Uncovering Reasons for Low Geographic Access to Neurologists in MS Care: Marisa McGinley, DO

WATCH TIME: 3 minutes

"This goes beyond just the healthcare systems, where clinicians’ like to practice, and how the US has developed over time. We, as a healthcare system, and as providers, need to be mindful that we can’t fix it on our own. It means that we need to be more proactive in thinking about these communities and how we reach them."

It’s no secret there continues to be a shortage of neurologists for the number of patients that are affected by neurologic disorders. Inequalities in access to neurologists and disparities in clinical outcomes have been well described, mainly involving Black and Hispanic individuals with neurologic conditions. For patients with multiple sclerosis (MS), ensuring access to the proper multidisciplinary team of experts, as well as having the ability to receive early and on-time disease-modifying treatments, is critical for the long-term prognosis of these individuals.

A group of investigators recently published a cross-sectional analysis of geographic access to neurologists and MS centers for US census tracts. The study, led by Marisa McGinley, DO, used Medicare data for neurologist location, 2020 American Community Survey 5-year estimates, 2010 rural-urban commuting area codes, and MS center locations as defined by the Consortium of Multiple Sclerosis Centers to define geospatial access to neurologists, geospatial access to MS centers, and demographic and community characteristics that examine geospatial access.

Of 70,858 census tracts, 388 had no neurologists within 60 minutes and 17,837 had no MS centers within 60 miles. Geographic access to neurologists was lower for rural (–80.49%; 95% CI, –81.65 to –79.30) and micropolitan (–60.50%; 95% CI, –62.40 to –58.51) areas compared with metropolitan areas. Above all, lower spatial access to neurologists was seen for census tracts that had a higher proportion of underrepresented minorities, uninsured people, and disabled individuals.

McGinley, a staff neurologist from the Mellen Center for MS Treatment and Research at the Cleveland Clinic, recently sat down with NeurologyLive® to discuss the data, including the most notable takeaways for the clinical community. She spoke on the reasons for issues with access to care and the ways to continue to help underserved communities. Furthermore, she spoke about the significance of the data, and why these challenges need to be addressed from a multi-level perspective.

REFERENCE
1. McGinley M, Harvey T, Lopez R, Ontaneda D, Buchalter RB. Geographic disparities in access to neurologists and multiple sclerosis care in the united states. Neurology. 2024;102(2). doi:10.1212/WNL.00000000000207916