[Neurology and neurologists in Spain: the consolidation of the family neurologist?].
BACKGROUND
The professional activity of the Spanish neurologists require an analysis because their current situation and future perspectives need some transformations.


METHODS
Author's review of the literature (Medline and grey). Several inquiries in official centres and to Spanish experts were performed.


RESULTS
The lack of historical development in this speciality until two decades ago was pointed out. Currently, they work more than 1.400 neurologists (3.4 neurologist per hundred thousand inhabitants [HTI]), those plus residents, neurophysiologists, and assimilated reaches 4.5 neurologists per HTI. The neurological practice is performed mainly in the National Health Service (NHS) (15% of the population have private insurance). The Spanish NHS is universal, free and efficient in relationship to the limited gross national product consumed; the primary care investment has decreased; this fact restricts its gatekeeper and cure function for neurological patients. The neurological demand is increasing, becoming excessive for the current neurological workforce, and is attended mainly in extra-hospital ambulatory settings with practice of limited quality (family neurologists). The solution to this situation requires: better neurological training (undergraduate and postgraduate) and of the family physician; to re-structure the ambulatory neurological assistance endowing it with more medical time and several modifications in hospitals (as stroke units). It is predicted that the neurological demand and neurologic workforce will continue to increase.


CONCLUSIONS
Ambulatory neurological assistance and neurological training (undergraduate and postgraduate and of the family physician) are the main professional aspects that require substantial improvement for the progress of the speciality.
Bermejo-Pareja
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Servicio de Neurología, Hospital Universitario Doce de Octubre, Madrid. fbermejop2004@yahoo.es
D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D005190:Family; D006301:Health Services Needs and Demand; D006280:Health Workforce; D006801:Humans; D008511:Medicine / Q000639:trends; D009462:Neurology / Q000639:trends; D010820:Physicians; D012196:Review Literature as Topic; D013030:Spain; D013038:Specialization