As demand for stroke and neurological care rises, so does the need for neurologists trained in the business of medicine. Unfortunately, relatively few neurologists lead hospitals, health systems, or even service lines like stroke teams. Fewer still have the skill and savvy to drive the development of innovative neurology programs.
To grow neurology's leadership pool, Vituity has teamed up with Stanford University to establish a joint fellowship in intraoperative neurophysiologic monitoring (IONM) and medical administration. Here's how we hope the program will nurture talented neurologists into tomorrow's healthcare leaders and innovators.
Barriers to neurology innovation
At first glance, it may seem surprising to see so few neurologists in leadership positions. Medical advances and increasing life span are driving demand for acute neurology services. As a result, many hospitals are seeking accreditation as Primary and Comprehensive Stroke Centers.
At the same time, the supply of neurologists — particularly those interested in hospital-based practice — is limited. Each of the country's 133 neurology residencies graduates only three or four physicians a year. And a large majority of them go on to practice in outpatient settings rather than hospitals.
In addition, modern medical education tends to emphasize clinical care over the business of medicine. "Most physicians don't come into practice knowing about regulations, Medicare, or insurance," says Yafa Minazad, DO, Vice President of Neurology Operations at Vituity. "This is unfortunate, because hospitals need neurologists who understand the business side of practice to help them grow their services."
Minazad, who cofounded one of the country's first neurohospitalist management groups, is intimately familiar with the barriers facing acute neurology services. "Many neurologists are interested in developing new programs but are frustrated by the lack of resources," she says. "There's nowhere they can go to learn how to set up a program, recruit providers, achieve lab accreditation, and so on."
Training tomorrow's leaders
When Minazad's neurohospitalist practice merged with Vituity, a multispecialty acute care management group, she quickly identified an opportunity to develop new neurology leaders.
Vituity’s administrative fellowships are immersive, one-year programs that provide physicians with the training they need to become healthcare leaders and innovators. Under the mentorship of Vituity executives, fellows are active members of the leadership team. They also complete projects that tackle important issues like quality, risk management, advocacy, and continuing education.
"I could definitely see us using Vituity's fellowship model to train neurology leaders," Minazad says. "Marrying management with neurophysiology made sense, because it's one of the neurology subspecialties that tends to be hospital-based."
Minazad shared her vision with fellow neurophysiologist Jaime Lopez, MD, a professor at Stanford University Medical Center and director of Stanford's IONM Fellowship. Together they led the creation of a two-year fellowship program that combines neuromonitoring with management training and mentoring.
Under the new program, fellows will complete one year of IONM training at Stanford — a top-ranked destination for this specialty. They will also spend one year as Vituity administrative fellows while also practicing on Vituity's teleneurology panel.
Minazad says that as far as she knows, the program is the first administrative fellowship for neurologists available in the country.
Meet Vituity's first neurology admin fellow
Shahla Moghbel, DO, will be the first physician to complete the new two-year Vituity-Stanford fellowship. She begins her training in July 2019 at Vituity.
Moghbel, a neurology resident at NIH-Georgetown University Hospital, learned about this opportunity when she applied to the one-year IONM fellowship at Stanford. As the administrative chief for her residency program, she had enjoyed supporting her 22 fellow residents. She realized that the combined fellowship, which married her interests in neurophysiology and leadership, was an excellent fit.
"I feel that it's very important for physicians to be part of the decision-making process in their organizations," Moghbel says. "We know inside out what's going on with the hospital, what's going on with the patients. And to be effective leaders, it's important to understand things like regulations, risk management, patient advocacy, and so on."
Down the road, Moghbel hopes to become a medical director. But for the moment, she's excited to continue growing as a leader and clinician. "I hope to learn a lot and be a good asset to the partnership," she says of her upcoming year at Vituity.
Shaping the future of acute neurology
While Moghbel will be the first Stanford-Vituity fellow, many others may soon follow in her footsteps. Minazad recently attended the annual meeting of the American Clinical Neurophysiology Society, where she discussed the new program with her colleagues. "The buzz among residents and fellows was very strong," she says. "They're hungry for these kinds of opportunities."
Minazad hopes that the new fellows will be trailblazers who dramatically improve access and quality in acute neurology care. "I really see these fellows as an incredible resource who bring the business and clinical sides of our specialty together," she says. "When it comes to improving patient care, they will be worth their weight in gold."
To learn more about Vituity’s approach to acute neurological care, visit our neurology page.
Originally published May 14, 2019.