Taxonomy I Part III-B (Neurology) 17 years ago Bill Burnett 10 minutes Last Updated on April 16, 2022 by Lee Burnett, DO, FAAFP(17 March 2006 20:15)NATIONAL PROJECT ON THE COMMUNITY BENEFITSOF FAMILY MEDICINE RESIDENCY PROGRAMSCUMULATIVE QUESTIONNAIRE RESPONSESTaxonomy Section I Part IIIB(Neurology)SD I.13k(1.1) (SD I.13k(2) (L32)) Does your residency program provide the following kinds of specialty care?k. Neurology? Yes__ No __Yes:WhittierPomonaArrowheadLoma LindaStocktonLouisvilleMCE BirminghamGlendaleOU TulsaOU Oklahoma CityDayton CommunityMiami ValleyDecaturMercerNatividadKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerLas VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandSD I. 13k(1.2) (SD I.13k(3)) If you do provide neurology, are these services provided as normal family health center appointments? Yes __ No __Yes:WhittierPomonaLoma LindaStocktonLouisvilleMCE BirminghamGlendaleOU TulsaOU Oklahoma CityDayton CommunityMiami ValleyDecaturMercerNatividadKlamath FallsLehigh ValleyKaiser LATylerLas VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandNo:ArrowheadSD I.13k(1.3) (SD I.13k(4)) If you do provide neurology, are these services provided during special clinics?Yes __ No __If yes, what is the number of patients seen? What revenues are generated in each specialty service?Yes:Arrowhead (200/yr)Loma Linda (40/yr)Stockton (8 per clinic; revenues are generated)No:WhittierPomonaLouisvilleMCE BirminghamGlendaleOU TulsaOU Oklahoma CityDayton CommunityMiami ValleyDecaturMercerNatividadKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerLas VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandSD I.13k(1.31) (AJ) Do you refer all patients with new onset severe headache to neurologists? Yes __ No __Yes:Las VegasNo:FresnoSpringfieldGlasgowLexingtonOHSU PortlandE-mail responses (2005 Questionnaire)No:UCSD TraditionalUCSD St VincentUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierGlendaleDayton CommunityDecaturMercerKlamath FallsLehigh ValleyMercy ToledoArrowheadLoma LindaKaiser LATylerNo Response:Lehigh ValleySD I.13k(1.32) (AJ) If the answer to SD I.13k(1.31) is no, do your residents routinely order CT scans for new onset headaches? Yes __ No __Yes:SpringfieldLexingtonNo:Fresno (We order CT scans for crescendo severe headaches. This is a clinical judgment question)Glasgow (Emphasizing “routinely”)E-mail responses (2005 Questionnaire)Yes:UC IrvineRiversideDecaturMercy ToledoKaiser LA (adjective “severe” written in prior to “headaches”)TylerNo:UCSD TraditionalUCSD St VincentWhite MemorialModesto (“routinely” is bolded with a question mark)Indiana U MethodistWhittierArrowheadGlendale (“Only with neuro signs, or suspicious hx”)Dayton CommunityMercerKlamath Falls (“Usually we use MRI”)Conditional Response:Loma Linda (“Depends on Severity”)No Response:Lehigh ValleySD I.13k(1.32.1) (AJ) If the answer to SD I.13k(1.31) is no, do your residents routinely order CT scans for new onset severe headaches? Yes __ No __Conditional Response:OHSU Portland (Depends on the definition of “routinely” and “severe”)SD I.13k(1.33) (AJ) Do you routinely refer all new onset seizures to neurology? Yes __ No __Yes:Las VegasSpringfieldGlasgowOHSU PortlandNo:FresnoLexingtonE-mail responses (2005 Questionnaire)Yes:UCSD TraditionalUC IrvineWhite MemorialModestoArrowheadLoma LindaDayton CommunityLehigh ValleyKaiser LA (“new onset” underlined)TylerNo:UCSD St VincentRiversideIndiana U MethodistWhittierGlendale (“Yes (in adults only)”)DecaturMercerMercy Toledo (“No, not routinely”)Klamath FallsSD I.13k(1.34) (AJ) If the answer to SD I.13k(1.33) is no, do you order CT scans routinely for new onset seizures? Yes __ No __Yes:FresnoLexingtonE-mail responses (2005 Questionnaire)Yes:UCSD St VincentRiversideGlendale (“Likely (in adults)”)DecaturMercerMercy ToledoNoIndiana U MethodistWhittierKlamath Falls (“Usually we use MRI”)SD I.13k(1.35) (AJ) Do you routinely refer carpal tunnel syndrome patients to neurology? Yes __ No __No:Las VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandE-mail responses (2005 Questionnaire)Yes:Loma LindaNo:UCSD TraditionalUCSD St VincentUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierArrowheadGlendaleDayton CommunityDecaturMercerKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerSD I.13k(1.36) (AJ) Do you provide follow-up care for seizures in your family medicine center? Yes __ No __Yes:Las VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandE-mail responses (2005 Questionnaire)Yes:UCSD TraditionalUCSD St VincentUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierArrowheadLoma LindaGlendaleDayton CommunityDecaturMercerKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerSD I.13k(1.37) (AJ) Do you care for multiple sclerosis patients in the family medicine center? Yes __ No __Yes:Las VegasFresnoSpringfieldGlasgow (Historically, yes; no active MS cases)LexingtonOHSU PortlandE-mail responses (2005 Questionnaire)Yes:UCSD TraditionalUCSD St VincentUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierArrowheadLoma LindaGlendaleDayton CommunityMercerKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerNo:DecaturNPCB P2 I.13k(1.37.1) Does your residency program provide a range of services for multiple sclerosis patients, including diagnosis, management and treatment, in the family medicine center?Yes __ No __Yes:Sparrow (We would not manage an MS patient all by ourselves, but as part of a team, including neurologists.)Ventura (We provide diagnosis and ongoing management in conjunction with neurologists.)Long Beach (We co-manage with neurology.)U PennJefferson (We diagnose and manage, but do not develop initial treatment regimens)Shadyside (We do so in consultation with neurology and sometimes also with oncology)Johnstown (Usually we do not diagnose; we co-manage with a neurologist)AltoonaFairfaxNo:Huntsville (We tend to refer MS patients to neurology)Crozer-KeystoneMcKeesportOahuSt MargaretNPCB P2 I.13k(1.37.2) Does your family medicine center refuse to provide ongoing care for a multiple sclerosis patients? Yes __ No __Yes:HuntsvilleNo:SparrowVenturaLong BeachU PennCrozer-KeystoneJeffersonMcKeesportOahuShadysideJohnstownAltoona (We do not refuse anything)St MargaretFairfaxSD I.13k(1.38) (AJ) Would you expect that a neurology referral from your residency program would be seen by a neurologist within two weeks? Yes __ No __Yes:OHSU PortlandNo:Las VegasFresnoSpringfield (it usually takes 3 months, unless a doctor says that it is an emergency)GlasgowLexingtonE-mail responses (2005 Questionnaire)Yes:UC IrvineWhite MemorialIndiana U MethodistWhittierDecaturMercerKlamath FallsKaiser LATylerNo:UCSD TraditionalUCSD St VincentRiversideModestoArrowheadLoma LindaGlendaleDayton CommunityLehigh ValleyMercy ToledoSD I.13k(1.39.1) (AJ) If a neurological cause of syncope is suspected, do you care for the patient in the family medicine center?Yes __ No __Yes:Las VegasFresno (We might admit them to our family medicine service)SpringfieldGlasgowOHSU PortlandNo:LexingtonE-mail responses (2005 Questionnaire)Yes:UCSD TraditionalUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierArrowheadLoma LindaGlendaleDayton CommunityDecaturMercerKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerMaybe:UCSD St Vincent (“Maybe, depends on the workup results & dx”)SD I.13k(1.39.2) (AJ) Are stroke inpatients discharged to your family medicine center for follow-up care? Yes __ No __Yes:Las VegasFresnoSpringfieldGlasgowLexingtonOHSU PortlandE-mail responses (2005 Questionnaire)Yes:UCSD TraditionalUCSD St VincentUC IrvineWhite MemorialRiversideModestoIndiana U MethodistWhittierArrowheadLoma LindaGlendaleDayton CommunityDecaturMercerKlamath FallsLehigh ValleyMercy ToledoKaiser LATylerSD I.13k(1.4) (SD I.13k(5)) Describe the kinds of neurology that typically takes place within the family health center (whether as normal appointments or during special clinics):Glendale (CVA, strokes; will evaluate onset of seizures; will refer out but will do plan maintenance)OU Tulsa (neurological evaluation; no EEGs, EMGs)OU Oklahoma City (headaches; seizures; strokes; MS; hemostasis)Dayton Community (neurological exams; specific neurological problems; we order EEGs, but do not read)Miami Valley (seizures, TIA; stroke; dementia (on our own patients and those we are co-managing)Decatur (neuropathies; strokes; no MS patient care)Mercer (stroke; Parkinson’s; seizures; headaches; dementia; MS; PLMD; MR)Natividad (headaches; dementia; stroke follow-up; seizure disorders; Parkinson’s)Klamath Falls (assessment and treatment of MS; post-CVA care; migraine and other headaches; neuropathies; dementia; deliriums; concussions)Lehigh Valley (MS patients; headaches; ALS patients; seizure patients; CVAs)Mercy Toledo (everything short of surgery; all general problems)Kaiser LA (seizures; the family medicine department’s geriatric faculty run the institution’s Alzheimer’s and dementia clinics)Tyler (monofilament testing; general neurologic exams; lumbar punctures)SD I.13k(1.4.1) (SD I.13k(5)) Describe any other kinds of neurology that typically takes place within the family health center (whether as normal appointments or during special clinics):Las Vegas (headaches; primary care for Parkinson’s disease patients; management of Alzheimer’s; neuropathies; post-polio syndrome; stroke patients)Fresno (Bells palsy; Guiane-Barre)Springfield (Bells palsy; headache; gait; Parkinson’s disease; tremors)Glasgow (diagnose and manage migraine headaches, post-herpetic neuralgia; chronic pain)Lexington (peripheral nerve diseases; degenerative brain diseases and dementia; neuropathic pain; cord impingement syndromes)OHSU Portland (migraine; Bells palsy; ALS; Alzheimer’s, other dementia; vertigo; diplopia; long list of diagnoses)NPCB P2 I.13k(1.4.2) For what conditions would your residency program refer patients to neurologists? What is the expected wait time before the patient is seen?Sparrow (Difficult migraine patients; neurogenerative diseases like MS, ALS, stroke patients)Huntsville (Interferon treatments or new biologic treatments)Ventura (Diagnosis and management of obscure or difficult neurological problems, such as difficult to manage seizure disorder patients, MS, degenerative neurological conditions, ALS, adrenal leukrodystrophy)Long Beach (Diagnostic dilemmas, sometime within a managed care program, only neurologists can order MRIs, some pharmaceuticals for MS are very expensive and are limited to neurologists. The wait for a neurologist referral is sometimes 6 weeks.)U Penn (Referrals are physician specific; the wait times are 1 day to 1 month.)Crozer-Keystone (Seizure management; headache management; some chronic pain; 2 week wait)Jefferson (We refer for seizure disorders; 8-12 week wait)McKeesport (Vague, undiagnosed problems like peripheral neuropathies; MS; Parkinson’s; diagnostic issues; wait time is 2 weeks)Oahu (Refractory headaches; seizure disorders; MS; some bad balance problems; hypertensive encephalopathy; AMS; inpatient neurology)Shadyside (Complex neurological conditions; refractory seizures; specialized diagnostic testing)Johnstown (Advanced neurologic problems; unresolved pain management; advanced motor problems; seiaures; we would do ongoing management after the neuro evaluation; in patient problems are seen within a day, headaches a week, chronic pain, a month)Altoona (Problems we cannot diagnose; consults for pregnant patients with seizures out of control)St Margaret (Complex seizures; multiple sclerosis; complex strokes; gait disorders such as Parkinson’s)Fairfax (Referrals seen within a week; acute strokes; initial evaluations of seizure disorders; chronic, recalcitrant migraines; difficult to control seizures; persistent neurologic deficits; consultation, in some cases, of dementia)*NPCB P2 I. Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?a) migraine headaches? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobeb) seizures? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobec) tremor? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobed) restless leg? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobee) Parkinson’s disease? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobef) stroke/TIA? Yes __ No __Yes:Santa RosaReadingYorkLebanonBillingsMonroevilleBeaverLatrobeLast Updated (17 August 2006 20:09) people found this article helpful. What about you?