Impressions and experience of non-neurologists in neurology

OBJECTIVE: Neurological disorders are common in Saudi Arabia and the demand for trained neurologists is strong. We aimed to study the impressions and experiences of general physicians in the neurology field and examine their referral practices.

METHODS: We included attendees of the ‘neurology for non-neurologists’ symposium, which took place from 14-15 October 2004 at King Faisal Specialist Hospital and Research Center in Jeddah, Kingdom of Saudi Arabia. We designed a structured 24-item questionnaire to examine their demographics, training, practice, and referral patterns.

RESULTS: One hundred and eight participants registered for the symposium, with 69 (64%) questionnaires returned. Attendee’s ages were 23-60 years (mean 35), with 53% being males. There were 46% consultants and specialists, 33.5% trainees, 14.5% students, and 6% other health professionals. Most physicians (62%) practiced in the field of general practice or internal medicine and 62% received a structured neurology rotation during training. Patients with neurological complaints constituted 29.5% of those seen in their practice, and they referred 33.3% to neurology. Only 13.5% and 15.5% were highly confident in diagnosing and treating these patients. Those who reported seeing many patients with neurological complaints (4 on the Likert scale) were 18.8 times more likely to feel highly confident in their diagnoses (95% confidence interval [CI]: 3-195, p=0.0002) and 23 times more likely to feel highly confident in their management (95% CI: 3.6-236, p=0.0005). Many physicians (20.5%) had no direct access to a neurologist for referrals.

CONCLUSION: Many general physicians were not highly confident in diagnosing and treating neurology patients. Given the limited number of neurologists, we recommend appropriate neurological training of generalists.