dr. Kenton has nothing to disclose.